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US Leads World in Overdose Deaths, Report Finds

Narcotic opiate drugs, heroin, and cocaine with syringe and spoon

Photo: Getty Images

The United States has the highest rate of overdose deaths among 30 developed countries, according to a recent report by the Commonwealth Fund. In 2022, the U.S. recorded 324 overdose deaths per one million people, significantly higher than countries like Scotland and Canada, which have seen declines in recent years. The report highlights the fragmented and inadequate approach to overdose prevention in the U.S., where policies on interventions such as naloxone and clean syringe services vary widely from state to state.

The Commonwealth Fund's analysis reveals that drug overdoses claimed over 100,000 American lives for the third consecutive year in 2023, marking a more than 50 percent increase since 2019. The rise in overdose deaths is largely driven by synthetic opioids like fentanyl, which is 50 times stronger than heroin. The report suggests that the U.S. can learn from other countries by adopting comprehensive approaches to prevention and treatment that prioritize public health and harm reduction.

Polysubstance use, involving multiple drugs, and the emergence of new substances like xylazine, a tranquilizer not approved for humans, pose significant challenges. Counterfeit pills containing multiple substances have also contributed to the increase in overdose deaths. Access to medication-assisted treatment remains inadequate in the U.S., with only 11 percent of Americans with opioid use disorder receiving opioid substitution therapy in 2020, compared to 87 percent in France.

The report calls for the U.S. to adopt harm-reduction policies similar to those in countries like Portugal, which emphasize public health approaches and integrated health care solutions. Such strategies could help address the crisis across diverse communities in the U.S. and ensure interventions are compassionate, equitable, and effective. Despite a slight decrease in overdose deaths in 2023, the report stresses the importance of maintaining momentum in prevention efforts and tailoring communication to reflect the unique needs of different populations.


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