US overdose deaths fell through most of 2025, federal data reveals

NEW YORK– Overdose deaths in the United States declined for most of last year, suggesting lasting improvement in an epidemic that had been worsening for decades.

Federal data released Wednesday showed that overdose deaths had been declining for more than two years — the longest decline in decades — but also that the decline was slowing.

And the monthly number of deaths still hasn’t returned to what it was before the COVID-19 pandemic, let alone what it was before the current overdose epidemic that hit decades ago, said Brandon Marshall, a Brown University researcher who studies overdose trends.

“Overall, I think it continues to be encouraging, especially as we see declines almost across the country,” he said.

Overdose deaths began to rise steadily in the 1990s with overdoses from opioid painkillers, followed by waves of deaths from heroin and — more recently — illicit fentanyl. Deaths peaked at nearly 110,000 in 2022, declined slightly in 2023, then fell 27% in 2024, to around 80,000. This is the largest one-year decline on record.

The new data from the Centers for Disease Control and Prevention extends through August 2025 and represents the first update of preliminary monthly drug overdose deaths since the federal government shutdown.

An estimated 73,000 people died of overdoses in the 12 months ending August 2025, a decrease of about 21% from 92,000 in the previous 12 month period.

CDC officials reported that deaths were declining in every state except Arizona, Hawaii, Kansas, New Mexico and North Dakota. But they noted that it’s likely that not all overdose deaths have yet been reported in every state, and that additional data in the future could affect that number for states.

Researchers cannot yet say with certainty why the number of deaths has decreased. Experts have offered several possible explanations: increased availability of the overdose-reversing drug naloxone, growth in drug treatment, changes in the way people use drugs and the growing impact of billions of dollars in settlement money for opioid-related lawsuits.

Some also point out that research suggests the number of people at risk of overdosing has declined, as fewer teenagers use drugs and many illicit drug users have died.

Two other theories have recently joined the list.

In a paper published last week in the journal Science, researchers at the University of Maryland highlight the drug supply. They say regulatory changes in China a few years ago appear to have decreased the availability of precursor chemicals used to make fentanyl.

Their argument is based in part on information from the U.S. Drug Enforcement Administration, which reported last year that the purity — and dangerous potency — of fentanyl increased early in the COVID-19 pandemic but declined after 2022. That suggests it became harder to make fentanyl and its potency was diluted.

One piece of evidence for this is that more US-based Reddit users have reported a fentanyl “drought” in 2023.

The authors link this to signs that the Chinese government – ​​at the request of US authorities – has taken steps in 2023 to crack down on the sale of substances used to make drugs. There is limited information on what exactly the Chinese government did, and the paper is a bit speculative, but “we thought we could make our case,” said Peter Reuter, one of the authors.

The recent deceleration in overdose deaths may be because producers in Canada and Mexico have found alternative sources, Reuter and his colleagues believe.

Their paper was inspired by a team of researchers at the University of Pittsburgh, who earlier concluded that regulatory changes in China regarding the drug carfentanil were an important explanation for the decline in overdose deaths in the United States in 2018.

Those same Pittsburgh researchers — Dr. Donald Burke and Dr. Hawre Jalal — are now focusing on another theory about what happened to overdose deaths. In a paper published last week in the International Journal of Drug Policy, they say overdose trends could be at least partly linked to federal stimulus checks sent out during the COVID-19 pandemic.

Researchers tracked three rounds of pandemic stimulus payments delivered to U.S. households in 2020 and 2021, and found an increase in overdose deaths after each one.

That money eased economic hardship for many families, but some of it also helped people pay for illicit drugs, the Pittsburgh researchers say. And the end of these payments partly explains why overdoses stabilized in 2022 and began to decline afterward, they say.

Both arguments appear to have merit, even if they don’t prove causation, said Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco.

“Personally, I think it’s more complicated,” with these partial explanations adding to other trends, he said.

The Maryland and Pittsburgh researchers raised questions about whether the Trump administration’s policies could slow the momentum.

They noted that U.S.-China relations became strained last year when Trump imposed significantly higher tariffs on imports from China, and speculated that China could ease its efforts to control fentanyl precursors.

They also noted that Trump promised a $2,000 check to Americans to help offset rising prices resulting from tariffs on China. These controls could encourage some drug users to splurge and overdose, said Burke, who urged federal officials to think about how the money is disbursed.

___

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.