The decline in fentanyl ODs nationally

There’s finally some good news in the horror of deaths from fentanyl overdoses in California, which have taken the lives of so many of our friends and family members.

A new analysis by the Center for Disease Control, based on provisional data as of Dec. 1, found overdose deaths for the 12-month period ending in July 2024 dropped 14% from a year earlier. In California, about 59% of overdose deaths are from fentanyl, a synthetic opioid of high potency commonly mixed with other drugs.

California fatalities remained high at 11,145. But this was the first downturn since overdose deaths began rising in 2014.

Why did this happen? An article in the San Jose Mercury cited “expanded treatment and intervention efforts, recent crackdowns on the illicit opioid trade and less lethal pills on the street — or simply because the overdose epidemic has passed its inevitable peak.” Also helping is expanded access to naloxone, brand name Narcan, which reverses overdoses.

California’s drop in drug deaths is consistent with the national drop, which is the largest ever recorded, Jacob Sullum told us; he’s a senior editor at Reason magazine and the author of “Beyond Control: Drug Prohibition, Gun Regulation, and the Search for Harm-Reducing Alternatives.” As to a crackdown causing the decline, Sullum pointed to a Dec.11 article of his, “Trump’s Plan To Fight Illegal Drugs With Punitive Tariffs Makes No Sense.” It noted Trump’s first-term tariffs didn’t reduce overdoses, and fentanyl’s low cost and high potency make it “possible to smuggle large numbers of doses in small packages.”

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Sullum pointed further to a September analysis by Nabarun Dasgupta and other researchers which found recent border seizures mainly have involved marijuana and meth, not fentanyl. The meth seizures actually led to it being adulterated with fentanyl. The apparent result, according to the study: “Decreasing fentanyl-only overdoses and increasing fentanyl-methamphetamine overdoses.”

Sullum said the main factors in the decline may be from users learning from experience, deaths reducing the vulnerable population, “or changes in the social and economic circumstances that make drug use appealing.”

Unfortunately, drug pandemics commonly lead to draconian policies. The crack cocaine crisis “reached epidemic proportions at the end of the 1980s,” according to study by the General Accounting Office, and caused a sharp rise in gang-shooting deaths and robberies. Yet the pandemic was subsiding in 1994 when voters passed the excessive “three strikes” initiative, Proposition 184.

In response to the fentanyl epidemic voters just passed Proposition 36, increasing penalties for drug crimes and low-level thefts.

Similar to natural epidemics, such as COVID-19 that hit five years ago, drug pandemics rise and fall. Policy-making should account for that, but usually doesn’t, with civil rights taking a hit. Prop. 184 was so draconian it led to a different Proposition 36 in 2012, which reduced some penalties for felonies not serious or violent.

In a few years, the 2024 Prop. 36, which escalates penalties for simple drug possession, likely will face similar pressures for reform.

We know from the past century that drug prohibition, like alcohol prohibition, doesn’t work. It only drives people underground, enriches criminal syndicates and makes drugs more dangerous. That remains true today.

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