In 2023, our nation witnessed the first annual decline in overdose deaths since 2018. In 2022, there were over 111,000 deaths. In 2023, that number fell to 107,543. Though modest, this suggests that nationwide efforts to reduce overdoses are making a positive impact. However, the work is not finished.

In March 2024, the National Center for Health Statistics released a data report (PDF | 410 KB) examining overdose deaths from 2002 to 2022. Their results show disparities that exist in fatal overdose between racial and ethnic groups. The population with the highest rate of fatal drug overdose in 2022 was Non-Hispanic American Indians and Alaska Natives, with a staggering 65.2 deaths per 100,000 people. This rate is approximately 13 times higher than Non-Hispanic Asians, who had the lowest rate of 5.3 deaths per 100,000.

This data demonstrates the importance of raising awareness of this issue through campaigns like International Overdose Awareness Day (IOAD). IOAD was established in 2001 in Australia as a day to remember and honor those who we have lost to overdose worldwide. Since 2012, the Penington Institute has led the campaign, which is observed annually on August 31st.

The 2024 theme for IOAD, “Together we can,” encourages community, unity, and action, reminding us that we have the power to make a difference when we work together. Cohesion between the Biden-Harris Unity Agenda for the Nation, the US Department of Health and Human Services (HHS) Overdose Prevention Strategy, and SAMHSA’s Strategic Plan allows for greater ability to target overdose.

SAMHSA’s role in preventing overdose and overdose fatalities is supported through a range of initiatives, including grants, publications, and implementing regulatory changes that support prevention, treatment, harm reduction, and recovery efforts throughout the country.

Grants

The State Opioid Response (SOR) and Tribal Opioid Response (TOR) Grants enables grantees to address barriers individuals face when receiving medications for opioid use disorder (MOUD), provide harm reduction services, and create a naloxone saturation plan. The TOR grant focuses on Indigenous populations, encouraging these communities to include traditional cultural practices into their grant activities.

According to SAMHSA’s 2022 Report to Congress on the SOR Grant (PDF | 1 MB), grantees distributed over 10 million kits of naloxone and reverse more than 550,000 overdoses. Many grantees used their funds to support opioid treatment programs (OTPs) and office-based opioid treatment (OBOT), allowing nearly 1.3 million individuals to receive MOUD. Since the TOR program began in 2018, Tribes have purchased and distributed nearly 50,000 naloxone kits and 40,000 fentanyl testing strips and trained over 26,000 community members on the use of naloxone.

The Harm Reduction Grant Program strengthens community-based programs to a range of services including distributing opioid overdose reversal medications, providing education on overdose, and referring individuals to care for HIV and hepatitis. Grantees may also use funds to buy necessary supplies such as fentanyl test strips and syringes.

Publications

In early 2024, SAMHSA released the Harm Reduction Framework, which provides a comprehensive overview of harm reduction and its role in shaping the work of HHS. After SAMHSA’s first Harm Reduction Summit in 2021, a steering committee of experts, including those with lived experience, helped inform the development of this framework.

Additionally, in 2024, SAMHSA revised its Overdose Prevention and Response Toolkit. The updated version of the document includes sections tailored for different audiences. Audiences include first responders, patients taking prescription opioids, and people who use drugs. The toolkit includes information on harm reduction and opioid overdose reversal medications such as naloxone. It is also available in Spanish.

Regulatory Changes

SAMHSA has played a major part in the revision and implementation of the Part 8 of Title 42 of the Code of Federal Regulations (CFR). These regulations set the standards for substance use treatment provided in opioid treatment programs (OTPs) and had not been updated in over 20 years. The revisions to the 42 CFR Part 8 reflect the progress that the field has made: increasing access to MOUD by providing telehealth and take-home medication flexibilities for patients receiving care in OTPs, eliminating stigmatizing regulatory language, and emphasizing the importance of patient-centered care.

These activities are a small sample of the work that SAMHSA does on a federal level to prevent substance use, support harm reduction, and increase access to treatment and recovery for substance use disorders.

Keeping in mind the theme for IOAD this year, there are actions we can all take to honor International Overdose Awareness Day on August 31 and make an impact all year round.

Together we can:

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug, or alcohol issues, visit FindSupport.gov. If you are ready to locate a treatment facility or provider, you can go directly to FindTreatment.gov or call 800-662-HELP (4357).