Opioid epidemic: The number of overdose deaths may have decreased in 2018. But there is a problem.

Preliminary data show that the number of drug overdose deaths could have decreased by 5% in 2018 – the first decline since the beginning of the opioid epidemic in the country in the 1990s.

The data, first reported by The New York Times, seems like good news. A 5% drop would represent hundreds or even thousands of lives saved each year: according to preliminary data from the Centers for Disease Control and Prevention, there would have been more than 68,000 drug overdose deaths in 2018, compared to more than of 72,000 overdose deaths reported in preliminary data for 2017. (Final data for 2017 indicates a slightly lower number of overdoses – just over 70,000.) The numbers suggest that the opioid crisis may begin to stabilize.

But there are also several reasons to be cautious about the report:

1) The latest CDC data is preliminary and subject to change. Overdose deaths may be higher or lower than what the data currently indicates. We will only know when the final figures are released later this year, probably around December.

The preliminary estimate for 2017 was approximately 2,000 overdose deaths. If the gap is the same in 2018, but this time, deaths due to overdose were underestimated, 2018 could have been worse, not better, than 2017. We are only a margin error over these figures that seem very different.

2) This is not the first time that the opioid epidemic has stabilized. Between 2011 and 2012, drug overdose deaths appeared to stabilize at around 41,500. Second, dangerous synthetic opioids, including illicit fentanyl, entered the black market – and the number of overdose deaths rose arrow to 70,000 in 2017.

The fentanyl epidemic is still concentrated in parts of the north-east and center-west. If fentanyl begins to spread to other parts of the country in strength, overdose deaths could also increase elsewhere – as well as the total number of deaths.

Or something unpredictable could happen, just as fentanyl took a lot of people by surprise.

3) According to preliminary CDC data, deaths from synthetic opioids, such as fentanyl, are still on the rise: Synthetic opioid overdose deaths excluding methadone were estimated at nearly 32,000 in 2018, compared to 29,000 in 2017. Deaths related to cocaine and psychostimulants, such as methamphetamine, also increased. Most of the decline in the number of overdose deaths is related to a decrease in the number of opioid badgesic deaths, as prescriptions for these drugs are also decreasing. But if other overdose deaths continue to increase, they could overcome any decline in the number of badgesic deaths.

4) Although the decline in the number of overdose deaths seen in the preliminary data holds up, America still displays an alarmingly high rate of overdose deaths. With more than 68,000 drug overdose deaths, 2018 would still be the second worst year for drug overdose deaths in US history – more than firearm-related deaths, cars or even HIV / AIDS at its peak. This is not where the country should want to end up with a drug overdose.

There is room for optimism. The number of pain relievers in particular suggests that efforts to reduce prescriptions on these drugs are yielding results, although concerns remain about the need to balance these efforts in order to ensure that people who really need painkillers can still get them.

In recent years, the federal government has also committed billions of dollars in addiction treatment in response to the opioid crisis. Although this is far from the tens of billions that experts say is ultimately necessary to completely reverse the epidemic, this funding is even more important – and this could help alleviate the crisis at the moment.

But the celebration should be tempered by the many warnings about CDC data and the tens of thousands of overdose deaths that continue each year in America.