Overdose deaths—with many tied to fentanyl—in the United States have dropped 17 percent in a one-year period ending in July 2024, according to recent statistics.
While experts can’t pinpoint the exact cause of the drop, Dr. Rahul Gupta, the Biden administration’s drug czar, believes several factors could be behind the decline.
Gupta noted that China, where many of the precursor drugs are manufactured, has been more cooperative over the past year in making arrests and curtailing online market sites.
Critics say cartels have taken advantage of the Biden administration’s border policy, which has allowed some 11 million illegal immigrants into the country along with an influx of drugs and crime.
The explosion in fentanyl deaths in America has sparked tension between the United States and China, from which many of the precursor drugs are shipped to cartel members in Mexico.
President-elect Donald Trump has promised to close the southwest border and floated the idea of using the military to deport illegal immigrant criminals, including Mexican cartels.
In November, Trump threatened a 25 percent tariff on Mexican and Canadian imports into America unless they took stronger action to stem the flow of fentanyl and illegal immigrants into the country.
“Until such time as they stop, we will be charging China an additional 10 percent Tariff, above any additional Tariffs, on all of their many products coming into the United States of America,” Trump said.
Gupta said there’s nothing wrong with keeping pressure on China.
He also said it was essential to recognize that China and other countries have been more cooperative with the United States recently when dealing with the public health crisis.
“We have worked with countries like the People’s Republic of China, with Mexico, with Colombia, with India, and others, both on the synthetics as well as the organic side, and developed cooperative means to address a scourge that is global in scope,” Gupta said.
Gupta noted the meeting between Chinese leader Xi Jinping and President Joe Biden last November in California, during which they agreed to cooperate on the fentanyl problem.
Since that meeting, Gupta said, Chinese officials have made arrests and shut down websites and online platforms that produce precursor drugs used to manufacture fentanyl.
His office now has a “direct hotline” with the Chinese Minister of Public Security to coordinate the battle against fentanyl.
“It’s a progress that’s contributing to a decline in numbers,” Gupta said. “We can work to make China part of the solution for this crisis, or they can remain a part of the problem.”
Efforts to expand treatment for opioid addiction and make life-saving naloxone more available to the public likely played a part in reducing the number of overdose deaths, he said.
Gupta drew from his experience in West Virginia when he took the job to stop the sharp rise in the national overdose rate.
“At that point, I realized that this is bigger than any one of us, and it’s one that all of society has to come together to address,” he said.
Naloxone, also known by the brand name Narcan, can save lives if administered in a timely manner, reversing respiratory depression caused by opioid overdose.
As the drug czar, Gupta did the same thing on a national scale, pushing to make naloxone available over the counter at a reduced rate.
Gupta said expanding treatment for addiction also helped lower the overdose rate.
Gupta, who started as a small-town country doctor, said he remembers wanting to help his community by treating drug addiction. Still, it was nearly impossible because of treatment licensing requirements.
Part of his mission in the Biden administration was to remove barriers for health providers to get addiction treatment licenses, he said.
Only a fraction of the 8 million Americans addicted to opioids are treated, Gupta said. Personal and societal reasons, along with stigma, play a part in people not seeking help, he said.
Removing special licensing requirements expanded treatment, increased the number of prescribers, and increased access to drugs like methadone and buprenorphine, two of the three FDA-approved medications for opioid addiction treatment, he said.
Help is now more readily available in rural communities, prisons, and for minority populations, he said.
Another problem Gupta faced was fentanyl-laced pills being sold online.
He advocated for public awareness campaigns, warning that unlicensed online sites could be dispensing pills containing the deadly drug.
“Oftentimes, death comes in a way people are not even expecting,” he said.
“They could be ordering what they think is Adderall online, or oxycontin or Xanax, and it turns out that between five and seven out of those 10 pills that are ordered online have a potentially lethal dose of fentanyl.”
Another factor that could be having an impact is law enforcement making it harder for fentanyl to be distributed within the United States.
Pressure from law enforcement can make it more difficult, expensive, and tedious for criminals to manufacture and traffic drugs.
“This is important because we have to make treatment more accessible than getting illicit drugs,” Gupta said.
