The opioid epidemic has stabilized in early 2018. But do not celebrate yet.

Suddenly, the news seems a little more optimistic about the opioid epidemic in America.

On Tuesday, Health and Social Services Secretary Alex Azar, who chaired President Donald Trump, spoke of new preliminary data provided by the Centers for Disease Control and Prevention, suggesting that the US could "start reversing the trend "in the face of the opioid crisis.

"The seemingly relentless trend of increasing the number of overdose deaths seems to finally be moving in the right direction," Azar said at a health care conference, according to Politico. "We are so far from the end of the epidemic, but we may be at the end of the beginning," he added.

Azar's comments followed reports from Stat and Opioid Watch referring to recent CDC data, indicating that the most lethal drug overdose crisis in US history could well turn the page. .

Data from the CDC, which runs until March 2018, appear positive. The number of drug overdose deaths appears to have peaked in September 2017, when the number of overdose deaths expected the previous year reached more than 73,000. But in March 2018, the expected number of deaths during the Last year had dropped to just over 71,000. (Overdose deaths are not all due to opioids, but about two-thirds have been linked to opioids in recent years.)

Here's what it looks like in graph form:

Centers for Disaster Control and Prevention

If you look at the line and the points above, it seems that the trend has moved slightly downwards. At the very least, it appears that deaths from drug overdoses have stabilized.

As a person who covers the opioid epidemic for years, I certainly hope it is true. But there are a few reasons why I'm cautious:

1) Data are preliminary and subject to change. Overdose deaths may be higher or lower than what is currently reported. We just do not know.

2) Recent positive trends only concern six months from October 2017 to March 2018. Since the opioid epidemic has been accumulating for literally decades, it is about 39, a relatively short time frame for data on overdoses and it could be more superficial than a real slowdown. .

3) It happened before. Between 2011 and 2012, drug overdose deaths appeared to stabilize around 41,500. Second, extremely potent synthetic opioids, including illicit fentanyl, entered the black market – and the number of overdose deaths was skyrockets. According to preliminary data from the CDC, the number of drug overdose deaths reached more than 72,000 in 2017. Keith Humphreys, Drug Policy Specialist at Stanford, said it was "reasonable to be cautious Faced with a further potential decline, given past disappointments.

4) Although the total number of drug overdose deaths appears to have stabilized over the last six months of data, deaths from fentanyl have continued to increase. In September 2017, there were an estimated 29,000 deaths from overdose of synthetic opioids. In March 2018, it was estimated that more than 30,000 people died of synthetic opioid overdoses in the past year. This is an indication that at least one aspect of the opioid epidemic is getting worse.

5) Until now, fentanyl has mostly reached the Appalachian and East Coast, as fentanyl is increasingly mixed with heroin on the black market or has completely replaced heroin. This is less likely in other parts of the country, particularly on the west coast, largely because it is more difficult to mix fentanyl with the popular black tar heroin in the west. But that could change, said Sarah Wakeman, an addiction medicine specialist and medical director at the Addictions Initiative at Massachusetts General Hospital. In this case, overdose deaths may increase in western states, reversing improvements elsewhere.

6) Overdose deaths from cocaine and stimulants (such as methamphetamine) continued to increase, according to CDC data. The total number of opioid-related deaths is not yet close, but this rise could be a harbinger of another future drug overdose crisis. (Historically, it is not uncommon for cocaine or stimulant outbreaks to follow opioid-related crises as the population moves on to other drugs.)

7) The March 2018 figures are even worse than those of March 2017, with the CDC estimating a 3.5% increase in overdose deaths from the year to March 2017 and through March. 2018. So even though things have improved better for six months, they still seem to be getting worse year after year.

8) Drug overdose deaths are still extremely widespread. In 1999 (the beginning of the opioid crisis), the number of drug overdose deaths was less than 17,000. They were above 72,000, more than four times the 1999 total, in 2017. Although Deaths stabilized in 2018, more than 700,000 people – more than the entire population of Boston – would die from drug overdoses over the next decade if there were no other declines. This should temper the first celebrations.

That said, there is something to be optimistic about. The number of painkillers and heroin, in particular, tends to decrease, resulting in a decrease in the number of deaths due to an opioid and drug overdose, even as fentanyl continues to grow . According to Humphreys, the figures on painkillers are particularly encouraging, as they may indicate that fewer people are starting to use opioids and become addicts, which should produce even better results in the long run, as fewer people start to abuse or become addicted to opioids. the first place.

Positive trends could be the result of action by some of the most affected states. Vermont, Rhode Island and Massachusetts in particular have taken steps to expand access to drug treatment, particularly drugs such as buprenorphine and methadone, considered the gold standard for the treatment of mental health disorders. consumption of opioids. These states have seen a decline in overdose deaths, even as their New England neighbors – Connecticut, Maine and New Hampshire, who were also hard hit by the crisis – have not yet done so .

Overdose deaths may also drop in some Appalachian states, such as Ohio and Pennsylvania, although West Virginia – which has by far the country's highest overdose death rate – continues to rise, according to reports. CDC data.

State-to-state variation may indicate that, despite the lackluster response to the opioid crisis at the federal level, some local and national initiatives are taking shape.

Again, take the recent data with a grain of salt. I hope that I am too pessimistic. But by covering the epidemic of opioids, pessimism unfortunately has served me very well.

To learn more about the opioid epidemic, visit Vox's main page on opioid coverage.