U.S. overdose deaths fall 14 percent in 2025, but Arizona, New Mexico, and North Dakota see sharp increases

The national decline in overdose deaths continued a pattern that began in the summer of 2023, when fatalities peaked at 112,418 in a single 12-month span. Public health experts credited several factors for the improvement, including wider access to naloxone — the medication that reverses opioid overdoses — as well as increased use of medications that reduce opioid cravings and a reported drop in drug use among younger Americans. Less potent illicit fentanyl circulating in parts of the country was also cited as a contributing factor.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, described the data as "very good news," noting that earlier declines in 2023 were small and their durability was uncertain. Three states — Alabama, New York, and Virginia — recorded particularly steep drops, with fatalities falling between 25 and 30 percent. New York Governor Kathy Hochul said opioid deaths in her state from fentanyl, heroin, and black-market pain pills have been cut in half since 2022.

Despite the national trend, drug deaths in the U.S. remain high by historical standards and in comparison with other wealthy nations. A January 2025 study noted that Scotland, which has the second-highest per-capita drug death rate in the world, still records significantly fewer fatal overdoses per capita than the United States. Death rates remain elevated among older Americans and in many predominantly Black and Native American communities.