2024 was the only year in the last 20 where U.S. drug overdose deaths did not increase from the year before, as data published by the Centers for Disease Control show an estimated 80,400 overdose deaths in the country last year — 27% less than 2023. But rather than this being an abrupt change, UNC epidemiologist Nabarun Dasgupta, who has worked in epidemiology for over two decades, said it’s more a result of a long-developing decline in overdoses since they peaked at the height of the COVID-19 pandemic. In a conversation with 97.9 The Hill’s Brighton McConnell, he also said part of the reason the national numbers decreased so much last year was because several large-population states such as California, Texas, and New York saw significant drops.
“This was actually a gradual decline that happened over three years on a state-by-state basis,” he said. “So some states peaked and were declining starting in 2021 and pretty much everybody got caught up by 2023 and early 2024. So the decline has been happening kind of steadily and quietly for two or three years in most places now. In North Carolina, we’ve been declining since 2023, and 2024 was a pleasant surprise, but we’ve been seeing these numbers trend down in North Carolina on a month-by-month basis for some time now.”
The decline in opioid deaths was uneven across demographics such as race and age. For example, overdose deaths remain very high among Native Americans, Dasgupta pointed out. He also noted that the most-affected age range has now changed from the young to the middle-aged.
“What that means is that younger folks are actually not getting as involved in drug use, or at least illicit opioid use, as they were a generation ago,” he said. “And the bulk of overdose deaths are really happening in the 40 to 55 age range in North Carolina, and that’s where we need to keep going in terms of focusing our resources on where the bulk of mortality really is.”
The Opioid Data Lab, in which Dasgupta works, is a collaboration between UNC-Chapel Hill, the University of Florida, and the University of Kentucky. His team at the UNC Injury Prevention Research Center started analyzing drug samples during the pandemic for the North Carolina Survivors Union, a Greensboro-based organization of people impacted by drug use. Eventually the team developed a system in which people can mail them samples of street drugs, they analyze the specific contents of the drugs, and they send back detailed information about what the substances contain and how they can affect people. The team has since expanded this work into a nationwide public service, with Dasgupta’s lab testing nearly 13,000 samples from more than 40 states in the past two and a half years.
“What we do that’s different from the traditional research paradigm is that we provide results directly back to the individuals who provided the samples using a QR code that’s part of the kits that we developed,” he said. “That allows individuals to see what’s in their local drug supply and make better decisions about what they put in their bodies. This is one of the specific ways in which we are going beyond the research and turning this moment of overdose crisis into a way for us to help people on the front lines. This is not a research study; it’s science and service. It’s a public service that we have at UNC.”
Among the most surprising things Dasgupta has seen is the sheer number of different substances he’s found within street drugs. He said this is something most people are unaware of, along with the wide range of harms the substances can potentially cause.
“I think most of us can name like a dozen or two dozen different drugs, but we found over 400 unique substances in street drugs, and a lot of those will cause really specific harms and hallucinations and things that are unexpected for that kind of drug,” he said. “When people who use drugs understand why that particular batch made them feel terrible or made them go to the hospital, they’ll take better actions to prevent that from happening to themselves in the future. And so we really want to encourage autonomy and having people make better choices about what they put within their bodies.”
He made sure to highlight the work being done on the streets of affected areas by people who are committed to saving lives in their communities.
“Let me just give credit to where credit is due first, which is that, us as researchers can describe things, but what’s really changing the overdose numbers is the work that gets done on the ground in communities, providing the antidote to people who use drugs, having more treatment options, and all these things that are being done in every local county across the state, across the country,” he said. “That’s really what’s driving the decline.”
Dasgupta said the ultimate motivation for this project was the devastation that so many people have endured because of the drug overdose crisis. Members of his own team have been personally affected by such tragedies, and the group remains determined to keep fighting this epidemic.
“Our team is steeped in grief. That’s the best way I can put it. We have lost a lot of people that we love and care about over the years, and there’s only so long you can stand on the sidelines and describe a problem without feeling compelled to jump in and do something about it,” he said. “We’re still losing way too many people we love, and this is not over. There’s a long way to go.”
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‘This is Not Over’: UNC Scientist on Decline in Overdose Deaths, Fighting Opioid Epidemic Chapelboro.com.
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