amna: New data from the CDC this week shows a significant drop in drug overdose deaths, down nearly 17% year-over-year from approximately 113,000 to just over 94,000.

It's a rare bit of good news after decades of rising fatalities.

Nationwide, overdose deaths have nearly quadrupled since 2002, and spiked to record highs during the pandemic.

But the root causes of this decline are still unclear.

To unpack it all we're joined now by Brian Mann, NPR's national addiction correspondent.

Welcome back and thank you for joining us.

These are encouraging numbers for sure but poor perspective even with that drop, annual overdose deaths are still above 90,000.

That would be a record high in year before 2020.

Remind us how those numbers got so high in the first place.

Brian: You know, so we had this terrible double hit.

The covid pandemic came and it disrupted addiction treatment and public health programs nationwide.

And at the same time, fentanyl landed, this very toxic, very powerful street opioid that comes from Mexico and China.

And those together, we saw in some years a 30% increase in deaths.

And so to see now this big shift to a 17% decline year over year, that's a big downward trend.

Amna: So we know the Biden administration is taking partial credit for it.

And they point to their efforts to distribute naloxone, the medicine that can rapidly reverse an opioid overdose.

They also point to their success disrupting global drug trafficking networks.

Did that play a role in this decline?

Do we know what's behind it?

Brian: So there is a mystery here.

I mean, this is such a huge decline.

It's unprecedented in the history of drug addiction in America to see a drop this fast.

But most of the researchers and frontline public health workers I talked to do think naloxone is reversing a lot of overdoses that would otherwise be fatal.

That's playing a role.

There has been an immense effort to target the cartels, and there's some sign that the fentanyl reaching American streets may be weaker and maybe a little bit less available.

So these are just some of the responses that the people I'm talking to say are really working, saving, at this point, tens of thousands of lives .

Amna: There are some pockets of data that seem to be bucking the trend, though, right?

Where are we not seeing progress and why not?

Brian: I talked about this mystery, and one of the things that we don't understand yet is why six states, mostly in the west, are still seeing dramatic increases.

Nevada and Alaska are particularly problematic.

They're up 25% to 40%.

Also, researchers are telling me that in black communities and native American communities, still a lot of vulnerability, a lot of people still dying.

So, this recovery really does appear to be happening.

Amna: So you mentioned this is a significant decline, unprecedented for what we've seen here in America.

But is it the beginning of a bigger downward trend?

I mean, where do we think the numbers will go from here?

Brian: So what we've seen now is an eight month long sustained recovery.

That is a good sign.

This does not appear to just be a one month statistical blip.

And another thing that really looks good here is that the rate of decline of drug deaths, that's growing month to month, it seems to be accelerating.

One of the reasons that researchers are trying to understand the mysteryryf why this is happening is so they can sustain it and maybe build on it.

As you say, 94,000 deaths is still catastrophically high, right?

This is not good enough.

And if we begin to plateau here, everyone agrees that this is not going to be the place we want to stay.

So that is going to be the big question.

As we transition to the trump administration, can they find ways to not only keep this going, but to build on it and to and to keep those deaths dropping month over month going on into the future?

Amna: While I've got you I want to ask about some other headlines that have gotten some attention.

There's been some controversy around the kind of harm reduction approach we've seen in some communities.

Oregon, for example, decriminalizing personal drug possession in 2020, then recriminalizing it this year.

Rhode Island now, one of the only places to open a safe injection site in the country soon.

What do we know in terms of data and your reporting about how effective those kinds of efforts are?

Brian: This is a really interesting thing about drug addiction is that sometimes harm reduction responses that do things like providing clean needles to people, in some cases even giving people safe places to use drugs where they're monitored by medical personnel.

These are controversial, but there is a lot of data showing that they work.

They do save lives.

Here's the problem.

They also can lead to community problems.

There are places where people worry about crime.

They worry about people doing drugs in their neighborhoods.

And so one of the tensions that a lot of communities, from Portland, Oregon to Seattle, Washington, right across the country, what they're wrestling with is trying to find ways to provide those harm reduction services, which have a pretty good track record saving lives, but doing it in a way that also deals with that crime issue and with that public safety issue.

Amna: That's Brian Mann, NPR's national addiction correspondent, joining us tonight.

Brian, thank you.

Brian: Thanks.