US overdose deaths fell, but not due to revival medication
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Researchers investigated why U.S. drug overdose deaths declined from around 111,000 per year at their peak in mid-2023 to under 71,000 per year by the end of 2025.
They initially considered that wider access to naloxone, a medication that reverses opioid overdoses, might be responsible for saving more lives. However, a study of emergency medical services agencies across the country revealed that responses to nonfatal overdoses and the use of naloxone itself both decreased.
Michael Barnett of Brown University School of Public Health and his team analysed almost 186 million emergency medical service activations from May 2020 to December 2025, finding that nonfatal opioid overdose calls fell by about 6,000 on average, roughly 33 percent below expectations, starting in May 2023. Naloxone administrations also dropped, falling around 4,700 below expected levels, or 21 percent.
The research indicates that the decrease in deaths wasn’t caused by more people being revived with naloxone, but rather by fewer overdoses occurring overall. The study did not track instances where bystanders administered naloxone without contacting emergency services. Barnett suggests changes to the illicit opioid supply, specifically disruptions in fentanyl availability, and a shrinking population at risk likely explain the downturn, but warns that supply-driven declines can be temporary as traffickers adapt.
