A view of Naloxone (Narcan) nasal spray on display at a Naloxone demonstration at the headquarters of the U.S. Department of Health and Human Services (HHS) on September 8, 2023 in Washington, DC. Alabama’s overdose deaths fell 18.24% in a year, a decline attributed to treatment efforts despite its history of high opioid prescriptions. (Photo by Drew Angerer/Getty Images)
Drug overdose deaths in Alabama dropped by 18.24% between July 2023 and July 2024, according to provisional data from the Centers for Disease Control and Prevention (CDC).
At its peak in 2012, Alabama had the highest rate of opioid prescription in the country with 143.8 prescriptions per 100 people compared to 81.3 prescriptions per 100 people nationwide. The state rate has decreased by about 50% over the last decade, down to 71.4 prescriptions per 100 people in 2023.
While the significant decrease in opioid prescription may have contributed to a decline in overdose deaths, Alabama was only 2nd in highest opioid dispensing rates among states in 2023, only behind Arkansas. Socioeconomic factors, like poverty, lack of access to health care and education, may also have contributed to higher rates of substance use and overdose.
State officials attribute the improvement to a combination of expanded treatment, prevention programs and increased access to life-saving interventions.
Commissioner Kimberly Boswell of the Alabama Department of Mental Health (ADMH) pointed to the state’s leadership for its investments, “who have supported an expansion of localized prevention, treatment, and recovery programs through our state’s Opioid Settlement Funds and state appropriations.”
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“These investments, along with federal funding sources, have expanded vital substance use treatment programs, saving lives every day. Alabama has increased access to care and decreased overdose deaths,” Boswell said in a statement.
In Jefferson County, home to Alabama’s largest city, local efforts have played a role in reducing fatalities. Megan Oelschig, a public health nurse with the Jefferson County Department of Health (JCDH) pointed to the ongoing positive trends in overdose statistics but that “there are a lot of ideas, but no certainties” on what is driving the downward trend in overdoses.
“Saying for sure how many deaths have been prevented would be hard to determine, but what I can tell you is our overdose deaths continue to trend down compared to last year,” Oelschig said when asked if the department had an idea of how many opioid deaths it was able to prevent. “Last year in Jefferson County alone we had 493 fatal overdoses; this year we are projecting far less.”
One factor, Oelschig noted, is likely the increased availability of naloxone (Narcan), an opioid overdose reversal drug now available over the counter.
“We have several in-county partners that help distribute Narcan kits to their clients, and JCDH has a mailing distribution program where we can ship free Narcan to anyone in the state of Alabama,” she said. To date, JCDH has distributed more than 29,000 individual doses of Narcan statewide. Free naloxone kits or fentanyl testing strips can be acquired by visiting www.jcdh.org/naloxone.
Provisional data are often incomplete and causes of death may be pending investigation, which can lead to estimates changing over time. In previous estimates for April 2023 and April 2024, Alabama had a decline of about 4% in overdose deaths.
Delays in reporting — caused by ongoing investigations or toxicology backlogs — can affect the timeliness of finalized data, according to Dr. Wes Stubblefield, district health officer at the Alabama Department of Public Health (ADPH).
Nationwide, drug overdose deaths decreased by 16.9% in the year ending July 2024 (that figure was previously 10% for the year ending in April), though many western states, including Alaska and Nevada, saw increases.
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