Overdoses Are Down — Crisis is Far From Over

In recent months, headlines have heralded a long-awaited shift in America’s overdose crisis: “Overdoses Are Down.”   

While this news offers a glimmer of hope, it risks obscuring a more sobering reality. Yes, the age-adjusted overdose death rate declined slightly in 2023 — from 22.7 to 22.2 per 100,000 — but the absolute number of lives lost remains catastrophically high.   

Nearly 80,000 Americans still died from drug overdoses last year. That’s more than four times the number who died in 2000. It’s more than the peak death toll of the HIV/AIDS epidemic. It’s roughly 200 lives that are lost every day, often in silence, often in preventable circumstances.  

There is a glimmer of light at the end of the tunnel, but we still need to do the hard work to reach it.  

The Numbers Behind the Narrative

The modest decline in overdose deaths masks how high they still are in absolute terms and the deep and persistent disparities that exist for some. According to recent CDC data, overdose fatality rates have increased among several populations:

• Black, Hispanic, and Native Hawaiian/Pacific Islander communities saw alarming spikes — up to 35% in some cases.  
• Older adults (55+) experienced rising overdose rates, even as rates declined among younger cohorts.  
• Men continue to die at rates nearly 2.5 times higher than women.  
• Geographic disparities persist, with some states and counties seeing increases while others improve. 

These trends underscore a critical truth: trends in data can mislead people. The same number would have been called a 15% increase in 2019.  Eighty thousand deaths are unacceptable, and the disaggregated analysis reveals the uneven burden of the crisis — and the urgent need for targeted interventions.  

Prevention is the Best Investment

A 2021 analysis of the Communities That Care prevention system revealed that a $600 investment in each child yielded an estimated $7,600 in savings by the time participants were 23 years old. The program has proven long-term results:  

• 17% lower drug use  
• 55% lower alcohol use  
• 20% higher college completion  

Further research has shown that prevention interventions in early childhood, such as the Raising Healthy Children Program, can have positive impacts on behavior and health outcomes for generations. Those whose parents participated in this intervention had fewer developmental delays in the first five years of life, fewer behavior problems, fewer symptoms of attention deficit hyperactivity disorder (ADHD) and better cognitive, academic and emotional maturity in the classroom. They were also significantly less likely to report using drugs or alcohol as a teenager.

Substance use disorders frequently co-occur with other mental illnesses. Preventing SUD helps prevent other mental illnesses later in life.   

Treatment That Works and Is Easy to Find

For those navigating SUD, the path to treatment can be opaque and unequal. That’s why Shatterproof created the Shatterproof Treatment Atlas, a first-of-its-kind quality measurement platform for addiction treatment. Treatment Atlas helps individuals find evidence-based care that fits their needs — and helps payers, providers, and policymakers identify where improvements are needed. 

We also advocate for insurance parity, a more compassionate culture, and better coordination across healthcare systems for those who need treatment and are in recovery — all essential to making treatment truly accessible.  

The Work Ahead

Yes, overdose deaths are down overall, but the number of annual deaths remains catastrophically high. We cannot afford to misread this moment. The crisis isn’t over. It’s shifting. And if we ease up now, we risk reversing hard-fought gains.  

We must continue scaling proven prevention, ensuring equitable access to quality treatment, and holding systems accountable for results.   

Shatterproof is proud to be part of the solution. But we cannot do it alone. It will take leadership across every level of government, partnership from the private sector, and compassion from every corner of society.   

This is our moment — to act boldly, to act together, and to make sure the next headline is not, “Overdoses Are Rising Again.” 

Kevin Roy is the Chief Public Policy Officer for Shatterproof. He leads its national advocacy initiatives as both federal and state leaders push for comprehensive solutions to the opioid epidemic.