One potential bright spot: Overdoses decreased during the last quarter of 2017, and that trend seems to have held through the first quarter of this year, he said. Yet, the death rate is "still substantially higher than previous years," he said. And it's unclear what may have kept those numbers down: increased distribution of the overdose-reversing drug naloxone, more careful drug use among people in addiction, increased treatment, decreased opioid prescribing, or a change in the levels of fentanyl sold on the street all could be involved, Farley said.