American overdose deaths went from 16,849 in 1999 to 107,941 in 2022 — more than six times as many in twenty-three years, with the steepest acceleration after illicit fentanyl entered the supply in 2013, and the single largest one-year rise in 2020. Then it turned: down 26.2% in 2024, the largest one-year fall on record, and lower again in 2025. Both directions belong in the record, and the reversal is the more unusual event — this is a curve that had only ever gone one way. But it runs down from a peak that did not exist a generation ago. Provisional 2025 is still roughly four times the 1999 count. A chart that began at the peak would show only the good news; a chart that stopped at the peak would show only the bad.
- CDC/NCHS 1999–2024 final, 2025 provisional: 16,849 → 107,941 (2022 peak) → 69,973
- 2020: +30.0% on 2019, the largest single-year rise in the series
- 2024: −26.2%, the largest percentage fall across 2014–2024
- CDC attributes the decline to naloxone distribution, treatment access, supply shifts and renewed prevention — recorded as an attribution, not adopted as a finding
Open questions
- The 2025 figure is provisional and will revise upward. Measured against CDC's provisional 2024 estimate the fall is almost 14%; against the final 2024 count, about 11.9%. Both are published; they compare different vintages of the same year.
Topics: Proposed solutions · Health & physical effects