Overdose deaths fall by one-third in 2024
Cartel cutback in fentanyl production is reason
Overdose deaths in Ohio have continued to decline sharply in the first four months of 2024, a Harm Reduction Ohio analysis of Ohio mortality data finds.
The decline extends a period of reduced overdose death that began in the second half of 2023 after an important branch of the Sinaloa cartel in Mexico ended fentanyl production. In June 2023, the family of cartel boss Joaquín “El Chapo” Guzmán announced it was quitting the fentanyl business and enforced that decision by killing more than 50 local fentanyl producers who did not stop quickly enough.
The result was a decline in the presence of fentanyl in Ohio (as measured in state drug seizure data) and a matching decline in overdose death.
The number of Ohio residents who died from accidental drug overdoses declined from 1,638 in the first four months of 2023 to an estimated 1,105 in the first four months of of 2024. That’s a 32.5% drop in overdose death.
This is the first time since 2015 that overdose deaths have numbered less than 300 in four consecutive months.
The overdose death counts used in this article are from the Ohio Department of Health mortality database. The numbers from 2023 are final counts. The numbers from 2024 are Harm Reduction Ohio estimates based on preliminary mortality data.
In 2023, Ohio had 4,452 overdose deaths, a 9.4% decline from 4,915 deaths in 2022. Overdose deaths increased slightly during the first half of 2023, then unexpectedly plummeted in the second half of the year, especially during the last four months of 2023.
This chart shows how overdose changed by month since 2015.
The chart below shows the actual death counts used in the graphic above. The numbers represent counts of unintentional drug poisoning deaths of Ohio residents as determined by the Ohio Department of Health and the National Center for Health Statistics at the Centers for Disease Control and Prevention based on the International Classification of Diseases system.
Cause of overdose death decline
The sharp drop in Ohio overdose deaths seems tied to a sudden, not fully understood decision by a major branch of the Sinaloa cartel in Mexico to quit the fentanyl business. (Harm Reduction Ohio has explained what happened in more detail here, here, and here.)
Joaquín “El Chapo” Guzmán
The family of Sinaloa cartel founder “El Chapo” left the fentanyl business for reasons that are not fully understood but likely were related to a negotiation strategy with the Mexican and U.S. governments. The family patriarch, “El Chapo,” is now 67 years old and serving a life sentence in a federal supermax prison in Colorado.
Since his extradition in 2017, the family business has been run by four sons — “Los Chapitos,” or Little Chapos. One son, Ovidio Guzmán, was arrested after a bloody battle with Mexican authorities and extradited to the United States in September 2023.
Then, last week, another brother, Joaquín Guzmán López, flew in a private jet to the United States along with another cartel leader and was arrested. Many claims — about cooperation, betrayal, kidnapping, etc. — exist around how the mysterious flight and arrests took place. It’s too early to know now what really happened.
Ovidio Guzman Lopez on flight to U.S. Credit: @derekmaltz_sr on X
Joaquín Guzmán López
Los Chapitos arrests effect on Ohio
The conflict between U.S. law enforcement and the El Chapo cartel branch may affect Ohio’s fentanyl supply and level of overdose death. With two of the four brothers now in U.S. custody, family control of its drug smuggling operation is unstable. The remaining brothers may retain control, another faction may take control or the operation could divide into multiple drug smuggling networks.
The cartel hierarchy that stopped shipping fentanyl to the United States is in a precarious position. New management of the operation could reverse the family decision to stop shipping fentanyl, causing the fentanyl faucet reopening and overdose deaths in Ohio to increase.
The Sinaloa cartel has about two dozen branches of various size and power. Other major cartels smuggle drugs to the United States as well.
The “El Chapo” family operation appears to have been the most important of the cartel’s many branches. The family was the first cartel operation to enter the fentanyl business, about a decade ago, and the El Chapo family may have a greater market share as a wholesaler in Ohio drug markets than elsewhere the U.S.
Fentanyl’s presence in Ohio’s drug supply has dropped by roughly 20% since the El Chapo family exited the fentanyl business, according to a Harm Reduction Ohio analysis of Ohio drug seizure data. (Charts on fentanyl in Ohio drug supply can be found in this article.) Drug seizure data is not currently available for other parts of the country, so comparisons with other states is not possible.
However, Harm Reduction Ohio found that overdose death has fallen more in Ohio than in the rest of the country. Overdose death rates are highly correlated to the presence of fentanyl, making overdose death a good proxy for levels of fentanyl — and vice vera.
What’s next?
The current chaos in El Chapo family operations poses a risk to the sustainability of the current decline in overdose death in Ohio. The El Chapo family’s crime operation is more than 50 years old. It is based in Culiacán, the political capital and cultural heart of the Mexican state of Sinaloa.
El Chapo’s family operation has competed, often violently, for years with other cartel operators. What happens next — and how it affects Ohio overdose deaths — is impossible to predict. What happens in Sinaloa over the next 12 months should be watched closely to understand overdose death in Ohio and, to a lesser extent, the United States
New management of the cartel branch could re-enter the fentanyl business or, perhaps, extend El Chapo’s operations exit from fentanyl to other parts of the cartel.
Drug war and overdose death
It’s sad but true that the lives of thousands of Ohioans who use drugs depends on Sinaloa cartel management decisions, The drug war creates perverse incentives with deadly consequences. It transfers power and pubic health decisions from civil institutions to criminal enterprises.
The drug war’s reality has rarely been so visible: Prohibition kills. Always has. Always will. Is doing so right now.
Ohio is in the middle of a natural experiment that measures how changing incentives for cartel managers affect their business operations and the lethality of drug markets. The results will be measured in fentanyl’s presence in Ohio and, in its corollary, the number of Ohioans who die because drugs aren’t safe.