Ohio overdose deaths decline about 6% in 2023

Most declines in second half of year

Overdose deaths still on track to exceed 4,600


GOOD NEWS: Overdose deaths in Ohio appear to have fallen about 6% in 2023, largely because of declines in the rate of fatal overdoses in the last four months of the year.

The final overdose death count for 2023 is months away from being complete, so the precise death toll is not certain. However, preliminary reports show a noteworthy drop in deaths in 2023 compared to what was reported at this time last year for 2022.

As of today, 4,307 overdose deaths in 2023 have been confirmed and recorded in state mortality data. On this day one year ago, 4,584 deaths had been registered for 2022 The final 2022 death count in Ohio Department of Health’s mortality data was 4,915. At the current pace, the 2023 death count will be between 4,600 and 4,650.

Those are horrific numbers, for sure — especially since every accidental overdose death is preventable. In the big picture, though, the death count should be the lowest in Ohio since Covid hit in 2020. Covid disrupted the flow of drugs and made the drug supply more dangerous and fentanyl-centric. Covid caused border restrictions, which limited the flow of bulkier (and safer) drugs (heroin, cocaine, meth) and increased the flow of compact drugs (fentanyl).

Ohio drug seizure data show fentanyl declined as a share of Ohio’s illicit drug supply in the first half of 2023. (Data from the second half of 2023 are not yet available.) The contents of the drug supply — i.e., fentanyl’s prevalence — is the primary driver of increases and decreases in overdose death rates.

Other factors in the modest (but noteworthy) decline in overdose deaths in the second half of 2023 could be:
* increased naloxone distribution and use.
* better access to treatment.
* declines in drug use levels, perhaps as the effect of Covid wanes.
* changes in international or local drug markets that are not yet understood.

Evidence is not yet available to know what role, if any, these factors may have played in the 2023 decline in death.

The drop in overdose deaths does challenge a popular current claim: that the increased presence of xylazine and/or nitazenes are causing increased overdose deaths.

Those drugs have increased in the drug supply, but overdose death rates have been flat or declining while this happened. Xylazene and nitazenes may cause some new problems — skin wounds from xylazine, for example — but the evidence does not yet point to increased overdose death as being an effect.

Dennis Cauchon

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