US overdose deaths fell again in 2025, but some worry about policy and drug supply changes

NEW YORK (AP) — About 70,000 Americans died of drug overdoses last year — about 14% fewer than the previous year, according to preliminary government data.

It was the third straight annual drop, making it the longest decline in decades, according to federal data released Wednesday. The 2025 total is about the same as the tally in 2019, before the COVID-19 pandemic.

Declines were seen across a number of drug types, including fentanyl, cocaine and methamphetamine. Overdose deaths fell in the vast majority of states, although seven saw at least slight increases, including jumps of 10% or more in Arizona, Colorado and New Mexico, the preliminary data from the Centers for Disease Control and Prevention showed.

“I’m cautiously optimistic that this represents really a fundamental change in the arc of the overdose crisis,” said Brandon Marshall, a Brown University researcher who studies overdose trends.

But the number of Americans dying from overdoses is still high, and deaths declined at a slower pace last year. A number of things could cause deaths to rise again — including government policy changes or a shift in the drug supply, Marshall and other researchers say.

“If deaths are going down rapidly, that means they can increase just as rapidly if we take our foot off the gas,” Marshall said.

Overdoses rose during the height of the pandemic

U.S. overdose deaths were generally rising for decades, but they shot up dramatically during the pandemic, peaking at nearly 110,000 in 2022. The pandemic spike was associated with social isolation and difficulties accessing addiction treatment.

Deaths declined as the pandemic waned. Researchers have pointed to numerous possible factors: an increase in the availability of the overdose-reversing drug naloxone, expanded addiction treatment, shifts in how people use drugs, and the growing impact of billions of dollars in opioid lawsuit settlement money.

Some research also suggests the number of people likely to overdose has been shrinking, as fewer teens take up drugs and many illicit drug users have died. Another theory suggests regulatory changes in China a few years ago appear to have diminished the availability of precursor chemicals used to make fentanyl.

The nation’s decades-long overdose epidemic has played out at different paces in different parts of the country, due at least in part to differences in the illicit drug supply and what people are using. The death increases last year in Arizona, Colorado and New Mexico could stem from more combined use of fentanyl and methamphetamine recently in those places, Marshall guessed.

New substances are showing up in the US drug supply

Health and law enforcement officials in recent months have been sounding alarms about newer drugs that were increasingly detected in 2025.

Alex Krotulski is director of the Center for Forensic Science Research and Education, a federally funded toxicology lab in Horsham, Pennsylvania, that is an important part of a national illicit drug early warning system.

In all of last year, the lab identified 27 new drugs. Less than five months into 2026, the lab already has identified 23, he said.

Among the drugs on the lab’s radar is cychlorphine, a potent synthetic opioid described as up to 10 times stronger than fentanyl. Experts say it is being used as a cutting agent, added to other illicit drugs, without the buyer’s knowledge.

“The drug supply continues to change and evolve,” Krotulski said.

Trump administration cuts some programs

Meanwhile, the Trump administration has been cutting programs designed to reduce overdose deaths and infections tied to drug use. In a letter last month, the federal Substance Abuse and Mental Health Services Administration notified federal grant recipients that the government would no longer pay for test strips and kits that help drug users see if their drugs contain highly-lethal additives.

Officials say they are shifting away from services that facilitate illicit drug use, including clean syringes and hotlines that people can dial into while they use drugs.

Last week, a group of women who lost children to overdoses spoke with reporters to protest government policies that emphasize punishment and incarceration.

Kimberly Douglas founded one group, Black Moms Against Overdose, after her 17-year-old son died.

“We are starting to see overdoses go down in some places and that’s because of harm reduction” services like those being targeted by the Trump administration, she said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.