NEW YORK (AP) — U.S. overdose deaths fell through most of last year, suggesting a lasting improvement in an epidemic that had been worsening for decades.
Federal data released Wednesday showed that overdose deaths have been falling for more than two years — the longest drop in decades — but also that the decline was slowing.
And the monthly death toll is still not back to what it was before the COVID-19 pandemic, let alone where it was before the current overdose epidemic struck decades ago, said Brandon Marshall, a Brown University researcher who studies overdose trends.
“Overall I think this continues to be encouraging, especially since we're seeing declines almost across the nation,” he said.
Overdose deaths began steadily climbing in the 1990s with overdoses involving opioid painkillers, followed by waves of deaths from heroin and — more recently — illicit fentanyl. Deaths peaked nearly 110,000 in 2022, fell a little in 2023 and then plummeted 27% in 2024, to around 80,000. That was the largest one-year decline ever recorded.
The new Centers for Disease Control and Prevention data runs through August 2025 and represents the first update of monthly provisional drug overdose deaths since the federal government shutdown.
An estimated 73,000 people died from overdoses in the 12-month period that ended August 2025, down about 21% from the 92,000 in the previous 12-month period.
CDC officials reported that deaths were down in all states except Arizona, Hawaii, Kansas, New Mexico and North Dakota. But they noted it's likely that not all overdose deaths have been reported yet in every state, and additional data in the future might affect that state count.
Researchers cannot yet say with confidence why deaths have gone down. Experts have offered multiple possible explanations: increased availability of the overdose-reversing drug naloxone, expanded addiction treatment, shifts in how people use drugs, and the growing impact of billions of dollars in opioid lawsuit settlement money.
Some also point to research that suggests the number of people likely to overdose has been shrinking, as fewer teens take up drugs and many illicit drug users have died.
Two other theories recently joined the list.
In a paper published last week in the journal Science, University of Maryland researchers point to the drug supply. They say regulatory changes in China a few years ago appear to have diminished the availability of precursor chemicals used to make fentanyl.
Their argument is based partly on information from the U.S. Drug Enforcement Administration, which last year reported that the purity — and dangerous potency — of fentanyl rose early in the COVID-19 pandemic but fell after 2022. It suggests it became harder to make fentanyl and its potency was diluted.
One piece of evidence for that: More U.S.-based Reddit users reported a fentanyl “drought” in 2023.
The authors connect that to signs that the Chinese government — at the urging of U.S. officials — took steps in 2023 to clamp down on the selling of substances used to make drugs. Information is limited on exactly what the Chinese government did, and the paper is a bit speculative, but “we thought we could make a case,” said Peter Reuter, one of the authors.
The recent deceleration of overdose deaths could be because producers in Canada and Mexico found alternative sources, Reuter and his colleagues think.
Their paper drew inspiration from a team of University of Pittsburgh researchers, who earlier concluded that regulatory changes in China concerning the drug carfentanil were an important explanation for a dip in U.S. overdose deaths in 2018.
Those same Pittsburgh researchers — Dr. Donald Burke and Dr. Hawre Jalal — are now focused on another theory for what's happened to overdose deaths. In a paper published last week in the International Journal of Drug Policy, they say overdose trends may be at least partly tied to federal stimulus checks sent out during the COVID-19 pandemic.
The researchers tracked the three rounds of pandemic stimulus payments to U.S. households in 2020 and 2021, and saw surges in overdose deaths after each one.
That money alleviated economic hardship for many families, but some of it also helped people pay for illicit drugs, the Pittsburgh researchers say. And the end of those payments helps explain why overdoses stabilized in 2022 and began falling afterward, they say.
Both arguments seem to have merit, though they do not prove causation, said Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco.
“I personally think it's more complicated,” with those partial explanations layering on other trends, he said.
The Maryland and Pittsburgh researchers raised questions about whether Trump administration policies could slow momentum.
They noted relations between the U.S. and China strained last year when Trump placed sharply higher tariffs on imports from China, and speculated China might ease efforts to police fentanyl precursors.
They also noted Trump has promised a $2,000 check to Americans to help offset the rising prices resulting from tariffs placed on China. Those checks could cause some drug users to splurge and overdose, said Burke, who urged federal officials to think through how the money is disbursed.
Meanwhile, the Trump administration this week canceled some 2,000 grants in a move expected to jeopardize programs that provide mental health and drug treatment and prevention services.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
FILE - This Tuesday, April 1, 2025 photo shows the Centers for Disease Control and Prevention building in Atlanta. (AP Photo/Ben Gray, file)
FILE - Jonathan Dumke, a senior forensic chemist with the Drug Enforcement Administration, holds vials of fentanyl pills at a DEA research laboratory on Tuesday, April 29, 2025, in Northern Virginia. (AP Photo/Mark Schiefelbein, file)
It's not just about sending federal law enforcement officers into Minnesota.
President Donald Trump's administration is also lashing out at the state by threatening to withhold billions in federal money, much of it intended to help low-income families with food aid, health care and child care — and with a new lawsuit against the state.
Trump's administration has struck out at Democratic-run states broadly, but it's made a prime example of Minnesota, where the president last month called the state's Somali population “garbage," targeting it with actions not seen elsewhere.
The administration has not spelled out its exact plans in most cases, and it's not clear if some of the money will actually stop flowing — or, if so, when.
Trump's administration has unleashed a wave of threats to halt the flow of some federal funds to other states, too — including federal funds to “sanctuary cities” that limit cooperation with federal immigration officials and their states.
Minnesota has been singled out in some cuts as Trump repeatedly criticizes Gov. Tim Walz over fraud in federal programs. Walz, the 2024 Democratic vice presidential nominee and a high-profile Trump critic, ended his campaign this month for a third term, saying he couldn't run a campaign while fending off the attacks and running the state.
Minnesota is pushing back in courts or otherwise.
Here's a look at the planned freezes in Minnesota.
The Agriculture Department said it’s freezing funding in the state and its largest city, Minneapolis — but without laying out many details. Agriculture Secretary Brooke Rollins said in a social media post Jan. 9 announcing the action: “No more handouts to thieves!”
In a letter to Walz and Minneapolis Mayor Jacob Frey, she cited a major fraud case involving a USDA-funded pandemic relief program that broke in 2022 in which 78 people have been charged — and 57 convicted.
Rollins said she was suspending all current and future awards to the city and state and told them to provide payment justifications for all transactions since Jan. 20, 2025, the day Trump returned to office. The justifications would be required to receive future money, too.
Rollins said the awards at risk total more than $129 million but did not specify which programs are included. Her department has not clarified whether the amount includes payments that go to individuals, or just those to government entities.
Based on the figure from Rollins, the freeze would not appear to include funds for the Supplemental Nutrition Assistance Program, which helps about 1 in 12 Minnesota residents buy groceries. Minnesota residents received more than $850 million through that program in 2024. Still, a Minnesota Department of Children, Youth and Families website says the department is analyzing any impacts to SNAP.
It also appears the National School Lunch Program, which provides and subsidizes school meals, is not included. Minnesota was expected to receive more than $240 million in that program in the budget year that ended Sept. 30.
The Agriculture Department also runs programs aimed at food producers, including disaster aid and price supports.
Minnesota Agriculture Commissioner Thom Peterson said at a news conference Wednesday that it's not clear exactly which programs might lose funding, but the state has started receiving notices from some pauses, including to a University of Minnesota poultry testing lab. He said that leaves uncertainty about who would pay if avian influenza is found at a farm and birds must be removed.
The Centers for Medicare and Medicaid Services also told Minnesota last week that it intends to withhold $515 million every three months from 14 Medicaid programs that were deemed high risk after rejecting a corrective action plan the federal government demanded because of fraud allegations.
The programs identified as high risk include adult companion services, residential treatment services and nonemergency medical transportation.
The amount to be withheld is equivalent to one-fourth of the federal money for those programs.
On a call with reporters Tuesday, state Department of Human Services said they were mounting an administrative appeal to the freeze.
They said the department has been emphasizing anti-fraud measures for more than a year and questioned the federal action, which they said is unlike anything they've found in other states.
“Minnesota cannot absorb the loss of more than $2 billion in annual funding for these programs without catastrophic consequences for the people we serve,” Temporary Human Services Commissioner Shireen Gandhi said, adding that the state can’t find other examples of similar federal decisions.
“It's not corrective action,” she said. “It's a punitive action.”
The U.S. Department of Health and Human Services told Minnesota in late December that it was freezing funds in the child Care and Development Block Grant, which subsidizes child care for low-income families, telling the state that it had to submit attendance records and other information before the money would flow again.
Last week, the Trump administration said it was halting payments of the child care money, along with temporary aid for Temporary Assistance for Needy Families, which provides job training and cash assistance, and the Social Services Block Grant, which funds a variety of social services, for Minnesota and four other states where Democrats lead the government.
The five states — along with Minnesota, California, Colorado, Illinois and New York — sued. Advocates and officials warned that stopping the childcare subsidy would put many daycare providers at risk of layoffs of closures. And those could put the families of all their clients in binds, not just those who rely on the subsidies.
Last week, a federal judge ruled that the administration cannot block the money for now.
The federal administration on Wednesday unleashed another line of attack on the Minnesota state government.
The U.S. Department of Justice sued the state government in federal court over its affirmative action hiring requirements. The lawsuit seeks to end programs intended to diversify the government workforce, claiming “Minnesota requires its hiring managers to jump through additional hoops to hire employees with disfavored skin colors or sex chromosomes."
The lawsuit also seeks money for employees and prospective employees who were impacted.
The state attorney general's office said it would respond in court.
A person confronts a U.S. Border Patrol officer Wednesday, Jan. 14, 2026, in Minneapolis. (AP Photo/Adam Gray)
Gov. Tim Walz speaks during a news conference on Tuesday, Jan. 6, 2026 at the Coliseum Building in Minneapolis. (Alex Kormann/Star Tribune via AP)
President Donald Trump delivers remarks to the Detroit Economic Club at the MotorCity Casino Hotel, Tuesday, Jan. 13, 2026, in Detroit. (AP Photo/Evan Vucci)
