National Overdose Deaths Decline But Regional Spikes raise Alarm
Even as the United states experiences a national decline in overdose deaths, emerging data reveals concerning increases in specific regions, prompting experts to call for a shift in focus from simply counting fatalities to prioritizing addiction prevention and treatment. According to Andrew Kolodny, a leading voice in the opioid crisis, the current emphasis on deaths obscures the underlying issue: a widespread crisis of addiction.
The lack of robust data on addiction rates in the US hinders effective prevention efforts. The National survey on Drug Use and health, relying on approximately 70,000 face-to-face interviews, is considered “rudimentary” and inadequate by Kolodny. This contrasts sharply with Portugal,which employs a thorough system-integrating data from health agencies,law enforcement,population surveys,and even wastewater analysis-through a dedicated agency to track and intervene in addictive behaviors. Consequently, Portugal’s per capita overdose death rate is less than 1/30th that of the US.
Concerns are also mounting over potential barriers to treatment access within the US. The future of SAMHSA, the agency responsible for the national survey, is uncertain under the current administration. Moreover, new rules requiring Medicaid recipients to work 80 hours a month, set to take effect in 2027 under the One Big Beautiful Bill Act, could compromise access to intensive substance-use recovery programs.
Kolodny argues that overdose deaths should be viewed as a symptom, not the primary problem. he draws a parallel to the AIDS crisis, noting that the focus shifted from Pneumocystis pneumonia (PCP) – a common cause of death among AIDS patients – to the underlying HIV infection, which could be prevented and treated. “We didn’t approach the Aids crisis by calling it a PCP pneumonia epidemic,” he explained. “We realized it was HIV… But for the opioid crisis, we have it backwards. This is a crisis of addiction: if you really understand that most of these deaths are occurring in people who are addicted, not people saying, ‘Hey, shooting up fentanyl would be a fun way to spend a Friday night.’ It’s people who are really struggling.”
