For the first time in a long time, more people are making it home for the holidays instead of being remembered at vigils. After years of devastating loss, overdose deaths in the United States are finally falling—and at a pace we haven’t seen in decades. Early data from the Centers for Disease Control and Prevention (CDC) suggest a nearly 25% decline in overdose deaths for the twelve months ending in April 2025.

This turnaround isn’t an accident. It reflects thousands of quiet, everyday actions: a pharmacist stocking naloxone, a clinic starting buprenorphine treatment, a parent learning to respond to an overdose, a lawmaker choosing to fund harm-reduction services instead of cutting them. But this progress is fragile. Many of the programs that make it possible depend on funding that Congress must renew—or risk watching the numbers climb again.

This page walks through what’s working, the science behind it, the stakes in Congress right now, and realistic, practical steps you, your community, and policymakers can take to keep turning this crisis around.


Protesters holding signs about the opioid crisis and OxyContin accountability
Public pressure and policy reform around opioid prescribing and pharmaceutical accountability helped set the stage for today’s decline in overdose deaths.
Doctor speaking compassionately with a patient in a clinic
Compassionate, evidence-based treatment is a key reason more people are surviving overdose and staying connected to care.

From Relentless Climb to Real Decline: Where the Overdose Crisis Stands

For years, overdose trends felt brutally predictable: each new report brought another record high. Families, clinicians, first responders, and people who use drugs were exhausted and grieving. Against that backdrop, a nearly 25% decline in overdose deaths over a twelve‑month period is extraordinary.

While final numbers from the CDC will take time to confirm, provisional data point in one direction: fewer people are dying of drug overdoses than in recent years. Many communities report:

  • Fewer fatal overdoses in emergency departments.
  • Increased use of medications for opioid use disorder (MOUD), like buprenorphine and methadone.
  • More naloxone kits distributed and more overdoses reversed in the community.
  • Stabilizing or declining rates of fatal fentanyl overdoses in some regions.

What’s Actually Working? The Evidence Behind the Turnaround

No single policy or pill can explain a 25% decline. Instead, evidence points to a combination of strategies that, together, create a safety net strong enough to catch more people before they die.

1. Expanded Access to Treatment That Works

The strongest evidence we have for reducing opioid overdose deaths is medications for opioid use disorder (MOUD)—especially buprenorphine and methadone. A large body of research shows:

  • MOUD can cut the risk of fatal overdose by roughly half or more while people remain in treatment.
  • People on MOUD are more likely to stay engaged in care, work, and family life.
  • Recent reforms have made it easier for primary care providers to prescribe buprenorphine.
“Medications for opioid use disorder are the gold standard of care. Expanding access to them is one of the most powerful tools we have to prevent overdose deaths.” — Summary of consensus from CDC, SAMHSA, and the National Academies

2. Harm Reduction: Keeping People Alive Long Enough to Choose Recovery

Harm reduction isn’t about endorsing drug use. It’s about accepting reality: people will continue to use drugs, and our first moral obligation is to keep them alive. Growing evidence supports:

  • Naloxone distribution: Wider availability in pharmacies, community organizations, and even vending machines has led to tens of thousands of overdose reversals.
  • Fentanyl test strips: Helping people identify contaminated supplies and use more cautiously.
  • Syringe service programs: Reducing infections, offering testing, and often serving as an entry point into treatment.

3. Policy Shifts and Funding Streams

Federal and state investments—often through opioid settlement funds and congressional appropriations—have allowed communities to:

  1. Launch new treatment programs in hospitals, jails, and primary care settings.
  2. Train first responders and laypeople in overdose recognition and naloxone use.
  3. Support housing, peer recovery coaches, and wraparound services.

What This Looks Like in Real Life: A Case Study

Consider a mid‑sized Midwestern city that, five years ago, had one of the highest overdose death rates in its state. Emergency rooms were overwhelmed, and local news regularly covered fatal clusters linked to fentanyl‑laced pills.

With a combination of state grants and federal funding, the city launched a coordinated effort:

  • A 24/7 “bridge clinic” where anyone could walk in after an overdose and start buprenorphine the same day.
  • Peer recovery coaches embedded in the ER and local jail.
  • Free naloxone and fentanyl test strips distributed through libraries, shelters, and faith communities.
  • Police officers trained to treat overdose as a health emergency first, not primarily a criminal issue.

Within three years, the city’s fatal overdose rate dropped by more than a third. People still overdosed—but more survived, more entered treatment, and more reconnected with families in time for holidays that might otherwise have been memorials.

Community health outreach worker talking with a person on the street
Community‑based outreach—often led by peers with lived experience—helps bridge the gap between the street, the clinic, and long‑term recovery.

Why This Success Is at Risk Unless Congress Acts

Many of the treatment and harm‑reduction options behind the current decline in overdose deaths rely on federal funding and policy protections. Without timely action by Congress, states and local communities could face:

  • Funding cliffs for programs that provide MOUD, housing supports, and peer services.
  • Reduced flexibility to use federal dollars for harm‑reduction services like naloxone or fentanyl test strip distribution.
  • Disruptions in Medicaid coverage for low‑income people with substance use disorders if key provisions lapse.

Historically, when public‑health funding has been cut—or allowed to stagnate—the gains made in areas like HIV prevention and mental health have stalled or reversed. There is no reason to think overdose trends would be different.

“We are finally bending the curve on overdose deaths. Pulling back support now would be like taking away a life jacket just as someone reaches the surface of the water.”

If You Love Someone Who Uses Drugs: Evidence‑Based Ways to Help

Living through the overdose crisis as a parent, partner, or friend can be terrifying and exhausting. You cannot control every choice your loved one makes—but you can stack the odds in their favor with a few practical, research‑supported steps.

  1. Keep naloxone on hand—and know how to use it.
    Ask your pharmacist, local health department, or harm‑reduction group how to get naloxone (often free). Practice using it with training devices or videos so you’re less likely to freeze in an emergency.
  2. Encourage medication‑based treatment, not just detox.
    Short‑term detox without follow‑up MOUD is associated with a higher risk of overdose because tolerance drops. When they’re ready, help your loved one find a provider who offers buprenorphine or methadone.
  3. Use non‑judgmental language.
    Shifting from “addict” to “person with a substance use disorder” might seem small, but stigma is a powerful barrier to seeking help. Calm, respectful conversations make it safer to be honest about use.
  4. Plan for high‑risk moments.
    Overdoses are more likely after jail release, detox, or a period of abstinence. Make sure naloxone is available, and try to check in more frequently during these windows.
  5. Take care of yourself, too.
    Support groups for families (such as those modeled after Al‑Anon or SMART Recovery Family & Friends) provide tools and emotional support so you don’t burn out.
Family and friends sitting together and offering emotional support
Strong, non‑judgmental relationships can be a protective factor against overdose and are often a bridge into treatment.

What Communities and Policymakers Can Do Right Now

While federal policy sets the stage, local decisions determine how people experience the overdose crisis day to day. Whether you’re a community leader, clinician, or engaged resident, you can push for changes that are both humane and evidence‑based.

Concrete Community‑Level Steps

  • Normalize naloxone everywhere: Encourage schools, workplaces, theaters, and bars to keep naloxone in first‑aid kits, just like AEDs.
  • Partner with peers: Fund and integrate peer recovery specialists into hospitals, jails, shelters, and outreach teams.
  • Support low‑barrier treatment: Advocate for same‑day MOUD starts and telehealth options where appropriate.
  • Track and share data: Use real‑time overdose dashboards (where available) to target outreach and resources.

Policy Priorities for Lawmakers

  • Extend and expand funding for evidence‑based overdose prevention and treatment programs.
  • Protect and enhance Medicaid coverage for substance use and mental health services.
  • Remove remaining barriers to prescribing MOUD, especially in primary care and rural settings.
  • Ensure opioid settlement funds are directed toward interventions with a proven track record, not one‑time, low‑impact projects.

Before & After: How Our Overdose Response Has Changed

To appreciate how far we’ve come—and how far we still have to go—it helps to compare the early years of the crisis with today’s emerging best practices.

Then

  • Overdoses often treated purely as criminal justice issues.
  • Limited access to MOUD; many areas with no waivered prescribers.
  • Naloxone restricted or expensive, with little public awareness.
  • High stigma toward people who use drugs, even in healthcare settings.

Now (Where Progress Is Being Made)

  • Growing recognition of overdose as a public‑health emergency.
  • Expanded MOUD access through primary care and telehealth.
  • Naloxone increasingly available without a prescription and often free.
  • More trauma‑informed, stigma‑aware care in clinics and hospitals.
First responders now more often carry naloxone and connect patients to follow‑up care, rather than treating overdose as a one‑time event.

Holding On to Hope—And to Each Other

The drop in overdose deaths we’re seeing now does not erase the grief of the past two decades. It doesn’t reach every community equally, and it doesn’t mean the crisis is “over.” But it does mean something profoundly important: what we’re doing is starting to work.

More people are surviving. More are making it to treatment. More are sitting around holiday tables who might otherwise have been missing. Those lives are the result of deliberate choices—by families who learned to use naloxone, by clinicians who prescribed MOUD, by community workers who showed up on street corners, and by policymakers who chose to fund health instead of despair.

The next chapter is not guaranteed. Keeping this progress going will require:

  • Individuals and families staying informed, prepared, and compassionate.
  • Communities investing in harm reduction and low‑barrier treatment.
  • Congress acting to protect and expand the programs that are saving lives.

If you take one step today, let it be this: learn where to get naloxone in your area and how to use it, then share that information with at least one other person. Small, concrete actions—multiplied across millions of households—are exactly how we turn an overdose crisis into a story of survival.