Early data on drug overdose deaths released by the Centers for Disease Control and Prevention this month showed declines in 14 states between August 2016 and August 2017, even as Pennsylvania and New Jersey saw rates skyrocket.

New Jersey had the country's second-highest increase, 44.6 percent, in death rates in that time. From August 2015 to August 2016, 1,682 people died of drug overdoses in New Jersey; in the 12 months that followed, the state saw 2,432 overdose deaths. In Pennsylvania, overdoses spiked 42.5 percent in the 12-month period ending August 2017, from 3,890 to 5,545. Only the District of Columbia saw a greater spike in overdose deaths. Most of the states that saw drops are in the Midwest or West, though Massachusetts and Rhode Island reported small decreases.

It's difficult to draw conclusions about what might be behind the declines in some states, experts said; the data are preliminary and are released each month mostly to help local health departments track the opioid crisis more effectively.

Change in Drug-overdose Deaths

New Jersey and Pennsylvania are the states with the largest percentage changes in drug overdose deaths from August 2016 to August 2017, according to provisional data from the Centers for Disease Control and Prevention.
Staff Graphic

"It's too early to say if the pattern will hold up, and these are very preliminary numbers and likely undercounted," said Jeff Lancashire, a spokesman at the National Center for Health Statistics. In Tennessee — one of the states hit hardest by the epidemic, but which saw a 12.3 percent drop in deaths between August 2016 and August 2017 — health officials said they, too, weren't sure whether those numbers would hold. Between August 2015 and August 2016, the state had 1,579 overdose deaths; in the 12 months that followed, it recorded 1,385. (The Nashville  Tennesseean reported last summer that the state has undercounted drug deaths in the past.)

In Philadelphia, health officials said they suspected several factors were behind the rise. An estimated 1,200 people died here last year, the highest rate among major cities. Pennsylvania historically has had a high opioid prescribing rate, which puts more people at risk of developing addiction, said Kendra Viner, manager of the city Health Department's opioid surveillance program.

And much of the heroin on the Eastern Seaboard is easily combined with fentanyl, the far-deadlier synthetic opioid, Viner said. The black tar heroin typically seen west of the Mississippi — as opposed to the East Coast's white powder — is harder to combine with fentanyl. And Philadelphia's heroin is particularly cheap and pure, drawing people in addiction from neighboring states who are then exposed to fentanyl, she said.

"It's a perfect storm of all three things," Viner said.

Jeffrey Hom, a policy adviser in the Health Department, said that the drops in other states were encouraging, and that the crisis has led his department to share ideas and strategies with others. Still, he said, the department doesn't generally base its policy on real-time data from the CDC, simply because the numbers are too preliminary.

And, Viner added, data collection on the effects of the opioid crisis outside of fatal overdoses varies by region. She and her counterparts in other cities are working with the CDC to come up with standards on how to track, for example, nonfatal overdoses.

"Because the opioid crisis is relatively new, we didn't have such standards in place," she said. "And the data is going to continue to get better and better."