In an article published earlier this year, Samantha Anderer (2026) attributed the rapid rise in opioid deaths starting in 2013 to the introduction of fentanyl, a drug discussed in this blog series in https://addictionsandrecoverydotblog.com/2024/08/07/32-fentanyl/ .
You can see this recent decline in the following graph from the US Center for Disease Control:
(Above graphic from https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html )
The lethal amount of fentanyl is remarkably small:
The crisis continued through the COVID-19 pandemic, but drug overdose deaths across the United States have since been declining.
On May 14, 2025, the US Center for Disease Control (CDC) Center for Health Statistics, Office of Communication sent out a press release entitled “U.S. Overdose Deaths Decrease Almost 27% in 2024.” The following table, adapted from that press release, shows the decline in deaths due to synthetic opioids (fentanyl), psychostimulants, cocaine, and natural/semi-synthetic compounds (presumably opioids):
| Drug type | Estimated Deaths (2024) | Estimated Deaths (2023) | Percent decline in deaths |
| Synthetic Opioids (fentanyl) | 48,422 | 76,282 | -44.3 |
| Psychostimu-lants (including metham-phetamine) | 29,456 | 37,096 | -20.5 |
| Cocaine | 22,174 | 30,833 | -28.1 |
| Natural/semi- synthetic | 8,006 | 10,511 | -23.8 |
Post et. al. (2025). provide a more detailed analysis of this decline, by region, substance, and demographics.
This decrease comes at the end of an 9-year period (2015-2024) in which the US annual drug overdose death (DOD) rate had doubled, from 16.25 per 100,000 population to 32.76.76 per 100,000.
Death rates in this study were analyzed across 4 US census geographic regions (Midwest, Northeast, South, and West) and by demographic characteristics.
The results of this study indicate the following:
- Between January 2015 and October 2024, 800,645 US residents died of a drug overdose, of whom 31.7% were female and 68.3% were male;
- The median age was 42 years;
- A total of 11.2% were Hispanic or Latino ethnicity, and 88.8% were not Hispanic or Latino;
- From 2018 through 2024, 1.4% of DOD decedents were American Indian or Alaska Native, 1.1% were Asian, 18.3% were Black or African American, 0.1% were Native Hawaiian or Other Pacific Islander, 77.6% were White, and 1.5% were multiracial. As shown by the Figure below, there appears to have been a surge from 2020 2022, particularly for opioids and methamphetamine:
Regarding geographic differences, the West showed a pattern unlike the other regions, starting with the lowest DOD rate in 2015, but peaking higher than any of the others in 2024:
While these results are encouraging, the national decline was not evenly distributed. Adults aged 55 years or older and belonging to a group other than White continued to experience rising DOD rates by the end of 2023.
Sanderer attributes the decline to several factors occurring simultaneously:
- The illicit fentanyl supply has been disrupted: When the supply of fentanyl has declined, dealers may reduce the purity, or the amount of the drug in the formulation. According to data from the US Drug Enforcement Administration, the purity of fentanyl powder declined from 25% between March 2023 to July 2023 down to 11% by the end of 2024;
- The population using illicit opioids is aging so that young people are using fentanyl less frequently than in the past;
- The availability of naloxone, the opioid overdose reversal medication marketed as Narcan, has become more accessible. Anderer states that nearly 2 million prescription and over-the-counter naloxone products were dispensed in retail settings in 2024
P.S.:
Anderer, S. (2026). As US Overdose Deaths Drop, Researchers Search for Explanations. JAMA, published online: January 30, 2026. doi: 10.1001/jama.2026.0553.
Post, L.A.; Ciccarone, D.; Unick, G.J.; D’Onofrio, G.; Kwon, S.; Lundberg, A.L.; Sharma, S.; Mason, M. (2025). Decline in US Drug Overdose Deaths by Region, Substance, and Demographics. JAMA Network Open 2025:8(6):e2514997. doi:10.1001/jamanetworkopen.2025.14997 .
Addictions and Recovery 