Drug overdose deaths in the US dropped 27% in 2024, approaching pre-pandemic levels. Competing factors make it challenging to determine whether this trend will continue.
Provisional CDC data released in May reported an estimated 80,391 drug overdose deaths in the US in 2024 – a 27% drop from the estimated 110,037 deaths in 2023.1
Drug overdose deaths for the US general population have been decreasing since 2023 – a notable change from the previous spikes that occurred during the acute phase of the COVID-19 pandemic. Increases in opioid-related overdose deaths were originally fueled by relaxed prescribing of prescription opioids;2 however, overdoses in the past decade have predominantly involved illegally manufactured fentanyl.3
Various factors may be contributing to the recent declines, including broader access to treatments and increased awareness of the risks of using drugs like fentanyl. Regulations and access to treatment vary significantly by state, with known regional differences in drug overdose mortality trends.4
While drug overdose mortality is currently decreasing, competing factors make it difficult to gauge if improving trends will continue or perhaps reverse. Potential challenges include contamination of drugs with more potent substances, which may not respond as effectively to overdose reversal medications.3
The general population drug overdose mortality trends vary significantly by different demographics, such as geography, education level, and age. For example, individuals with lower education levels tend to experience higher drug overdose mortality rates as shown in Figure 2.
Other substance usage also created concerns regarding mortality trends. Alcohol-induced mortality showed spikes in 2020 and 2021 but has declined since 2022.5 While the nature of these deaths vary – drug overdose deaths are acute, while alcohol-induced deaths tend to be more chronic – they both reflect overall substance use and related mortality trends within the US. According to the results of the National Survey on Drug Use and Health for 2023, approximately 47.5% of respondents aged 12 or older reported any alcohol use in the 30 days before the interview, as shown in Figure 3.
Trends are expected to vary between general and insured populations. Within the insured population, substance-related deaths may vary by key policy details or demographics, such as policy year or age. Understanding these differences is critical for insurers to better assess the impact of these trends. Insurers must also consider the risks related to today’s underwriting methods and the interrelationship to other risk factors such as mental illness. There is potential for long-term risk related to substance use that may not yet be seen.
In light of the dynamic environment surrounding drug overdose mortality and substance use disorder, the Society of Actuaries is taking a deep dive into the trends, drivers, and considerations for insurers. The report from the SOA and authored by RGA is expected to be published in the coming months. It will elaborate on these findings and will also include analyses of trends for both general and insured populations within the US.
Interested in learning more? Contact RGA today.
With thanks to Hilary Henly, Sara Goldberg, Dan Brandt, and Julianne Callaway for their contributions on this research.
