WASHINGTON D.C. – The United States is witnessing an encouraging reversal in two long-standing public health crises, with deaths due to drug overdose and alcohol misuse showing significant declines in 2023. Provisional data for 2024 even predict an unprecedented 27 percent one-year drop in overdose fatalities. These reductions follow two decades of alarming increases in such deaths.
Despite this positive shift, the scale of the challenge remains immense. In 2023, over 200,000 Americans died from alcohol, drug overdose, and suicide combined – a rate twice that of 20 years ago. Public health experts attribute the recent improvements to strategic investments in primary prevention, mental health services, harm reduction initiatives, and overdose prevention programs.
“Data show that decades of investment and capacity building in substance use prevention, harm reduction programs, and mental health services have helped reduce associated deaths,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “The challenge now is to build on these investments and sustain this progress. These programs save lives; their funding should not be cut.”
Drug Overdose Deaths See Notable Drop In 2023, 105,007 Americans died from drug overdoses, marking a 4 percent decrease from 2022, which itself saw a leveling off after sharp increases in 2020 and 2021. The provisional 2024 data, projecting a 27% national decrease, indicate accelerated progress. Experts point to improved data systems for real-time tracking, along with expanded access to overdose prevention strategies like naloxone, buprenorphine, and drug-checking tools, as key factors in this downturn.
However, this improvement was not uniform. In 2023, white individuals were the only racial/ethnic group to experience a statistically significant decrease in drug overdose deaths. Disparities remain stark: drug overdose death rates were highest among American Indian/Alaska Native people (65.0 deaths per 100,000), adults aged 35 to 54 (57.3 deaths per 100,000), Black people (48.5 deaths per 100,000), and males (45.6 deaths per 100,000).
Alcohol-Induced Fatalities Also Decline Alcohol-induced deaths also saw a decrease, with 47,938 Americans dying from such causes in 2023. The overall age-adjusted mortality rate dropped by 7 percent from 2022 to 2023 (from 13.5 to 12.6 deaths per 100,000), building on a 6 percent reduction the previous year. While this decline was observed across nearly all demographic and geographic groups, some populations continue to be disproportionately affected. In 2023, alcohol-induced death rates were highest among American Indian/Alaska Native people (61.5 deaths per 100,000), adults aged 55 to 74 (32.5 deaths per 100,000), adults aged 35 to 54 (20.2 deaths per 100,000), and males (18.1 deaths per 100,000).
Suicide Deaths Remain Stable In contrast to the declines in overdose and alcohol-related deaths, the U.S. overall suicide mortality rate remained virtually unchanged from 2022 to 2023, standing at 14.1 deaths per 100,000 people in 2023, with a total of 49,316 lives lost. Age-adjusted suicide rates in 2023 were highest among American Indian/Alaska Native people (23.8 deaths per 100,000), males (22.7 deaths per 100,000), and adults aged 75 and older (20.3 deaths per 100,000).
While the recent declines are encouraging, public health officials warn that current and proposed federal budget cuts, along with public health workforce reductions and agency reorganizations, threaten to undermine this progress. There is a clear call for sustained effort and investment to ensure these reductions are felt equitably across every community and population group nationwide.
