Drop in U.S. opioid overdose deaths nears 50% since 2023, Arizona deaths increase

Since their peak less than three years ago, opioid overdose deaths
dropped nearly by half as of October, according to a Stateline analysis.
The drop comes as a shrinking fentanyl supply has made the drug weaker
and less deadly and volunteer efforts get more people into treatment.

The weaker fentanyl tracks to a crackdown on materials used to make
fentanyl in China around the time U.S. deaths started dropping in 2023.
Some experts see it as a welcome, but possibly temporary, break for
states in a scourge that boosted crime as people who are using the drugs
sometimes fall into homelessness and steal to support fentanyl habits.

The numbers and rates of opioid overdose deaths fell for all races between 2023 and 2026, according to more detailed data from the federal Centers for Disease Control and Prevention analyzed by Stateline. That’s in contrast to an earlier trend from 2019 to 2023, when rates dropped only among white people and rose sharply among Black and Indigenous Americans.

Ohio had the nation’s largest decrease since mid-2023, when the
nation’s opioid overdose deaths peaked. Ohio has seen fewer deaths but
more risky behavior lately as fentanyl supplies dry up and people turn
to substitutes tainted by animal tranquilizers.

Ohio is seeing a difference in the bottom line, said Erin Reed,
director of RecoveryOhio, the state agency charged with reducing
overdose deaths.

“We’re seeing things you would expect — like reductions in emergency
department visits and reductions in Medicaid costs,” Reed said. “But
we’re also seeing a positive impact on violent crime and recidivism, and
I think this is really, really encouraging. At the end of the day,
people want to be safe.”

Sarah Beckman, 36, stopped using illicit drugs 11 years ago when she
learned she was pregnant with her first child. Now she works through
Hamilton County’s Quick Response Team to help Ohio residents who use
fentanyl.

When overdoses peaked a few years ago, the team started spending more time talking to people after overdoses.

“We saw overdoses were going up and up, and going out two days a week
was not enough. We expanded it to full time,” Beckman said. “That
window is so small. It has to be kind of a perfect storm for an
individual to be, like, ‘OK, I’m ready.’”

Even if people aren’t ready for treatment, kindness can help build
trust and prevent some of the thefts and arrests that lead to police
involvement, as it did for her when she stole to get money for drugs and
was charged with resisting arrest, she said.

“When you’re in the midst of addiction you need help with everything.
For us it’s just meeting people where they are and saying, ‘Hey, are
you hungry? Do you have enough clothes?’” Beckman said. “You’re showing
consistency and empathy, and by doing that you can slowly move someone
closer toward accepting overdose prevention materials or hopefully,
eventually, treatment.”

Nationally there were 46,066 opioid overdose deaths in October,
barely more than half the peak of 86,075 in June 2023 and the lowest
since April 2017. The numbers, often delayed because of the process of
determining overdose deaths, were released this month based on
information available March 1 by the federal National Vital Statistics System.

Deaths fell the most in Ohio, West Virginia, Virginia and Florida since June 2023, but increased in Alaska, Arizona and Nevada.

In Ohio, deaths fell 63% from about 4,300 in June 2023 to about 1,600 in October 2025.

As in many other states, deaths in Ohio started falling before 2023,
but then dropped more sharply — 34% in that year alone, said Reed.

Arizona and Nevada, however, saw deaths increase since the national
peak in 2023. Arizona’s border crossings with Mexico are among the
largest fentanyl smuggling points in the country, with fentanyl traffic
dominated by the Sinaloa Cartel in Mexico. One Arizona crossing, the
Port of Lukeville, was the site of the largest fentanyl seizure
in U.S. Customs and Border Protection history: 4 million fentanyl pills
hidden in a trailer brought to the border by a 20-year-old U.S. citizen
in July 2024.

The state’s notorious summer heat exacerbates overdose deaths, according to recent research.

Plentiful supply from the border may help explain continued increases
in Arizona, said Will Humble, executive director of the Arizona Public
Health Association, a public health workers organization.

Political infighting over how to spend the state government’s share of $1.2 billion in opioid settlement money hasn’t helped, he said. The state attorney general, governor and legislature have gone to court over plans to use some of the money to balance the state budget.

“Many other states are way ahead of Arizona when it comes to
distributing the state portion of the opioid settlement dollars,” Humble
said. “It could be there are fewer interventions because the state
dollars are locked up. There’s this dispute in Arizona over who gets to
decide. Many other states are not having this jurisdictional issue.”

An Arizona Army National Guard member inspects a vehicle within a railcar entering the U.S. in Nogales, Ariz., in April 2025 as part of Task Force Stopping Arizona’s Fentanyl Epidemic. Arizona is one of three states with more opioid overdose deaths as of October 2025 than at their national peak in 2023, according to a Stateline analysis. Photo by Staff Sgt. Amber Peck/U.S. Army National Guard.

On the national stage, opioid overdose deaths fell across demographic groups. Even older Americans, whose overdose death numbers had surged
earlier even as they fell for other groups, saw a 25% decline from 2023
to 2025, about half the national decrease, according to the Stateline
analysis.

In a sign of a weaker fentanyl supply, the Drug Enforcement
Administration said in December that 29% of the pills it seized in
fiscal 2025 contained a lethal dose of fentanyl, down from 76% in fiscal
2023.

“These reductions in potency and purity correlate with a decline in synthetic opioid deaths,” the DEA said.

Keith Humphreys, a health policy professor at Stanford University who testified
to the U.S. Senate in 2023 about increases in accidental overdose
deaths among older adults, told Stateline that a “fentanyl supply shock”
originating in China made fentanyl supplies weaker. That would include
fentanyl-tainted cocaine, which had caused many deaths among older Black
men, Humphreys said.

“This likely includes some long-term cocaine users who had the bad
luck to get cocaine that had fentanyl in it,” Humphreys said in an
interview. White women are more likely to overdose on prescription drugs
in order to commit suicide, a trend that would be less likely to be
affected by fentanyl supply, he added.

Humphreys and a team of other researchers, in a Science magazine
report published in January, found a “drought” of fentanyl that could be
traced on the social media platform Reddit.

Elevated mentions of a “drought” started in May 2023, nearly the same
time as overdoses began to drop, their research found. Also, the Drug
Enforcement Administration reported decreasing potency in seized
fentanyl and fewer seizures, both indicating a shortage of supply.

“Drug dealers often adapt to supply shortages by lowering purity more
than raising prices,” the report stated. The likely reason: China
cracked down on source chemicals for making illicit fentanyl. Such
“precursor” chemicals typically arrive from China and are processed in
Mexico before being smuggled into the U.S. as illicit fentanyl.

“Actions by the government of China that resulted in greater scrutiny
of production and export of precursor chemicals, including the removal
of online advertisements and several marketplaces,” may have been what
caused the drought in fentanyl and thus saved lives, the report
concluded.

The DEA concluded that Mexican fentanyl producers were cutting
potency because they were having a hard time finding source chemicals
from China, the report noted. That makes it likely supply is the biggest
reason for the drop in deaths, not enhanced U.S. border searches or
other actions such as the Trump administration’s attacks on drug boats
off the South American coast. Those boats are typically used to
transport cocaine rather than fentanyl.

Data shows a similar drop in overdose deaths in Canada, where
fentanyl supplies are usually produced from Chinese chemicals inside the
country rather than smuggled in. That’s another reason to suspect that
China’s crackdown affected both countries, despite differing policies
and law enforcement strategies.

In their Science article, Humphreys and the other researchers noted
that the recent decline in deaths offers the chance to prepare for
future opioid-related problems.

“The incentive to restore the fentanyl trade will persist as long as
there is demand for the drug,” the authors wrote. “It may be wise to use
the current drought as an opportunity to ramp up the prevention and
treatment programs that have evidence of decreasing demand.”

There have been some more recent upticks in death numbers.

Colorado saw an increase in synthetic opioid overdose deaths starting in late 2024, according to a Common Sense Institute report released this month.
The institute is nonpartisan but has ties to the Republican Party, and
concluded the state needs stiffer penalties for fentanyl possession and
distribution, similar to Texas law. Opioid overdose deaths in Colorado
are down 9% since the national peak in 2023, according to the Stateline
analysis.

In Ohio, the recent trend among people who use fentanyl is to find
pills spiked with an animal tranquilizer that causes severe addiction,
said Beckman, of the Hamilton County Quick Response Team. Three recent
clients survived overdoses but required emergency treatment, she said.

“We can educate people in the community: ‘Hey, your drugs are not
what you thought they were, that’s why you’re experiencing all these
weird side effects,’” Beckman said. “These substances are so severe that
a traditional detox hasn’t been able to handle them.”