Despite a handful of states in the West where overdose deaths are surging, overall street drug fatalities in the U.S. continued to drop at a historic rate in 2025, falling roughly 14 percent compared with 2024.
In all, 69,973 people died from fatal overdoses last year nationwide, according to the latest preliminary data from the Centers for Disease Control and Prevention. While that toll is painful, it means roughly 11,300 fewer people lost their lives to drugs compared with the year before.
"This is very good news," said Dr. Nora Volkow, head of the U.S. National Institute on Drug Abuse [NIDA], the federal government's leading addiction research agency. "We started to see the declines in 2023 but they were small and we weren't certain they were going to be sustainable."
Public health experts point to a range of factors saving lives, including wider use of medications that reduce opioid cravings and reverse opioid overdoses.
"Seeing this national decline, we should definitely be happy because we know some structural things have made a difference," said Beth Meyerson, a drug policy researcher in Arizona who heads the Harm Reduction Research Lab at the University of Arizona's College of Medicine in Tucson.
"Access to naloxone or Narcan has become widespread in communities. We're beginning to see that naloxone is first aid and that is absolutely critical," Meyerson said, referring to the medication that reverses opioid overdoses.
Improvements during last year build on a pattern of steep declines in fatal overdoses that began in the summer of 2023. Experts say less potent illicit fentanyl and a drop in the number of young people using drugs have also contributed to the decline.
Three states saw particularly dramatic drops in in deaths in the twelve months ending in December 2025, with Alabama, New York, and Virginia registering between 25 and 30 percent fewer fatalities.
"I am very pleased that over the past three years, we have seen a decline," said New York Governor Kathy Hochul, in a statement.
She noted opioid deaths in her state from fentanyl, heroin and pain pills sold on the black market have been cut in half since 2022. "We will continue our focus on removing health disparities and responding to new substances that are emerging in the illicit drug supply."
Nationwide, 2025 saw the lowest level of drug deaths in the U.S. in a 12-month span since at least 2019. It's a stunning decrease from the peak of 112,418 deaths measured in the summer of 2023.
Troubling trends remain in some states and communities
Still, drug deaths in the U.S. remain high by historic standards and compared with other countries. Scotland, the country with the second highest rate of drug deaths, has fatal overdoses significantly lower than the U.S. per capita, according to a January 2025 study.
Overdose deaths also remain high among older Americans and in many predominantly Black and Native American communities. Toxic new synthetic drugs, made from industrial chemicals, continue to turn up on U.S. streets. And a handful of states, including Arizona, New Mexico and North Dakota, also saw sharp increases in fatal overdoses in 2025.
According to Meyerson, Arizona's troubling spike in deaths may reflect more potent fentanyl and methamphetamines being sold in her state. She also pointed to lack of access to medical care.
"Arizona is the gateway for fentanyl into the United States [from Mexico]," she said. "Also our treatment is stressed. Two studies by our team documented the drive time in Arizona is over two hours for opioid treatment in rural communities."
Volkow, at NIDA, said widespread use of potent methamphetamines in Arizona and New Mexico is "very problematic." She also said more progress is needed reducing overdose deaths Native American communities, especially those in isolated rural areas where medical care is often inadequate or unavailable.
"Both Arizona and New Mexico have relatively large Native American population and when you look at the demographics, what is clear is the overdose mortality among Native Americans is double that of the general rest of the United States," Volkow said.
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