Drug Deaths in the US 2025 | Statistics & Facts

Drug Deaths in America 2025

The United States has reached a pivotal turning point in combating one of its most devastating public health crises. After decades of escalating drug overdose deaths, the nation witnessed an extraordinary reversal in 2024, with provisional data from the Centers for Disease Control and Prevention (CDC) revealing an estimated 80,391 drug overdose deaths throughout the year. This represents a remarkable 26.9% decrease from the 110,037 deaths recorded in 2023, marking the steepest single-year decline in modern overdose surveillance history. The magnitude of this achievement cannot be overstated: more than 81 lives are being saved every day compared to the previous year, translating to approximately 220 deaths per day in 2024 versus over 300 daily deaths at the epidemic’s peak. This dramatic shift demonstrates that comprehensive, evidence-based public health interventions can successfully reverse even the most entrenched drug epidemics when implemented with sufficient scale and coordination.

The decline in drug deaths in the US 2025 extends across nearly all regions and demographic groups, with 45 states reporting decreases in overdose fatalities. States including Louisiana, Michigan, New Hampshire, Ohio, Virginia, West Virginia, Wisconsin, and Washington, D.C. experienced declines exceeding 35%, while only South Dakota and Nevada reported modest increases. Multiple factors contributed to this historic decline, including the widespread distribution of naloxone (the opioid overdose reversal medication), expanded access to medication-assisted treatment for substance use disorders, strategic disruptions to illicit drug supply chains, and sustained federal funding through programs like the CDC’s Overdose Data to Action (OD2A) initiative. Since President Trump first declared the opioid crisis a public health emergency in 2017, Congressional support has enabled CDC to expand critical data systems and strengthen overdose prevention capacity across all states, with these investments empowering communities to collect, analyze, and respond to local overdose patterns with unprecedented speed and precision.

Key Facts About Drug Deaths in the US 2025

Data source: CDC National Vital Statistics System (NVSS), CDC National Center for Injury Prevention and Control, May 2025

The statistics presented in this table represent verified provisional data from the CDC’s National Vital Statistics System, which collects death certificate information from all 50 states and the District of Columbia. These figures illustrate the most significant single-year decline in drug overdose deaths since comprehensive national surveillance began, with the 26.9% reduction surpassing even the most optimistic public health projections from early 2024. The data reveals that synthetic opioids, particularly fentanyl, experienced the steepest declines, with fentanyl-involved deaths dropping from 76,282 in 2023 to 48,422 in 2024, representing a 36.5% decrease. This extraordinary reduction in fentanyl fatalities accounts for the majority of the overall decline, suggesting that targeted interventions addressing synthetic opioid distribution and harm reduction have achieved measurable population-level impact.

The geographic distribution of the decline demonstrates both the breadth and variability of the overdose crisis response. While 45 states reported decreasing death rates, the magnitude varied substantially, with eight jurisdictions achieving reductions exceeding 35%. These high-performing states implemented comprehensive strategies combining naloxone distribution, medication-assisted treatment expansion, robust surveillance systems, and coordinated public health-public safety partnerships. Conversely, Alaska, Montana, Nevada, South Dakota, and Utah reported increases, highlighting persistent regional challenges related to rural healthcare access, limited treatment infrastructure, and evolving drug supply dynamics. The fact that more than 81 lives are saved daily in 2024 compared to 2023 represents approximately 29,600 prevented deaths over the course of the year, underscoring the profound human impact of sustained prevention efforts.

Drug Overdose Deaths by Type in the US 2025

Data source: CDC National Vital Statistics System (NVSS), CDC WONDER, NIDA Drug Overdose Death Rates, May 2025

Drug Deaths in the US – By Month 2025

Data source: CDC National Vital Statistics System (NVSS), Provisional Drug Overdose Death Counts, September 17, 2025 Release; CDC Newsroom May 2025

The most recent drug overdose deaths data in the US for 2025 shows that the historic decline continues through the first third of the current year, with provisional data revealing 76,516 deaths for the 12-month period ending April 2025. This figure, released by the CDC on September 17, 2025, represents a 24.5% decline compared to the previous 12-month period (May 2023 to April 2024), which recorded 101,344 deaths. The April 2025 data marks the lowest 12-month overdose death toll since June 2020, demonstrating that the nation has successfully reversed more than three years of epidemic growth. With an average of approximately 210 deaths per day during this period, the United States is saving over 65 lives daily compared to the same period one year earlier, translating to nearly 24,000 prevented deaths over the 12-month span.

However, more recent provisional data indicates some volatility in the declining trend. The 12-month period ending January 2025 showed approximately 82,138 deaths, representing a slight 1.7% increase from the 12-month period ending January 2024, which had 80,738 deaths. This modest uptick of roughly 1,400 additional deaths represents the first increase after 17 consecutive months of declines, raising questions among public health experts about whether this signals a temporary fluctuation or a potential reversal of the downward trend. Researchers analyzing geographic patterns suggest the January 2025 increase was primarily driven by upticks in Texas, Arizona, California, and Washington, while most other states continued experiencing declines. The CDC notes that fluctuations in drug overdose deaths can result from changes in the illicit drug supply, shifts in treatment access, and normal statistical variation in provisional data. Despite this single-month increase, the overall trajectory from the epidemic’s peak of 114,664 deaths in August 2023 to the 76,516 deaths in the April 2025 reporting period represents a remarkable 33.3% reduction from peak levels, affirming that the nation has achieved unprecedented progress in reducing overdose mortality.

The breakdown of drug deaths by type in the US 2025 reveals that every major drug category experienced substantial declines in 2024, with synthetic opioids showing the most dramatic improvement. Opioid-related overdose deaths decreased by 34.2%, falling from 83,140 in 2023 to 54,743 in 2024, representing the removal of over 28,000 opioid deaths from the national toll in a single year. Within the opioid category, synthetic opioids (primarily illicitly manufactured fentanyl) accounted for the majority of the decline, with deaths dropping by 36.5% from 76,282 to 48,422. This reduction suggests that public health interventions specifically targeting fentanyl—including widespread naloxone distribution, fentanyl test strip programs, and enhanced surveillance of the illicit drug supply—have achieved meaningful population-level effects.

Stimulant-involved deaths also declined significantly in 2024, though at lower rates than opioids. Psychostimulant deaths (primarily methamphetamine) decreased 20.6% from 37,096 in 2023 to 29,456 in 2024, while cocaine-involved deaths fell 28.1% from 30,833 to 22,174. These reductions are particularly noteworthy given that stimulant deaths had been rising steadily throughout the early 2020s, even as opioid deaths plateaued. The concurrent decline in both opioid and stimulant deaths suggests that harm reduction strategies—including naloxone distribution, drug checking services, and treatment expansion—benefit people who use multiple substance types. Notably, approximately 70% of stimulant-involved deaths in 2023 also involved synthetic opioids, indicating that many methamphetamine and cocaine users are exposed to fentanyl contamination. The decline in polysubstance deaths demonstrates the critical importance of addressing the entire illicit drug supply rather than focusing exclusively on single drug categories.

Drug Overdose Deaths by State in the US 2024-2025

Data source: CDC NVSS Provisional Data, CDC Pressroom Release May 2025, State Health Departments

The state-by-state analysis of drug overdose deaths in the US 2025 demonstrates that the national decline was geographically widespread, with the vast majority of jurisdictions experiencing substantial improvements. Seven states and one territory (Louisiana, Michigan, New Hampshire, Ohio, Virginia, West Virginia, Wisconsin, and Washington, D.C.) achieved reductions exceeding 35%, representing extraordinary public health achievements within a single year. Ohio, which has been among the hardest-hit states throughout the opioid epidemic, reduced its overdose death toll by an estimated 37.3%, preventing approximately 1,900 deaths in 2024 compared to 2023. Similarly, West Virginia, which has consistently reported the highest age-adjusted overdose death rate in the nation, achieved a 37.5% reduction, demonstrating that even the most severely affected states can reverse epidemic trends with comprehensive interventions.

Large population states also contributed significantly to the national decline. California reduced overdose deaths by approximately 28%, preventing an estimated 2,800 deaths, while Florida achieved a 28.6% reduction, avoiding approximately 3,000 deaths. Texas prevented approximately 1,400 deaths with its 26.9% reduction. These improvements in high-population states are particularly impactful from a national perspective, as California, Texas, and Florida collectively account for approximately 27% of the U.S. population. The two states reporting increases—Nevada and South Dakota—experienced only modest upticks, with Nevada adding 50 deaths (a 3.5% increase) and South Dakota adding just 2 deaths (a 2.3% increase). These limited increases in only two states, compared to major decreases in 45 states, underscore the breadth and consistency of the national decline. Public health experts attribute state-level variations to differences in naloxone access, treatment availability, drug supply composition, and the timing and intensity of local prevention efforts.

Opioid Overdose Deaths in the US 2024-2025

Data source: CDC NVSS, NIDA Drug Overdose Deaths Facts and Figures, CDC WONDER, May-June 2025

Opioid-related overdose deaths in the US 2025 experienced the most substantial declines of any drug category, with total opioid deaths falling 34.2% from 83,140 in 2023 to 54,743 in 2024. This reduction of 28,397 opioid deaths in a single year represents the largest absolute decrease ever recorded in U.S. overdose surveillance and suggests that opioid-specific interventions—particularly naloxone distribution and medication-assisted treatment expansion—have reached critical threshold levels of population coverage. Synthetic opioid deaths, dominated almost entirely by illicitly manufactured fentanyl, declined by 36.5%, removing 27,860 deaths from the national count. This dramatic reduction in fentanyl fatalities is particularly remarkable given that fentanyl had driven nearly all increases in overdose deaths from 2015 through 2023, making it the single deadliest drug in American history.

The decline in fentanyl deaths appears to result from multiple converging factors. Naloxone availability has expanded dramatically, with the medication becoming available over-the-counter in pharmacies nationwide in 2023 and through extensive community distribution programs funded by opioid settlement dollars and federal grants. The CDC’s Overdose Data to Action program currently funds 49 state and 41 local health departments to implement comprehensive surveillance and response strategies, enabling rapid identification of fentanyl-contaminated drug supplies and targeted naloxone deployment. Additionally, medication-assisted treatment with buprenorphine, methadone, and naltrexone has become more accessible through regulatory changes that expanded prescribing authority and integrated treatment into primary care, emergency departments, and criminal justice settings. The reduction in heroin deaths by approximately 11.5% continues a longer-term trend, with heroin-involved fatalities declining from a peak of 15,469 in 2016 to fewer than 4,000 in 2024. However, approximately 80% of heroin-involved deaths now also involve fentanyl, indicating that the heroin supply is heavily contaminated with synthetic opioids, making pure heroin increasingly rare in most U.S. drug markets.

Age-Specific Drug Overdose Deaths in the US 2024-2025

Data source: CDC NCHS Data Brief No. 491, National Vital Statistics System Mortality Data, 2022-2023

Age-specific analysis of drug overdose deaths in the US 2025 reveals that Americans aged 35-44 years continue to experience the highest overdose death rates, with approximately 55 deaths per 100,000 population in 2023, down from 59.9 per 100,000 in 2022. This age group has consistently maintained the highest overdose mortality rate since 2016, when deaths among 35-44 year-olds surpassed the previously highest-risk 25-34 age group. Overdose remains the leading cause of death for Americans aged 18-44, surpassing motor vehicle accidents, gun violence, suicide, and all other causes of preventable death. This sobering statistic underscores that despite recent declines, drug overdose continues to exact an enormous toll on individuals during their most economically productive years, with profound implications for families, workplaces, and communities.

The 25-34 year age group experiences the second-highest overdose death rate at approximately 46 deaths per 100,000 in 2023, representing a decline from 50.1 per 100,000 in 2022. Together, the 25-44 age range accounts for the majority of total overdose deaths nationwide, making this population the primary target for prevention interventions. Notably, the 15-24 age group shows substantially lower rates (15.5 per 100,000), though recent data indicates concerning increases in adolescent and young adult fentanyl exposure. Meanwhile, adults aged 65 and older have the lowest overdose death rates, with those 75 and older experiencing just 3.5 deaths per 100,000 population, approximately 16 times lower than the highest-risk age group. This dramatic age gradient reflects both cohort differences in substance use patterns and age-related differences in drug metabolism, with older adults less likely to use illicit opioids and more likely to survive overdoses when they do occur due to lower typical doses and different use contexts.

Stimulant-Involved Overdose Deaths in the US 2024-2025

Data source: NIDA Drug Overdose Deaths Facts and Figures, CDC WONDER, CDC NVSS, June 2025

Stimulant-involved overdose deaths in the US 2025 declined substantially in 2024, with both methamphetamine and cocaine deaths experiencing double-digit percentage reductions. Psychostimulant deaths (primarily methamphetamine) fell 20.6% from 37,096 in 2023 to 29,456 in 2024, while cocaine-involved deaths declined 28.1% from 30,833 to 22,174. These reductions are particularly significant because stimulant deaths had been rising steadily throughout the 2010s and early 2020s, even as efforts to address the opioid crisis intensified. From 2015 to 2023, psychostimulant deaths increased from 12,122 to 59,725, representing an almost five-fold increase over eight years. The 2024 reversal therefore marks a critical turning point in what had been the “fourth wave” of the overdose epidemic, characterized by polysubstance use involving both stimulants and opioids.

The high rate of fentanyl co-involvement in stimulant deaths—approximately 70% of all stimulant-involved overdoses in 2023 also involved synthetic opioids—suggests that many people who die from stimulant-related overdoses are either intentionally using both stimulants and opioids or unknowingly consuming stimulants contaminated with fentanyl. This contamination of the methamphetamine and cocaine supply with fentanyl represents a major evolution in drug market dynamics and substantially increases overdose risk for people who use stimulants but have no opioid tolerance. The decline in polysubstance deaths involving both stimulants and opioids in 2024 indicates that naloxone distribution and harm reduction interventions benefit not only people who intentionally use opioids but also those exposed to fentanyl through contaminated stimulants. Public health messaging has increasingly emphasized that naloxone should be available to anyone who uses illicit drugs, regardless of their primary drug of choice, given the pervasive contamination of the drug supply with synthetic opioids.

Naloxone Distribution and Overdose Reversal in the US 2024-2025

Data source: CDC, SAMHSA, State Health Departments, JAMA Network Open, BMC Public Health, 2024-2025

Naloxone distribution and availability in the US 2025 has reached unprecedented levels, contributing significantly to the historic decline in overdose deaths. The life-saving medication is now available over-the-counter in pharmacies across all 50 states following FDA approval of Narcan nasal spray in 2023, eliminating prescription requirements that had previously created barriers to access. Additionally, all 50 states and Washington, D.C. have implemented naloxone access laws that allow individuals to obtain the medication through various mechanisms, including pharmacist-dispensed naloxone under standing orders, harm reduction programs, and community distribution initiatives. The CDC’s Overdose Data to Action program funds 49 state and 41 local health departments to implement comprehensive overdose prevention strategies, with naloxone distribution representing a core component of these evidence-based interventions.

The public health impact of expanded naloxone availability is substantial and measurable. Cost-effectiveness analyses demonstrate that community-based naloxone distribution programs generate approximately $2,742 in benefits for every dollar spent, primarily through overdose deaths avoided and associated healthcare cost savings. Research from Massachusetts examining pharmacy-based naloxone distribution under standing orders found that communities where pharmacies dispensed naloxone showed a 16% annual reduction in opioid fatality rates compared to communities without pharmacy distribution. Tennessee’s Regional Overdose Prevention Specialists program distributed over 854,000 naloxone units between 2017 and 2024, with documentation of at least 103,000 lives saved, though the actual number is believed to be higher due to under-reporting related to stigma. Similarly, a New York State study covering a two-year period documented over 6,500 lives saved through naloxone distribution, representing more than 204,000 years of life. These state-level outcomes demonstrate that when naloxone is distributed at scale through multiple channels—including pharmacies, community organizations, syringe service programs, and first responders—it achieves measurable reductions in overdose mortality at the population level.

Racial and Ethnic Disparities in Drug Overdose Deaths in the US 2024-2025

Data source: CDC NCHS Data Brief No. 491, National Vital Statistics System, 2021-2022

Racial and ethnic disparities in drug overdose deaths in the US 2025 reveal profound inequities in overdose mortality, with American Indian and Alaska Native populations experiencing the highest age-adjusted death rates at 55.0 deaths per 100,000 population in 2022. This rate is approximately nine times higher than the rate for Asian and Pacific Islander populations (6.2 per 100,000) and 50% higher than the rate for Non-Hispanic White populations (36.8 per 100,000). The elevated overdose mortality among Native American communities reflects longstanding structural inequities in healthcare access, economic opportunity, and trauma exposure, compounded by limited availability of evidence-based treatment services in many tribal areas and rural regions with significant Native populations.

Non-Hispanic Black populations experienced an overdose death rate of 40.5 per 100,000 in 2022, representing a 6.0% decrease from 2021 but remaining substantially elevated compared to the national average. The overdose death rate for Black Americans increased dramatically during the pandemic years, rising from approximately 20 per 100,000 in 2018 to over 43 per 100,000 in 2021, largely driven by fentanyl contamination of the drug supply. Non-Hispanic White populations had a rate of 36.8 per 100,000, declining 7.1% from 39.6 in 2021. Hispanic populations experienced substantially lower rates at 17.6 per 100,000, approximately half the rate of Non-Hispanic White and Black populations, while Asian and Pacific Islander populations had the lowest rates at 6.2 per 100,000. These disparities reflect complex interactions between drug market dynamics, policing patterns, healthcare access, and social determinants of health. Notably, while White populations historically experienced the highest overdose rates during the early phases of the opioid epidemic, recent years have seen convergence across racial groups as fentanyl has proliferated in diverse drug markets and geographic regions.

Federal Response and Prevention Programs for Drug Deaths in the US 2024-2025

Data source: CDC, SAMHSA, Federal Budget Documents, CDC Newsroom, 2024-2025

Federal response efforts to drug deaths in the US 2025 have achieved unprecedented coordination and funding levels, with multiple programs working synergistically to reduce overdose mortality. The CDC’s Overdose Data to Action program represents the cornerstone of federal overdose prevention efforts, providing funding to 49 state and 41 local health departments to implement comprehensive surveillance and intervention strategies. The OD2A program enables jurisdictions to rapidly collect and analyze overdose data, identify emerging drug threats, deploy targeted naloxone distribution, link individuals to treatment, and evaluate intervention effectiveness. This data-driven approach allows communities to respond to their specific overdose patterns rather than implementing one-size-fits-all strategies, dramatically improving the efficiency and impact of prevention resources.

SAMHSA’s Fiscal Year 2025 budget totals $8.1 billion, representing a $612 million increase over the agency’s FY 2023 enacted budget, with substantial portions specifically targeting the overdose epidemic and mental health crisis. This funding supports medication-assisted treatment expansion, recovery support services, harm reduction programs, and workforce development for addiction treatment providers. Additionally, opioid settlement funds from litigation against pharmaceutical companies and distributors have provided billions of dollars to state and local governments for overdose prevention, with most jurisdictions allocating these resources toward evidence-based interventions including naloxone distribution, treatment access, and prevention programming. The public health emergency declaration first issued by President Trump in 2017 remains in effect, facilitating enhanced federal coordination, regulatory flexibility for treatment programs, and sustained Congressional appropriations for overdose response. In August 2024, federal agencies awarded an additional $416 million to support substance use treatment and recovery services, demonstrating ongoing commitment to addressing the crisis even as mortality rates decline. The Overdose Response Strategy operates in all 50 states, fostering public health-public safety data collaboration that allows law enforcement to better understand and intercept illicit drug supplies while connecting individuals to treatment and harm reduction services.

Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.

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