U.S. drug overdose deaths fell for a third consecutive year in 2025, with about 70,000 Americans dying from overdoses, according to the Centers for Disease Control and Prevention. The decline, the longest in decades, brought the annual total to roughly the same level as in 2019, before the COVID-19 pandemic.

Overdose deaths declined across multiple drug types, including fentanyl, cocaine and methamphetamine. Deaths fell in most states, although seven states experienced slight increases, and Arizona, Colorado and New Mexico saw increases of 10% or more. U.S. overdose deaths had generally been rising for decades and peaked at nearly 110,000 in 2022, a spike associated with social isolation and difficulties accessing addiction treatment during the pandemic.

"I'm cautiously optimistic that this represents really a fundamental change in the arc of the overdose crisis," said Brown University researcher Brandon Marshall. He said the increases in Arizona, Colorado and New Mexico may be due to more combined use of fentanyl and methamphetamine.

Contributing factors to the broader decline include increased availability of naloxone, expanded addiction treatment, shifts in drug use patterns and billions of dollars in opioid lawsuit settlement funds. Some research suggests the population likely to overdose has been shrinking as fewer teens take up drugs and many illicit drug users have died. Regulatory changes in China a few years ago also appear to have reduced the availability of precursor chemicals used to make fentanyl.

Overdose deaths remain elevated and the rate of decline slowed in 2025. "If deaths are going down rapidly, that means they can increase just as rapidly if we take our foot off the gas," Marshall said.

The illicit drug supply is continuing to shift. The Center for Forensic Science Research and Education, a federally funded toxicology lab in Horsham, Pennsylvania, identified 27 new drugs in 2025 and had already identified 23 new drugs less than five months into 2026. Among them is cychlorphine, a synthetic opioid described as up to 10 times stronger than fentanyl and used as a cutting agent in other illicit drugs without buyers' knowledge. "The drug supply continues to change and evolve," said Alex Krotulski, director of the lab.

The Trump administration has cut programs designed to reduce overdose deaths and infections tied to drug use. The Substance Abuse and Mental Health Services Administration notified federal grant recipients it would no longer pay for test strips and kits that detect highly lethal additives including fentanyl and xylazine. Officials say they are shifting away from services that facilitate illicit drug use, including programs providing clean syringes and hotlines intended to ensure emergency services can be called in case of an overdose. The White House said drug overdoses continue to be one of the country's most urgent public health challenges.

"It doesn't make sense that one day something is an evidence-based protocol, and you decide, because of political climate, it is no longer evidence-based," said Shreeta Waldon, executive director of the Kentucky Harm Reduction Coalition. Her organization lost a $400,000 grant it had used to distribute tens of thousands of fentanyl test strips, a spokesperson said.