US drug overdose deaths decreased slightly in 2023, according to preliminary statistics released this week by the Centers for Disease Control and Prevention (CDC), a 3 percent drop from 2022, when 111,029 died. The US, however, continues to be devastated by a drug overdose epidemic, with the CDC data showing that 107,543 people died from a drug overdose last year.

Americans are still dying at near-record rates, fueled by a toxic supply of drugs dominated by the synthetic opioid fentanyl and deaths resulting from the use of opioids combined with stimulants like methamphetamines and cocaine. The CDC cautioned that the data compiled by the National Center for Health Statistics are incomplete and subject to change.

Since 2020, at least 1.2 million Americans have died from COVID-19 and there are currently more than 786,000 active cases of the disease in the US, according to Worldometer. Stress and isolation in the early days of the pandemic certainly led to an increase in drug overdose deaths. Less talked about, however, is the continued economic and social impact of the pandemic, with job and wage losses, and cuts to public education, healthcare and other social programs, including the shuttering of drug treatment programs.

Since 2021, the first year when the impact of the pandemic registered in drug overdose deaths, overdose fatalities have remained above the 100,000 mark. CDC data show that drug overdose deaths in the US stood at 106,699 in 2021, 111,029 in 2022, and 107,543 in 2023, according to preliminary data. While Biden administration officials touted the supposed “flattening” of drug overdose deaths in 2022, preliminary figures for 2023 are in fact higher than in 2021.

The surge in fatal drug overdoses over the past five years originated in the opioid epidemic, which saw a rapid increase in the overuse and abuse of opioids beginning in the 1990s. Purdue Pharma’s introduction of OxyContin, an extended release form of the semi-synthetic opioid Oxycodone, is the most well-known contributor to the opioid crisis. The company pushed the highly addictive drug to doctors and pharmacists as a miracle pain reliever that would not lead to addiction.

Entire communities in Appalachia, the Northeast, Midwest and elsewhere were consumed by addiction and death as a network of opioid “clinics” as well as pharmacies pushed OxyContin, egged on by the marketing campaigns of the Sackler family of Purdue Pharma, who were well aware of the drug’s potential for abuse.

Since 2000, more than 300,000 people have died in the US from prescription opioids. No Sackler family members have been jailed for their marketing and sale of the highly profitable OxyContin, which have led to what amounts to mass murder.

Many of those addicted to Oxycontin and other semi-synthetic opioids in the early 2000s subsequently turned to less expensive heroin and then fentanyl, which is 20 to 40 times more potent than heroin and 100 times more potent than morphine. A new form of illicit synthetic opioids may be even more powerful than fentanyl and require more doses of naloxone to reverse an overdose.

The changing landscape of overdose deaths has seen the number of deaths from fentanyl and other synthetic opioids, which still account for the majority of fatal overdoses, decline slightly from 76,226 in 2022 to 74,702 last year.

Since illegal forms of fentanyl began to predominate about a decade ago, the drug has accounted for a surge in overdose deaths. The number of prescription opioid pain pills distributed between 2011 and 2019 plummeted nearly 45 percent between 2011 and 2019, but fatal overdoses continued to rise to record levels. 

Since illicit fentanyl’s introduction, it has been mixed with other drugs like heroin, cocaine or marijuana. Now, cocaine and stimulants like methamphetamines are increasingly being mixed with fentanyl. In 2023, about one in three fatal overdoses involved stimulants, while one in four involved cocaine. The US counties that received the most doses of prescription opioids per capita in 2006-2013 later saw the highest death rates from heroin and fentanyl.

Daniel Ciccarone, a researcher at the University of California at San Francisco School of Medicine, who studies overdose trends, told the Washington Post, “We created a huge cohort of people dependent on opioid pills and when we pulled back on those, we created a heroin wave—and that quickly got replaced by fentanyl, and then people really started dying.”

According to the CDC’s preliminary data, several US states saw drug deaths decline by 15 percent, including Nebraska, Kansas, Indiana and Maine. The Pacific Northwest fared much worse, with Washington, Oregon and Alaska seeing increases of least 27 percent over the previous year.

The hundreds of thousands of people lost to fatal drug overdoses has caused a grim ripple effect in the US population. According to a 2023 survey published in the American Journal of Public Health, more than 4 in 10 Americans, or about 125 million people, personally know someone who has fatally overdosed. The study found 19 percent knew one person who had died of an overdose, 18.9 percent knew 2 to 5 people, and 4.5 percent knew 6 or more who died.

The study projected that more than 40 million adults have had their lives disrupted by overdose loss, and 12.5 million are still feeling a “significant or devastating effect” from the death of a loved one.

The Biden administration has described the slight decrease in drug overdose deaths as evidence of the success of federal efforts to help prevent deaths and treat addiction. “This progress over the last 12 months should make us want to reinvigorate our efforts knowing that our strategies are making a difference,” Deb Houry, CDC chief medical officer, said in a statement.

In reality, the Biden administration spends a pittance on drug treatment programs, seeking only $8.1 billion in the fiscal year 2025 budget to support mental health and substance use services across the entire US. This is in line with the administration’s ending of the COVID-19 public health emergency, which has resulted in millions losing Medicaid coverage, along with cuts to child care and other vital social programs.

Even relatively inexpensive programs that could save lives—such as universal and free distribution of naloxone, or syringe exchange programs—have not been federally funded and have come under attack by conservative and Christian fundamentalist forces that claim they promote drug use.

By contrast, Biden signed legislation in April that provides $95 billion more for the US-NATO war against Russia in Ukraine, the Israeli military’s genocidal slaughter in Gaza, and for preparing Taiwan as a military base against China.

White House efforts to reduce overdose fatalities—to the extent that they exist—are concentrated on the Democrats anti-immigrant, “border control” policies, shifting blame for the opioid crisis from the US ruling class and its corporate sponsors to the Mexican drug cartels sourcing drug-making chemicals from China.