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.
(LOS ANGELES) — While Los Angeles County is reporting three locally acquired cases of dengue this year — which is rare for the region — there have been at least 3,085 cases nationally of locally acquired virus so far this year, according to data from the Centers for Disease Control and Prevention.
There has been about double the number of locally acquired dengue cases so far this year nationally compared to last year, according to the CDC. Puerto Rico currently makes up the bulk of those cases – with over 2,960 reported. The U.S. territory declared a public health emergency back in March.
“The City of Baldwin Park is aware of the recent cases of locally acquired dengue in our community. While the risk of transmission remains low, we must take this situation seriously and act proactively,” said Mayor Emmanuel J. Estrada.
Dengue viruses spread through mosquito bites. The most common symptom is a fever with aches and pains, nausea, vomiting and rash. Symptoms usually begin within two weeks after being bitten by an infected mosquito and last 2-7 days. Most people recover after about a week.
Locally acquired cases mean that the people infected have no history of traveling to an area where dengue normally spreads. Local dengue transmission is typically common in tropical and subtropical areas of the world – including Florida, and U.S. territories in the Caribbean.
Last year, there were only two locally acquired cases reported in the state of California, the first local cases in the state reported in over a decade, according to CDC data.
The CDC issued a health alert in June warning health care providers of an increased risk of dengue virus infection this year. Globally, new cases of dengue have been the highest on record, according to the CDC. The agency also noted that cases are likely to increase as global temperatures increase.
The best way to prevent dengue is to avoid mosquito bites, according to the CDC.
(ST. PETERSBURG, Fla.) — Residents of St. Petersburg — on Florida’s central-west coast — were temporarily left without clean drinking water after a water main break occurred during Hurricane Milton.
City officials said the break caused them to shut off potable water services at 12 a.m. ET on Thursday until repairs could be made.
“Residents and businesses should prepare for this temporary shutdown, which is expected to last until the necessary repairs can be completed,” the city said in a release.
“Repairs to the water line will begin once it is safe for crews to be outside. Affected areas may already be experiencing low water pressure or service interruptions,” the release continued.
By Thursday afternoon, officials said potable water service was back but that pressure may be low.
Additionally, officials said a helicopter from the Sheriff’s Office in Pinellas County, where St. Petersburg is located, was assisting in searching for water main leaks.
Typically, water distribution systems are kept under enough pressure that, even when there are cracks, dirty water and contaminants are unable to get in. However, when a water main breaks, system pressure drops and pathogens are allowed to seep in.
“When water main breaks, we can see the obvious water coming out, and we think, ‘Oh, we’re losing water.’ But what’s happening in other areas of the system is the pressure is going down,” Dr. Sandra McLellan, a distinguished professor at the University of Wisconsin-Milwaukee’s School of Freshwater Sciences, told ABC News.
“What is in the soils can seep into the pipes. … If there’s a water main break and there’s a lot of flooding or a lot of rainwater, then all of that sewage that’s kind of sitting around these pipes and in the soil can seep into our drinking water systems,” she continued.
Some of the contaminants may be visible to the naked eye and just lead to discoloration or cloudy water. Other containments may not visible and lead to serious illnesses including E. coli or norovirus.
McLellan said people may not realize their drinking water is contaminated until they experience symptoms of illness.
“There’s no real way to easily test for pathogens in the water because they’re kind of at low levels,” she said. “So it isn’t that everybody’s going to get sick, but, if 100 people drink the water, chances are one or two people may be drinking a part of the water that contains those pathogens.”
Dr. Norman Beatty, an assistant professor of medicine at the University of Florida College of Medicine and an infectious disease physician, told ABC News that ingesting bacteria found in storm surge waters can lead to diarrheal illnesses, but can progress to sepsis in some and lead to hospitalization.”
The city issued a boil water notice for water used for drinking, cooking and brushing teeth and said it will remain in place as repairs continue.
Beatty recommends using bottled water until the water is drinkable or boiling water.
“When boiling water, start the timer once you reach a rolling boil and after one minute, let the water cool naturally. If water is cloudy, let is settle and then filter through a clean coffee filter paper or clean cloth,” he said.
McLellan said after a main break, crews will dig up the street, fix the pipes and restore pressure. She added that after pressure is restored, one flushing of the pipes should restore clean drinking water.
If people are worried about their water supply, she recommended they use a pitcher with a home water filter before drinking tap water.
“I think people think, ‘Oh, if my water’s off, of course there’s a problem. But if my water’s on, the water will be safe,'” she said. “But we really have to remember, in areas where there’s hurricanes, there’s certainly damage that could happen, so it’s better to be on the safe side.”
On Wednesday evening, St. Petersburg officials also turned off power to two sewer treatment plants in the northeast and southwest part of the to protect employees and the facilities from potential storm surges.
As of Thursday morning, sewer services were back online, and city crews were out inspecting and re-energizing both plants.
Hurricane Milton made landfall on Florida’s west coast as a Category 3 hurricane Wednesday night.
Gov. Ron DeSantis said Thursday morning that the hurricane “thankfully” spared the state from “the worst-case scenario” but that flooding Is expected to continue over the next several days.
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.”
