The Good News About Overdose Deaths in the U.S.

New data from the CDC's National Vital Statistics System released in February 2025 revealed nearly a 24% decline in drug overdose deaths in the United States for the 12 months ending in September 2024 compared to the previous year. Provisional data shows there were about 87,000 drug overdose deaths from October 2023 to September 2024, down from 114,000 the previous year. This is the fewest overdose deaths reported in any 12-month period since June 2020.

CDC and White House Comments

"It is unprecedented to see predicted overdose deaths drop by more than 27,000 over a single year," said Allison Arwady, MD, MPH, Director of CDC's National Center for Injury Prevention and Control. "That's more than 70 lives saved every day.” Arwady says CDC's public health investments, improved data and laboratory systems for overdose response, and partnerships with public safety colleagues in every state mean they are more rapidly identifying emerging drug threats and supporting public health prevention and response activities across America.

Neera Tanden, Director of the White House Domestic Policy Council, described the data as “the largest recorded reduction in overdose deaths, ever,” emphasizing the concerted efforts that led to this outcome. However, while this national death decline is encouraging, overdoses remain the leading cause of death for Americans aged 18 to 44, the CDC says. Five states recorded increases in overdose deaths, including Alaska, Montana, Nevada, South Dakota, and Utah, highlighting a continued need for local initiatives, data collection, analysis, and a tailored response.

State Overdose Death Trends

By September 2024, U.S. overdose deaths dropped to about 87,000 (a 24% decline from the peak), marking the lowest number of overdose deaths since June 2020. However, nonfatal overdose rates may be increasing, with many people who overdose being rescued yet experiencing repeat overdoses. There were 296,323 visits to emergency departments for nonfatal opioid overdoses in 2023 (129.3 per 100,000 population) across 26 states with data. This suggests missed opportunities to intervene and treat. For example, in one study, 6.5% of patients treated with naloxone (Narcan) by emergency medical services (EMS) in Massachusetts died later the same day, and an additional 9.3% died within one year. This suggests a revolving door pattern for overdoses.

Great Progress in West Virginia

West Virginia is the state most experts point to because it had the most deaths per capita and was ground zero for the OxyContin, heroin, and fentanyl epidemics. The latest West Virginia data shows a 38% decrease in overdose deaths from January to July 2024 compared to the same period in 2023. This reduction translates into 318 more people alive today.

According to WVU Chairman of Psychiatry James Berry, D.O., “I am very proud of the work West Virginia has done in decreasing the rate of overdose deaths. This is a combination of many factors and many dedicated, compassionate people working incredibly hard to save lives.”

One of the biggest factors has been increasing access to evidence-based treatment for opioid use disorder (OUD). However, Berry says that with the state's rural population and limited transportation infrastructure, gaining access to treatment has been challenging.

Berry says, “Our Department of Behavioral Medicine and Psychiatry at West Virginia University’s Rockefeller Neuroscience Institute has been using telemedicine to provide opioid use disorder treatment to the hardest hit southern coal counties of West Virginia for the past 10 years.” Before COVID, treatment was limited to people who could travel to primary care clinics where addiction specialists treated them. “Regulations were eased during the COVID epidemic, and we were able to expand our care to people across West Virginia, treating them in their own homes. This was a godsend.”

The state provided grants to other healthcare providers in the Comprehensive Opioid Addiction Treatment (COAT) model using a group-based medical appointment for buprenorphine and group therapy.

Berry says, “This COAT care delivery model significantly increases the treatment slots and makes treatment economically feasible. Furthermore, we have been able to use virtual modalities to expand our training of healthcare providers throughout the state and surrounding regions through our designation as a ‘Super Hub’ for a program called Project Echo.” He notes that in 2018, they began a specialty fellowship program in Addiction Psychiatry and Addiction Medicine. “This is an extra year of training for resident physicians that equips them with state-of-the-art skills to train other providers and treat addictions.”

The state also increased access to naloxone and mobile crisis units to rescue people from overdose, transitioning them quickly to treatment. The expansion of Peer Recovery Support Specialists was another critical factor turning the tide. Berry explains, “These are specially trained people in recovery from addiction themselves who help others get treatment and recovery services. Our department, as well as other hospitals across the state, have these peers in the Emergency Department to meet people at their greatest moment of need and facilitate their entry into long-term addiction treatment.” He adds, “We still have a long way to go and cannot let up the gas.”

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A Wide Range of Factors Made Reducing Overdose Deaths Possible

Frontline experts like Berry attribute the overdose decline to several factors, including improved access to addiction treatments, increased availability of naloxone, and law enforcement's efforts to disrupt the fentanyl supply chain. I have emphasized the role of interventions, medication-assisted treatment initiation, and treatment retention. Treatment of OUD, while fraught with slips, relapses, and treatment discontinuation, works, and buprenorphine or methadone reduces morbidity and mortality.

Efforts to expand buprenorphine initiation to the emergency department have been successful at Yale's Department of Psychiatry, West Virginia University, and across the U.S. For example, more emergency room doctors in California are prescribing buprenorphine, contributing to the state’s battle against the U.S. opioid epidemic, a new study suggests. In this study, about 16% of the prescriptions written for buprenorphine in California came from an ER doctor, up from only 2% in 2017.

Today, board-certified American Society of Addiction Medicine (ASAM) specialist addiction practitioners are almost everywhere. In 2009, ASAM-ABAM was awarded its first addiction board certifications. In 2009, there were approximately 17,000 clinicians authorized to prescribe buprenorphine. By 2019, this number quadrupled to 68,000.

Other key initiatives reduced overdose deaths, especially changing payment by Medicaid, Medicare, and private insurers for medication-assisted treatment (MAT). Medicaid represents the largest commitment by the federal government to the treatment of people with opioid use disorder (OUD) and other types of substance use disorders (SUDs). About 39% of nonfatal overdoses in emergency departments were paid for by Medicaid, a majority of such visits among insured patients. The five states with the highest rates of Medicaid beneficiaries treated for OUD are West Virginia (7.5%), New Hampshire (7.5%), Maine (6.9%), Delaware (6.2%), and Maryland (6.2%).

One last factor: Regions hit the hardest by past waves of overdose deaths in West Virginia and Kentucky have lost so many users that deaths declined in part because fewer high-risk individuals remained alive.