Overdose deaths have continued to drop, now at their lowest level in three years, data shows
In this Jan. 25, 2024, file photo, a used Narcan brand Naloxone nasal spray rests on the street after paramedics and police responded to a suspected fentanyl drug overdose in Portland, Oregon. — Patrick T. Fallon/AFP via Getty Images, FILE
(ATLANTA) — The estimated number of drug overdose deaths in the U.S. have been dropping for months and are now at their lowest levels in three years, according to data from the Centers for Disease Control and Prevention (CDC).
Deaths from overdoses dropped for the first time in five years in 2023, following a steady rise during the pandemic. However, the current number of overdose deaths still remains higher than pre-pandemic levels.
In April 2024, the latest month with data, the estimated number of deaths in the past 12 months was 101,168, according to the CDC. The last month with figures that low was in May of 2021, with 100,997 deaths.
Data from other sources, such as emergency department visits and calls to EMS, support the downward trend, according to an analysis led by Dr. Nabarun Dasgupta, a senior scientist at the Injury Prevention Research Center at the University of North Carolina at Chapel Hill. He tells ABC News that the data may point to 20,000 fewer deaths annually, or more.
While experts continue to explore possible reasons driving the decline, there are a few public health initiatives to curb drug overdoses that may be showing signs of success.
“Enhanced access to naloxone, expanded treatment programs for opioid use disorder, and increased public awareness about the dangers of synthetic opioids like fentanyl are likely playing significant roles in saving lives,” said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor.
Another potential explanation for the downturn, Dasgupta says, may be related to changes in the drug supply, such as more people using xylazine, a dangerous, non-opioid animal sedative that’s often mixed with other illicit drugs, including fentanyl.
“Xylazine makes people use less fentanyl, is the bottom line,” Dasgupta told ABC News, while citing research that showed that those who overdosed and tested positive for xylazine had less severe health outcomes than those who did not have xylazine in their system. This could be due to the fact that those who used illicit substances, like fentanyl, mixed with xylazine may be using those substances less often, Dasgupta said.
“We’re seeing this pattern kind of happening that looks a lot like a change in the drug supply, more so than just explained by all the interventions in the public health space,” Dasgupta added. “It’s probably a mix of all these things at the end of the day, but something really changed in the third quarter of last year.”
Within each state, however, the decline in overdose deaths is not uniform among all people. Maryland, for example, experienced a decline in deaths among white populations, yet an increase among Black populations, Dasgupta points out.
Changes in drug overdose deaths also vary greatly by state, with some still experiencing increases in the past 12 months, CDC data shows. States with the greatest dips in overdose deaths over the past year, according to the same data, were Nebraska, North Carolina, Vermont, Ohio, and Pennsylvania, in that descending order.
While the national downward trend may continue, experts told ABC News it may not be permanent.
“We’ve seen dips that have been erased a year later. So, I’m cautious. I feel like things really haven’t cooled down yet,” Dasgupta said. “It feels like we’ve put the lid on the pot, but we’re still at a rolling boil. There’s still a lot of people dying of overdose.”
“It’s crucial that we continue to intensify our efforts to address the root causes of the opioid epidemic,” Brownstein said. “We need to continue investing in comprehensive strategies that address the complex factors driving the opioid crisis.”
Jake Goodman, MD, MBA is a psychiatry resident physician and a member of the ABC News Medical Unit.
(NEW YORK) — A recall on apple juice due to potentially harmful levels of arsenic has expanded to include more brands sold at several additional retailers across the country.
The initial voluntary recall by Refresco Beverages was first announced in a class 2 enforcement report from the U.S. Food and Drug Administration last month and included 9,535 cases of Great Value 100% Apple Juice sold at Walmart. On Monday, the recall was updated to a total of 133,500 cases of juice, which were sold at several stores in addition to Walmart, under varying brand names.
According to the FDA’s report, the recalled product “contains inorganic arsenic above action level set in guidance to industry.”
“The safety of consumers is always our top priority,” the Tampa, Florida-based Refresco Beverages said in a new statement on its website. “On August 23, 2024, out of an abundance of caution, we voluntarily initiated a recall of some select lots of 100% apple juice products produced using supplier provided concentrate when we became aware that previously manufactured product contained inorganic arsenic slightly above the FDA’s 10 ppb (parts per billion) action level as set by the FDA in June 2023 in the FDA Final Guidance to Industry on Action Level for Inorganic Arsenic in Apple Juice.”
“At this time there are no reported incidents caused by these products,” the statement continued. “We are working diligently to address the situation and encourage consumers to check the FDAs recall list … and use the information on their site to determine if they are in possession of products that fall within this proactive, voluntary recall.”
Apple juice recall expands to more brands, retailers
The newly expanded recall now includes juice that was sold at Aldi, BJ’s Wholesale Club, Market Basket, Walgreens and Weis Markets, under brands such as Nice! 100% Apple Juice and Clover Valley 100% Apple Juice, among others.
Click here for the full list of affected products from the FDA.
Originally, the Great Value brand apple juice sold at Walmart in 25 states, Puerto Rico and the District of Columbia was the only brand recalled by Refresco Beverages.
Product details of recalled apple juice by store
The first wave of contaminated Great Value beverages in question were sold in six-packs of 8-ounce plastic bottles with the UPC code 0-78742-29655-5. The product had a “best if used by” date code of DEC2824 CT89-6.
All of the products were produced by Tampa, Florida-based Refresco Beverages US Inc.
Below, see details for the items included in the newly expanded recall.
Walmart
Recalled products sold at Walmart include Great Value 8-ounce Apple Juice in six-pack plastic bottles with “best if used by” dates of Dec. 26 and Dec. 27, 2024, and Great Value 96-ounce Apple Juice with “best by” dates of Dec. 26, Dec. 27 and Dec. 28, 2024.
The six-pack juice bottles were sold in stores in Alabama, Florida, Georgia, Indiana, Kentucky, Ohio, Maine, New York, Pennsylvania, South Carolina and Virginia. The 96-ounce containers were sold in Walmart stores in Indiana, Ohio, Maine, New York, Pennsylvania, Puerto Rico and Virginia.
Aldi
Aldi is recalling Nature’s Nectar 64-ounce plastic bottles of 100% Apple Juice with “best by” dates of March 26 and 27, 2025. This product bears the UPC code 4099100036381 and was sold at Aldi stores in 16 states including Alabama, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Michigan, New York, North Carolina, Ohio, Pennsylvania, South Carolina, West Virginia and Wisconsin, according to a press release from Aldi U.S.
Walgreens
Walgreens is recalling Nice! 100% Apple Juice 64-ounce bottles with a March 25, 2025, “best by” date. The products were sold in Florida, Georgia, Ohio, Pennsylvania and Wisconsin.
Key Food
Key Food is recalling Urban Meadow 100% Apple Juice sold in 64-ounce bottles with a March 26, 2025, “best by” date. The products were sold in Pennsylvania stores.
BJ’s Wholesale Club
BJ’s Wholesale Club is recalling Wellsley Farms 100% Apple Juice 96-ounce bottles with a “best by” date of March 26, 2025. These products were sold in Florida, Massachusetts and New Jersey.
Dollar General
Dollar General is recalling Clover Valley 100% Apple Juice with a “best by” date of March 27, 2025. The product was sold at the discount retailer locations in Florida, Georgia, Indiana, Kentucky, New York, Ohio and South Carolina.
Weis
Weis 100% Apple Juice 64-ounce bottles with a “sell by”‘ date of March 25, 2025, are also impacted by the expanded recall. The products were sold at stores in Pennsylvania and Maryland.
Market Basket
The supermarket chain is recalling Market Basket 100% Apple Juice from concentrate in 64-ounce plastic bottles with the “best by” date March 25, 2025. The impacted product was sold in Maine.
Lidl
Lidl is recalling Solevita 100% Apple Juice 64-ounce plastic bottles with the “best by” date March 27, 2025. This product was sold in Virginia.
Company responds to apple juice recalled over arsenic levels
In an earlier statement to ABC News when the recall was first initiated, a representative for Refresco said, “We are aware that certain lots of the 100% apple juice we previously manufactured contains inorganic arsenic slightly above the FDA’s 10 ppb (parts per billion) action level in the FDA Final Guidance to Industry on Action Level for Inorganic Arsenic in Apple Juice, which aims at reducing the dietary exposure of contaminants to as low as possible. As a result, impacted products are being voluntarily recalled.”
The statement continued, “At this time there are no reported complaints or incidents of illness caused by the product. Per the FDA, it is not possible to completely prevent arsenic from entering the food supply, yet exposure to high levels of inorganic arsenic can have adverse health effects.”
The representative added that “the safety of consumers and the satisfaction of our customers are our top priorities” and that the company is “working diligently to address the situation.”
Editor’s note: An earlier version of this story was published on Aug. 26, 2024.
(TEL-AVIV, Israel) — The last day of the polio vaccination campaign is wrapping up in Gaza, the World Health Organization (WHO) said Thursday.
The campaign was launched after the first case of polio in Gaza in more than 25 years was recently detected. Health officials from the WHO, the Hamas-run Gaza Ministry of Health and partner organizations said they would be vaccinating children in three-day phases starting in central Gaza, then in southern Gaza, and ending in the north.
As of Thursday morning, more than 552,000 children under age 10 out of 640,000 have been vaccinated in Gaza, according to the WHO. The organization said at least 90% coverage is needed to stop a potential outbreak in Gaza, and the campaign may be extended if that 90% figure isn’t achieved on Thursday.
Poliovirus was first detected in sewage samples from the cities of Deir al-Balah and Khan Younis – in central and southern Gaza, respectively – in mid-July, in tests conducted by the Gaza Ministry of Health in coordination with the UN.
In mid-August, the Ministry of Health reported the first case of polio in Gaza in 25 years, in a 10-month-old child who had not been vaccinated. Doctors suspected polio after symptoms resembled the virus, which was confirmed in test conducted in Amman, the capital of Jordan, according to the WHO.
Children are receiving two drops of novel oral polio vaccine type 2 (nOPV2), which has been used for outbreak response under the WHO’s Emergency Use Listing approval since March 2021. A second dose is typically given four weeks after the first.
“We want to protect our children from diseases and give them the necessary vaccines because prevention is better than cure,” Islam Saleh, a mother in northern Gaza, said in a video issued by the United Nations (UN) on Wednesday.
“I fear for my son because there is no cure for polio. This dose he received will protect him, and it is safe,” Saleh added.
Officials have said that the vaccination operation is complicated by access restrictions, evacuation orders and fuel shortages. Israel has agreed to “temporary” pauses in fighting each day in order for the vaccinations to be administered.
Earlier this week, a convoy of UN vehicles in northern Gaza was stopped and questioned by Israeli Security Forces before being released, the Israel Defense Forces (IDF) said in a statement.
Polio largely affects children under age 5 and can lead to paralysis or death. According to the Palestinian Central Bureau of Statistics, there are about 341,000 children under the age of five in Gaza.
Children in the U.S. are recommended to get the inactivated polio vaccine as part of routine childhood immunization, according to the Centers for Disease Control and Prevention (CDC). It consists of four doses in total administered first at 2 months of age, then at 4 months, 6-18 months, and 4-6 years.
“It has been heartening to see the response to the campaign,” the WHO said in comments released after a press briefing on Thursday. “Everywhere the team has gone, parents are doing all they can to ensure their child does not miss vaccination. Many vaccination sites received more than expected crowds. Special coordinated missions were also conducted to reach children in insecure and heard to reach areas.”
ABC News’ Jordana Miller and Dana Savir contributed to this report.
While the United States has made considerable progress fighting the HIV/AIDS crisis since its peak in the 1980s, headway has not been equal among racial/ethnic groups.
Overall, HIV rates have declined in the U.S. and the number of new infections over the last five years has dropped among Black Americans and white Americans. However, Hispanic and Latino Americans have not seen the same gains.
Between 2018 and 2022, estimated HIV infections among gay and bisexual men fell 16% for Black Americans and 20% for white Americans, according to data from the Centers for Disease Control and Prevention. Meanwhile, Hispanic Americans saw rates held steady, the CDC said.
There may be several reasons for the lack of decline, including Hispanic Americans facing health care discrimination, experts told ABC News. Some may also face the stigma that prevents patients from accessing services or makes them feel ashamed to do so. There is also a lack of material that is available in their native language or is culturally congruent, experts said.
“Where we are in the HIV epidemic is that we have better tools than ever for both treatment and for prevention, and we have seen a modest slowing in the rate of new infections, but we have seen a relative increase in the rate of new infections among Latino individuals, particularly Latino men who have sex with men,” Dr. Kenneth Mayer, a professor of medicine at Harvard Medical School and medical research director at Fenway Health in Boston, told ABC News.
“So, the trends are subtle, but they’re concerning because it does speak to increased health disparities in that population,” he continued.
Hispanic Americans make up more cases and more deaths
Although Hispanic and Latino Americans make up 18% of the U.S. population, they accounted for 33% of estimated new HIV infections in 2022, according to HIV.gov, a website run by the U.S. Department of Health and Human Services. This is in comparison with white Americans, who make up 61% of the U.S. population but just 23% of HIV infections.
Hispanic and Latino gay men currently represent the highest number of new HIV cases in the U.S.
What’s more, Hispanic males were four times likely to have HIV or AIDS compared to white males in 2022 and Hispanic females were about three times more likely than white females to have HIV over the same period, according to the federal Office of Minority Health (OMH).
Additionally, Hispanics males were nearly twice as likely to die of HIV Infection as white males and Hispanic females to die of HIV Infection in 2022, the OMH said.
Erick Suarez, a nurse practitioner and chief medical officer of Pineapple Healthcare, a primary care and HIV/AIDS specialist located in Orlando, Florida, told ABC News that watching the lack of progress made in the HIV/AIDS crisis for the Hispanic and Latino population is like “traveling back in time.”
“When I say traveling back in time for the Hispanic/Latino population with HIV, I mean [it’s like] they are living before 2000,” he said, “Their understanding of treatment and how to access it is in that pre-2000 world. … The state of HIV and AIDS in the Hispanic/Latino population in the United States right now is a few steps back from the general American population.”
He said many Hispanic/Latino HIV patients come to the United States unaware of their HIV status. If they are aware of their status, they come from countries where prevention and pre-exposure prophylaxis (PrEP) is hard to find or doesn’t exist.
When they get to the United States, they be afraid or unsure of where or how to access health care. Even Hispanic/Latino Americans whose families have been here for generations, have trouble accessing health care due to racial and ethnic disparities, Suarez said.
Previous research has shown Hispanic/Latino Americans with HIV reported experiencing health care discrimination, which could be a barrier to accessing care.
Facing discrimination, stigma
Hispanic and Latino patients with HIV report facing discrimination in health care, experts told ABC News. A CDC report published in 2022 found between 2018 and 2020, nearly 1 in 4 Hispanic patients with HIV said they experienced health care discrimination.
Hispanic men were more likely to face discrimination than Hispanic women and Black or African American Hispanic patients were more likely than white Hispanic patients to face discrimination, according to the report.
There may also be stigma — both within the general population and within their own communities — associated with HIV infection that could prevent patients from accessing services, according to the experts.
Suarez said one of his most recent patients, who is Cuban, traveled two hours to a clinic outside of their city to make sure no one in their familial and social circles would know their status.
“The interesting part is that even though I speak with them like, ‘You understand that everything that happens within these walls is federally protected, that it is private information. No one will ever know your information, and our goal is for you to get access healthcare. You can do this in your own city,'” Suarez said.
“Now, because of the stigma, they will travel long distances to avoid contact with anyone and make sure that no one knows their status. So, stigma is a huge factor,” he continued.
Rodriguez said this stigma and mistrust has led to many Hispanic and Latino Americans to not seek medical care unless something is seriously wrong, which may result in missed HIV diagnoses or a missed opportunity to receive post-exposure prophylaxis, which can reduce the risk of HIV when taken within 72 hours after a possible HIV exposure.
Making resources ‘available, attainable and achievable’ Experts said one way to lower rates is to make information on how to reduce risk as well as how to get tested and treated available in other languages, such as Spanish, and making sure it is culturally congruent.
However, Rodriguez says translating documents is not enough. In the early 2010s, when the CDC was disseminating its national strategy to reduce HIV infection, the agency began to circulate materials on how to reduce HIV incidence, reducing stigma and increasing use of condoms for sex, Rodriguez said.
He said that of a compendium of 30 interventions, maybe one was in Spanish. When he took the materials back to his native Puerto Rico, many were having trouble understanding the materials because it has been translated by someone who is of Mexican heritage.
Secondly, rather than the materials being written in Spanish, they had been translated from English to Spanish, which doesn’t always translate well, Rodriguez said.
“When we talk about Hispanics, we have to talk about, first of all, the culture. Our culture is very complex. Not one Spanish language can speak to all of the Hispanic communities,” he said. “And then we also have to look at the generations of Hispanics. Are you first generation, second generation, third generation? “
He added that the key is making resources “available, attainable and achievable.”
This month, the White House convened a summit to discuss raising awareness of HIV among Hispanic and Latino Americans and to discuss strengthening efforts to address HIV in Hispanic and Latino communities.
Mayer said it’s also important to make sure information is disseminated on social media that is culturally tailored for Hispanic and Latino experiences.
“It’s important for social media to seem culturally relevant, to make sure that they understand that HIV is not just a disease of old white guys, and that they may have a substantial risk,” he said. “Make sure that they’re educated by what they can do to protect themselves since we have highly effective pre-exposure prophylaxis, and we have ways to decrease STIs with a doxycycline post-exposure prophylaxis.
The experts added that having more Hispanics and Latinos represented in medicine, research and public health may encourage more Hispanic and Latino Americans with HIV or at risk of HIV to seek care or treatment.
“Seeing and being able to recognize that your healthcare provider looks like you, sounds like you, in some way it represents you, is a key aspect of getting people on treatment and access,’ Suarez said. “And not only that, but keeping them in treatment and having them come back and stay and keep that going, that’s a key issue.”
