Shift in Overdose Death Rates Sparks Concern Over Future Actions
On May 14, 2025, the CDC’s Division of Overdose Prevention reported a significant 27% decrease in overdose deaths for 2024. This was quite a remarkable finding, especially after decades of unrelenting increases, claiming the lives of over a million Americans. Projections suggested that another million could die by the end of the decade. For over a year, the trend has shown a consistent monthly decline, particularly for deaths linked to illicit fentanyl—an especially tough issue due to its potency and ease of production and trafficking.
Curiously, on that same day, the new Secretary of Health and Human Services, Robert F. Kennedy Jr., testified before Congress without mentioning the overdose crisis or the recent positive developments. Just a week later, his agency released an extensive “Making America Healthy Again” report that didn’t even acknowledge opioids. Instead, he suggested dismantling the CDC along with other crucial agencies tackling the overdose problem. These proposals are part of the administration’s fiscal 2026 budget plan, which has passed the House and is now pending in the Senate.
Having spent nearly thirty years as a CDC scientist, I have been critical of the agency’s approach to the opioid crisis. However, I believe that dismantling the institutions working to protect public health isn’t the answer, especially now that we seem to be making progress. Ignoring such a pressing health issue shows a lack of interest in understanding the reasons behind the decline in deaths.
Among various national efforts, increasing access to naloxone (known as Narcan), an opioid overdose antidote, has been a key factor. Between 2021 and 2023, naloxone prescriptions from pharmacies doubled, with additional doses distributed by harm reduction organizations. In March 2023, the FDA approved an over-the-counter nasal spray version of naloxone.
By the end of that year, around 20 million doses had been dispensed. The decline in overdose deaths began shortly after the nasal spray became more widely available, although one must be cautious in attributing direct cause and effect in public health. Still, the easy administration of an antidote that costs just $25 to save a life is a notable step forward.
However, shortly after assuming his role in February 2025, Kennedy called for reduced funding for naloxone. He also proposed abolishing the National Institute on Drug Abuse (NIDA), which has contributed to naloxone’s development. NIDA’s ongoing research into safer opioid alternatives and early warning systems for illicit substances could be compromised. Remaining functions of NIDA may end up merged into a single entity focused on “behavioral health.”
Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA), a key funder of naloxone distribution, is also under threat, as is the CDC’s Division of Overdose Prevention—despite reporting the unprecedented drop in overdose deaths. Alarmingly, the CDC recently warned of a sharp rise in overdoses from carfentanil, an opioid far more potent than fentanyl. The remnants of SAMHSA and the CDC may be folded into a newly proposed “Agency for Healthy America.” Even if every bit of funding for the targeted drug control agencies were eliminated, it would hardly make a dent in the federal budget.
With these proposed changes, the new director of the Office of Management and Budget indicated that they would leave the federal workforce feeling “traumatically affected” and “villainized.” This raises a key question: If the agencies currently fighting the drug epidemic are dismantled, what would be the future of overdose rates? The last time the current president held office, overdose rates surged by over 44%, marking a tragic peak in American history. This time, if monitoring systems are removed, it may be impossible to tell if a similar pattern emerges. Those who lose loved ones to overdoses may find themselves wondering if 2025 became a turning point toward more American deaths.
