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The Epidemic Preceding the Pandemic: Will Utah's Progress Hold?

Recently the Social Capital Project documented the national resurgence of the opioid epidemic in the latter half of 2019 and in the first half of 2020. This follow-on post explores how the opioid crisis has changed in Utah since the Social Capital Project last visited the issue in 2018.

Fortunately, overall drug overdose deaths, and opioid-related deaths in particular, fell significantly in Utah since record highs in 2015—highs that exceeded the overall drug overdose death rates in the United States at that time (Figure 1). Falling overdose death rates in natural and semi-synthetic opioids, which include most prescription opioids, led the Utah decline. In contrast, the overall U.S. drug overdose death rate is still rising, led by synthetic opioids like fentanyl.

Figure 1. Provisional Overdose Deaths by Type, Utah and the United States, Jan. 2015-July 2020Fig 1

Source: Social Capital Project analyses of CDC's Provisional Drug Overdose Death Counts as of February 7, 2021. January 2015 to July 2020. Monthly resident population data for U.S. from Census Bureau via Haver Analytics, averaged over prior 12 months ending in the concurrent provisional drug overdose death count month. Quarterly resident population data for Utah from the Bureau of Economic Analysis via Haver Analytics, disaggregated into months and averaged over prior 12 months ending in the concurrent provisional drug overdose death count month.

However, this fortunate trend in Utah seems to have stalled in 2019 and early 2020, and provisional drug overdose data suggests that the rapid decreases in drug overdose death rates slowed during that time. Although death rates from natural and semi-synthetic opioids continued to fall in Utah during that period, death rates from synthetic opioids like fentanyl, heroin, and non-opioids (e.g. psychostimulants with abuse potential) were rising. And even though the 2019 death rate from all causes is lower in Utah than the U.S. overall, this is largely due to Utah’s younger population, and the share of deaths attributable to drugs among those under 65 years old is still higher in Utah than in the U.S. overall.1

Furthermore, although fatal drug overdoses recently stalled, news reports suggest Utah’s nonfatal drug overdoses increased since the beginning of April 2020, and this is a growing source of concern for health officials. While there is significantly more variation in drug overdose data at the state level compared to the national level, there are still some notable differences in non-fatal drug overdoses in Utah compared to national trends (Figure 2).  

Figure 2. Non-Fatal Drug Overdoses by Type, Utah and the United States, Jan. 2019-Feb. 2020

Fig 2

Source: Social Capital Project analyses of CDC's Drug Overdose Surveillance and Epidemiology (DOSE) System, annual percent change January 2019 to February 2020.

CDC surveillance data on emergency department visits confirms non-fatal drug overdoses fell in Utah in both December 2019 and January 2020 as compared to a year ago, but during the yearlong period from February 2019 to February 2020 emergency visits for non-fatal drug overdoses increased 9.6 percent. Emergency department visits for non-fatal opioid overdoses (and more specifically non-fatal heroin overdoses) jumped in Utah towards the beginning of 2020.2 Despite the jump in early 2020, the sustained declines in emergency department visits for non-fatal opioid overdoses in the final months of 2019 (as compared to the same months in 2018) suggest continued improvements in Utah’s handling of the opioid epidemic before the COVID-19 pandemic hit.

As the Project noted in a previous post, it is unclear whether the pandemic affected trends in drug overdoses and other trends related to deaths of despair, because the current rise in U.S. overdoses predates the pandemic. However, it has certainly been more difficult to seek drug addiction treatment due to pandemic safety protocols, and the lack of in-person social connections can make it difficult to maintain sobriety for many recovering addicts.

Nevertheless, there is reason to believe that Utah maintained some progress from its years-long fight against the opioid epidemic during the pandemic: a report issued last month from the Utah Department of Health suggests that drug overdoses reported to emergency departments “remained stable through the first 50 weeks of 2020” and that drug overdose deaths also “remained stable throughout the first 39 weeks of 2020.” The report also noted 2020 mental distress, suicidal ideation, and suicide attempts in Utah remained similar to rates in 2019. Although they are higher than the U.S. overall, suicide deaths in Utah have fallen since 2017 (Figure 3).

Figure 3. Deaths of Despair by Component, Utah and the United States, 1999-2019
Fig 3

Source: Social Capital Project analyses of CDC data using Case and Deaton definitions. Underlying Cause of Death 1999-2019 on CDC WONDER Online Database, released 2020.

All told, deaths of despair in Utah fell in 2019 in contrast to the overall rise in the United States. In addition, preliminary data for 2020 from the Utah Department of Health report suggests that, although there is still room for continued improvement, Utah has retained some of its progress in reducing deaths of despair, including drug overdoses and suicide.

1 Social Capital Project calculations based on CDC’s definition of drug overdose deaths “using underlying cause-of-death codes from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined).” See additional information here:

2 Note that as a subset of opioid cases the changes in visits for heroin are much more volatile.

Christina King
Senior Economist

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