NEW YORK – Fewer Americans died from drug overdoses in 2018 than the year before, the first decline in almost three decades, new federal data show.
The reversal contributed to an increase in overall life expectancy in the United States for the first time since 2014, according to an annual report from the Centers for Disease Control and Prevention. The agency’s final tally of death records for 2018 also shows diminishing mortality from 6 of the 10 leading causes of death, including heart disease and cancer.
Deaths from accidental opioid overdoses in Rhode Island peaked in 2016 at 336, declined to 324 in 2017 and declined further to 314 in 2018, according to the R.I. Department of Health. Estimated totals in the state for 2019 were 277 deaths, although data for the fourth quarter has not been finalized.
The ebb in fatal drug overdoses in the U.S. marks at least a respite from a decades-long opioid epidemic that has devastated communities across the country. The death rate from overdoses involving any drugs more than tripled between 1999 and 2017, according to the CDC, killing more than 700,000 Americans, or more than the current population of Vermont.
Mortality rates and life expectancy reflect a society’s well-being. For most of the last century, improvements in public health and medical advances contributed to substantial, long-term gains in how long people can expect to live. In wealthy nations, babies born today can generally expect longer lives than those born earlier. That trend has rarely been interrupted except by war or epidemics such as HIV.
Reports in the middle of the last decade showing life expectancy in the U.S. had fallen thus alarmed many public-health experts, economists and policy makers. Rising suicide rates, drug overdoses and illnesses tied to alcohol were taken as a sign of deepening distress in American society.
Some troubling trends remain visible in the data. While deaths from overdoses of heroin and some types of prescription opioids declined in 2018, fatal overdoses from potent synthetic opioids such as fentanyl continued to climb. And researchers noted a resurgence of deaths from cocaine and the class of drugs that includes methamphetamine.
Cocaine-related overdoses took the lives of more than 40 Americans a day in 2018. It’s increasingly mixed with fentanyl, which turns the stimulant into a much more lethal drug than it once was.
Early data from the first half of 2019, which wasn’t included in Thursday’s report, suggest it is premature to say the drug overdose epidemic is receding, said Robert Anderson, chief of the CDC’s mortality statistics branch.
“I think it’s too early to say whether we’ve reached a turning point,” Anderson said. “I’d like to say that we have, but I can’t really say that based on what we’re seeing.”
The CDC measures mortality rates in the annual report relative to a standard population, expressed as deaths per 100,000 people, to isolate mortality trends from the effect of population growth and demographic changes. In 2018, the death rate from drug overdoses was 20.7, down from 21.7 the year before.
That translates to thousands of people who were alive in 2018 who would have perished if the rate of fatal overdoses had persisted or increased. Some states that recorded particularly high rates of fatal overdoses in preceding years, including Florida, Kentucky, Ohio, and West Virginia, saw declines.
Policy makers have been trying to slow overdose rates by limiting prescriptions of opioid painkillers and expanding access to treatment and overdose reversal drugs like naloxone, among other measures.
The drop in drug deaths combined with declines in other leading causes of death to reduce the overall mortality rate and push up Americans’ life expectancy for the first time in four years. Life expectancy at birth in 2018 was 78.7 years, a 0.1 year increase from a year earlier. It remains below its peak of 78.9 in 2014.
U.S. life expectancy at birth still lags other developed countries such as Japan (84), Spain (83), and Canada (82), according to data from the Organisation for Economic Co-operation and Development. Americans’ expected lifespans are closer to those of Turkey (78) or the Czech Republic (79).
As far back as the 1980s, the U.S. diverged from other wealthy nations in the pace of life-expectancy increases, said Laudan Aron, a senior fellow at the Urban Institute who co-edited a 2013 report on the subject.
She cautioned that a one-year increase in life expectancy doesn’t mean those longer-term trends have abated. “The overall trendline is not particularly encouraging,” Aron said.
“This overall picture of where we stand in this country with respect to our health, our well-being, our survival and the fact that we are such an outlier among high-income countries is a point that still needs to be shared widely,” she said.
Deaths from heart disease, cancer, chronic lower respiratory disease, stroke and Alzheimer’s disease all decreased in 2018 compared with the year before, according to the National Center for Health Statistics, the statistical arm of the CDC that compiles the data from local authorities. Mortality increased slightly for suicides, influenza and pneumonia. Overall, the death rate fell 1.1% in 2018.
Infant mortality, another broad indicator of the overall health of a population, fell 2.3%. In a separate report, the agency found a maternal mortality rate of 17.4 per 100,000 live births. That’s higher than the CDC’s previous estimate, last published in 2007, but the agency said the difference mostly reflects changes to how the data is collected and reported.
John Tozzi is a reporter for Bloomberg News. PBN contributed to this article.
