Are overdose drug deaths finally going down, as Conway says?

A conservative broadcaster who predicts President Donald Trump will be re-elected recently asked White House counselor Kellyanne Conway, "What will you do during the second term?"

Whatever he wants me to do," Conway said, referring to Trump. She said she hoped to continue leading the president’s efforts to combat drug abuse.

"We now have the first decline in overdose deaths due to drugs in 30 years - since 1990," she told radio host John Fredericks, a Portsmouth-based broadcaster during a Nov. 20 interview.

We checked if Kelly is right about overdose drug deaths going down for the first time in three decades. The White House press office referred us to statistics from the Centers for Disease Control and Prevention.

CDC records show there were 9,463 overdose deaths in 1990, and the number rose every year through 2017, when it peaked at 70,669. 

All the CDC figures through 2017 are final counts of reported overdose deaths. The figures from 2018 onward are provisional, meaning they still may be adjusted slightly upward because overdose deaths sometimes require special investigations, creating a lag time before they are reported.

Provisional numbers show a downturn in 2018, when there were 68,039 overdose deaths. That’s a 3.8% decrease from the record 70,669 in 2017. It’s a preliminary drop of 2,630 deaths.

The CDC says the discrepancy between preliminary and final numbers is "typically small." In 2017, "approximately 200" overdose deaths were added between the provisional and final tally.

Experts told us it’s almost certain the decrease will be verified in the final numbers, due in spring 2020. Until then, "You’re safe if you say there’s a downturn based on provisional numbers," said Andrew Kolodny, a senior scientist at Brandeis University specializing in opioid and heroin addiction. Conway didn’t make that distinction.

Technical phrasing aside, Kolodny said the apparent decrease is significant, although he added that the 68,039 overdose deaths in 2018 show "we still have a long way to go."

Kolodny and Keith Humphreys - a professor of psychiatry and behavioral sciences at Stanford University who studies addiction and drug control policy, said the apparent downturn has been largely caused by three factors:

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• Better addiction treatment; 

• More caution by doctors in prescribing opioids; and 

• Greater availability of Naloxone, a drug that counters an opioid overdose.

The decrease appears to be continuing, according to CDC provisional numbers. In the 12-month period ending April 30, 2018, there were 69,065 overdose deaths. In the year ending April 30, 2019, there were 67,123 such deaths - a 2.8% drop.

Kolodny thinks the drop in overdose deaths is the start of a trend. Humphreys is skeptical, noting the spread of Fentanyl, a painkiller the CDC says is 50 to 100 times more potent than morphine. "Fentanyl has still largely not penetrated the Western United States but it could very easily do so, increasing overdose deaths in the future," he said.

Although the provisional downturn started during Trump’s term, the two professors we spoke to don’t give the president much credit for it. They said Trump waited until 2018 to set an an anti-drug agenda and goal to end Obamacare could make it harder to get addiction treatment.  

Kolodny, however, commended Trump for publicizing the opioid crisis and faulted his predecessor - Barack Obama - for doing little to combat drugs. "Compared to Obama, President Trump has done a better job speaking to the problem," he said.

Our ruling

Conway says, "We now have the first decline in overdose deaths due to drugs in 30 years - since 1990."

CDC statistics show U.S. overdose drug deaths increased every year from 1990 to 2017, when there were 70,639 fatalities. Figures show 68,039 overdeath deaths in 2018  - a drop of 2,630.

An issue: The 2018 figures are preliminary, and will increase before the final count is completed in spring 2020. The small downturn is not official. It needs to be qualified as provisional, and Conway doesn’t do that. 

There are overwhelming odds, however, that Conway’s statement will turn out to be right. The CDC says the difference between preliminary and final numbers is "typically small." In 2017, about 200 overdose deaths were added between the preliminary and final tally.

So Conway’s statement, although technically flawed, almost assuredly is on track. We rate it Mostly True.