White zigzag arrow pointing downward on a dark background, symbolizing a decline.
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What you need to know

  • Many experts point to wider access to naloxone, a medication that can reverse an opioid overdose, as a major reason overdose deaths are declining.
  • Other factors may include expanded access to treatment, changes in the fentanyl supply, fewer opioid prescriptions, and shifts in how people use drugs.
  • Experts caution that progress could stall or reverse if the drug supply becomes more dangerous again or prevention and treatment programs lose funding.

On May 13, the Centers for Disease Control and Prevention released provisional data showing overdose deaths declined in 2024. It was the third consecutive year overdose deaths fell—the longest sustained decline the U.S. has seen in decades.

Still, experts say there’s no single explanation for the shift.

“I would caution attributing the decline to any single factor,” Dr. Bennett Allen, a substance use policies and programs expert and assistant professor at New York University, tells Public Good News. Instead, Allen says a mix of “drug market changes, alongside increased availability of evidence-based treatment and preventive services” is likely driving the trend.

Here’s what experts say may be contributing to the decline in overdose deaths, and why they warn the progress could still be fragile.

Naloxone

Most experts credit the decline in overdose deaths to the availability of naloxone, often sold as Narcan.

“Naloxone is a crucial tool to prevent fatal overdoses,” Allen explains. “There have been tremendous efforts nationally to expand access to naloxone—not only among public health, health care, and public safety professionals, but also for the general public, so that people can keep their communities safe.”

Naloxone can quickly reverse an opioid overdose and is designed to be used by anyone, even without medical training. Instructions are included in the package, and free online trainings are also available.

Many local health departments and community organizations offer naloxone for free, sometimes by mail. It’s also sold over the counter at pharmacies, grocery stores, convenience stores, and other retailers.

Better access to medications for opioid use disorder

Medications for opioid use disorder (sometimes called MOUD) can help people stop or reduce opioid use and lower the risk of overdose. These medications include methadone, buprenorphine, and naltrexone. A 2025 JAMA study found prescriptions for methadone and buprenorphine among Medicaid enrollees increased sharply between 2010 and 2020, a trend researchers say may have contributed to declining overdose deaths.

Even so, many people still face barriers to treatment, including cost, stigma, and shortages of health care providers. The study noted that only 25 percent of people with OUD receive medication treatment, though some research suggests the gap may be even larger.

Changes in the drug supply

Fentanyl, a powerful synthetic opioid, is linked to most overdose deaths in the U.S. But some organizations that test street drugs report that illicit fentanyl may be less potent than it was several years ago. Researchers are still studying how much that shift may be affecting overdose rates.

Even weaker fentanyl can still be deadly.

Fentanyl test strips can help people check whether fentanyl is present in drugs, though the strips are not legal in every state. Community programs sometimes provide them for free, and they’re also available online.

Fewer opioid prescriptions

Over the past several years, opioid prescribing rates in the U.S. have dropped substantially. Between 2019 and 2024, the rate of opioid prescriptions per 100 people declined by more than a third. Some experts believe that may have reduced  the number of people exposed to prescription opioids or using them in ways other than prescribed.

Still, anyone can develop opioid use disorder or experience an overdose, including people taking medication exactly as prescribed.

New trends in drug use

Research suggests young people today are using both legal and illegal substances at lower rates than previous generations. Some researchers have also found that certain people who use drugs have shifted from injecting substances to smoking them, which may lower their overdose risk.

At the same time, overdose risk remains uneven across communities.

In 2024, opioid overdose death rates were highest among adults ages 26 to 64, American Indian/Alaska Native adults, Black adults, and men. Older adults and people who combine opioids with other substances also face elevated risks.

What’s next?

Experts say the recent decline in overdose deaths is encouraging, but far from guaranteed to continue.

“First, the drug supply [could] become more lethal again, due to fentanyl or other emergent substances or adulterants [like] medetomidine,” Allen explains. “Second, stimulant-involved overdose deaths remain a serious concern. Third, threats to public health and health care infrastructure, including reduced funding for evidence-based treatment and prevention interventions, could limit our capacity to build on recent declines in deaths.”

For now, experts say individuals can help by carrying naloxone, learning how to respond to an overdose, and supporting access to treatment and prevention resources in their communities.

Helpful resources

This article was supported by Life Unites Us, a health campaign that receives funding from the Pennsylvania Department of Drug and Alcohol Programs. Public Good News retains full editorial control over its reporting.