Opioid-related deaths in the United States have fallen to their lowest level since 2017, when the federal government declared the opioid crisis a public health emergency, the Department of Health and Human Services (HHS) said on October 27. Secretary Robert F. Kennedy Jr. announced the findings in Detroit, citing a new analysis from the department’s Office of the Assistant Secretary for Planning and Evaluation.
The HHS report, titled “The U.S. Age-Adjusted Death Rate Reached a Record Low in 2025: What Drove the Decline?”, credits a mix of policies pursued across President Donald Trump’s two terms: reducing unnecessary opioid prescribing, disrupting the fentanyl supply chain and expanding treatment and recovery services. “Those actions are saving lives and driving opioid deaths to the lowest in nearly a decade,” Kennedy said at the Detroit event, held at the Detroit Wayne Integrated Health Network.
Opioid prescribing cut by more than half
Prescription opioid exposure has fallen steeply over the past decade. The companion analysis, “Two Opioid Policy Trends Are Moving in the Right Direction: Sustaining a Decade of Progress,” tracked dispensing over 11 years and found prescriptions at less than half their 2015 level by March 2026. HHS presented the drop as evidence that prescribing controls put in place over that period have held.
The public health emergency was declared in October 2017, when the overdose death rate stood at 21.9 deaths per 100,000 people, according to a Northwestern University analysis of federal data. Today’s rate is lower than it was on the day of that declaration, though the same analysis noted that lower does not mean low, and the country remains in territory once considered catastrophic. The emergency declaration itself did not end the crisis, but it framed the federal response that followed, from prescribing guidelines to treatment funding and enforcement against illicit supply.
What drove the opioid decline
The fall in deaths is part of a longer turn that began in May 2023, after three decades of rising overdose mortality. Preliminary federal data put total drug overdose deaths in 2025 at about 70,000, around 14 percent fewer than the year before and roughly the same as the 2019 total. It was the third straight annual drop, the longest decline in decades, with falls recorded across fentanyl, cocaine and methamphetamine deaths and in the vast majority of states.
Researchers are still debating what explains the turn. A research letter published in JAMA, based on records from 5,324 emergency medical services agencies, found that naloxone use did not rise relative to the number of overdoses, which challenges the idea that wider availability of the overdose-reversing drug explains most of the fall. Michael Barnett, a researcher at the Brown University School of Public Health and a co-author of the study, said a disruption in the fentanyl supply best explains how sudden and widespread the change was, while warning that a supply-driven decline can reverse.
Fentanyl, which the administration has said is in the alleged drug boats, typically comes into the United States through the United States-Mexico border in passenger vehicles, according to Government Accountability Office reports cited by USNI News. Supplies often come from China, the same reports said. That route differs from the sea routes used by the vessels struck in the Caribbean and the Eastern Pacific, a point raised by critics of the campaign.
Opioid deaths remain high despite the fall
The improvement has limits. Seven states saw at least slight increases in overdose deaths in 2025, including rises of 10 percent or more in Arizona, Colorado and New Mexico. The decline also slowed during 2025, and the monthly death toll is still above where it stood before the COVID-19 pandemic. Brandon Marshall, a Brown University researcher who studies overdose trends, said he was cautiously optimistic that the change represents a real shift in the arc of the crisis, but added that deaths can rise just as fast if attention slips.
Kennedy said the department will keep pressing forward until every American struggling with addiction has a real path to recovery and a chance to rebuild a healthy life. The ASPE analysis and the Health Affairs Forefront article were released together on October 27, with the announcement event held in Detroit.