September Monthly Policy Update

There was tremendous news out of the Centers for Disease Control (CDC) this month: overdose deaths in the United States have declined at the highest rate in decades.

We at Faces & Voices of Recovery are delighted by this news and feel confident that our advocacy played a major role in driving these overdose numbers down.

National surveys compiled by the CDC already show an unprecedented decline in drug deaths of roughly 10.6%. Overdose deaths involving fentanyl and other synthetic opioids are down 20% year-over-year, CDC data shows. (These drugs are now involved in about 2/3 of all fatal overdoses, which is down from more than 3/4 of all overdose deaths a year ago.) This is based on data gathered from various states.

In many states, the decline was considerably greater. Researchers also believe the drop in state-level mortality numbers corresponds with similar steep declines in emergency room visits linked to overdoses.

In Vermont, for example, the overdose rate is down 22%. Deaths in King County, Washington linked to all drugs have dropped by 15% in the first half of 2024. Fatal overdoses caused by street fentanyl have dropped by 20%. Missouri is seeing a similar trend that sees overdose deaths decelerating. After dropping by 10% last year, preliminary data shows drug deaths in the state have now fallen roughly 34% in the second quarter of 2024.

While the data doesn’t point to a clear cause of the decrease, many researchers believe that access to life-saving measures such as Narcan play a major role, as does broader access to medication that treats opioid use disorders. Ensuring access to these tools – for both Recovery Community Organizations (RCOs) to distribute and for consumers to utilize – remains a cornerstone of our advocacy efforts.

One extremely useful tool in the fight against overdose is access to methadone, a pharmaceutical with a high efficacy rate and low diversion rate amongst those who use it for Opioid Use Disorder. Changes were made during the COVID-19 pandemic to the previously strict rules that had governed its distribution wherein consumers were allowed “take-home” doses and were allowed to self-administer. Overdose deaths and drug diversion didn’t increase; people even stayed in treatment longer. Now, on October 2, those rule changes will become permanent (except in certain states with more restrictive regulations).

The new federal rules allow stable patients to take home 28 days’ worth of methadone. Colorado, New York, and Massachusetts are among states taking steps to update their rules to align with the new flexibility. Some others have not, including West Virginia and Tennessee (which are incidentally the states with the nation’s highest drug overdose death rates). Tennessee officials have drafted new rules that are stricter than the federal government’s. The state’s proposal would increase random urine drug screening, make counseling mandatory for many patients, and obligate clinics to hire pharmacists if they want to dispense take-home doses.

Other changes will be made as well, including:

• In states that adopt the rules, methadone treatment can start faster. People will no longer need to demonstrate a one-year history of opioid addiction.
• Counseling can be optional instead of mandatory.
• Telehealth can be used to assess patients, improving access for rural residents.
• Nurse practitioners and physician’s assistants — not just doctors — can start people on methadone.