After years of decline, U.S. life expectancy has rebounded significantly, increasing by 0.9 years to reach 78.4 years in 2023, according to new data from the U.S. Centers for Disease Control and Prevention (CDC). This marks the first improvement since 2019, driven largely by declining drug overdose deaths and reduced COVID-19 mortality.
Men experienced a full year increase in life expectancy, rising from 74.8 to 75.8 years, while women saw a 0.9-year improvement, from 80.2 to 81.1 years. The turnaround represents a critical shift after the pandemic-related life expectancy declines of recent years.
Dramatic Reduction in Overdose Deaths
Drug overdose deaths fell 17% between July 2023 and July 2024, with approximately 94,000 fatalities compared to more than 113,000 in the previous 12-month period. This represents "the largest recorded reduction in overdose deaths, ever," according to Neera Tanden, director of the White House Domestic Policy Council.
Most significantly, the data revealed the first decrease in overdose deaths involving synthetic opioids like fentanyl since 2013. The age-adjusted rate for drug overdose deaths involving synthetic opioids decreased by 2.2% between 2022 and 2023, while deaths related to natural opioids like morphine and oxycodone declined by 17.1%. Heroin-related fatalities showed an even more substantial decrease of 33.3%.
Despite these improvements, the overall drug overdose death rate remains 3.5 times higher than in 2003, when 8.9 people per 100,000 died from overdoses, compared to 31.3 per 100,000 in 2023.
Matthew Garnett, an injury epidemiologist with the CDC's National Center for Health Statistics (NCHS), noted, "The rate also decreased for deaths involving natural and semisynthetic opioids and heroin between 2022 and 2023."
COVID-19 No Longer a Leading Cause of Death
The waning pandemic has contributed significantly to improved life expectancy. COVID-19 deaths decreased more than 73% between 2022 and 2023, falling from 44.5 to 11.9 deaths per 100,000. This dramatic reduction moved COVID-19 from the fourth leading cause of death in 2022 to the tenth position in 2023.
"From 2022 to 2023, age-adjusted death rates decreased for 9 of the 10 leading causes of death," reported the research team led by Elizabeth Arias, a health scientist with the NCHS. Deaths due to heart disease, accidental injury, stroke, respiratory disease, Alzheimer's disease, diabetes, kidney disease, liver disease, and COVID-19 all declined significantly. Cancer deaths also decreased, though not at a statistically significant level.
Effective Public Health Interventions
Public health experts attribute the decline in overdose deaths to several targeted interventions. The widespread distribution of naloxone, an opioid overdose reversal medication now available over-the-counter, has been particularly effective. White House officials estimate that naloxone has reversed as many as 500,000 overdoses nationwide.
"A soldier or a trauma doc will tell you the very first thing you need to do is to [stop] the bleeding," Dr. Rahul Gupta from the White House Office of National Drug Control Policy told CBS News. "If you don't do that, nothing else matters. We cannot treat dead people."
Additional contributing factors include expanded access to addiction treatment, the distribution of fentanyl test strips to help drug users protect themselves, and international efforts to disrupt drug production and trafficking networks.
"For far too many years, drug traffickers counted their money while we counted our debt. And we needed to turn that around. We needed to understand that this is a global business, and we need to treat it like one," Gupta explained.
Geographic Variations in Overdose Trends
The reduction in overdose deaths varied significantly by state. North Carolina experienced the greatest improvement, with a nearly 36% decline in fatal overdoses. Other states with substantial reductions included Virginia (29%), Ohio (27%), Delaware (25%), Nebraska (24%), Pennsylvania (24%), South Carolina (23%), Wisconsin (23%), and West Virginia (23%).
However, some states continued to see increases in overdose fatalities. Alaska experienced a troubling 40% rise, while Utah (10%), Oregon (5%), and Washington (2%) also reported increases.
Challenges Remain Despite Progress
While the overall trends are encouraging, public health experts caution that significant challenges remain. Overdose deaths related to cocaine increased by 4.9% between 2022 and 2023, and deaths from stimulants like methamphetamine rose by 1.9%.
Additionally, infant mortality rates have not shown improvement. "The infant mortality rate of 560.2 infant deaths per 100,000 live births in 2023 was not significantly different from the rate in 2022," researchers noted.
Andrew Kessler, founder of Slingshot Solutions, a consulting firm specializing in addiction and mental health issues, told STAT, "The colossal drop in overdose deaths is undoubtedly cause for optimism, but not necessarily for celebration. The Biden administration has certainly been aggressive in its approach to this issue, yet still even more needs to be done."
Looking Forward
The reversal of declining life expectancy and the reduction in overdose deaths represent significant public health achievements. However, sustaining and building upon these gains will require continued investment in prevention, treatment, and harm reduction strategies.
As opioids continue to account for most drug overdoses—causing nearly 68,000 deaths between July 2023 and July 2024—maintaining focus on this epidemic remains crucial even as overall trends improve. The data suggests that coordinated public health responses can effectively address even deeply entrenched health crises when properly resourced and implemented.
