While the United States saw encouraging signs with a decline in fentanyl-related deaths between April 2024 and April 2025, the nation’s drug crisis is far from over. Hundreds of people continue to die each day from illicit substances, and new research shows that one in four children in the U.S. lives with a parent who struggles with addiction.
As substance use disorder continues to impact millions of families, authorities are tracking new drugs entering the illicit market, and researchers are exploring new ways to prevent relapse and treat addiction.
In 2025, both the Drug Enforcement Administration and the Food and Drug Administration issued multiple alerts warning about emerging substances increasingly found in the U.S. drug supply.
Among them are nitazenes, a class of synthetic opioids similar to fentanyl but potentially even more potent. According to the DEA, nitazenes are showing up more frequently in counterfeit pills and mixed substances. Emily’s Hope has reported on a sharp rise in nitazene-linked deaths nationwide.
Another growing concern is bromazolam, often referred to as “designer Xanax.” The DEA says bromazolam is commonly used in counterfeit alprazolam tablets and is largely sourced through overseas chemical suppliers, primarily in China and India, where kilogram quantities are advertised online.
The DEA also issued a warning this year about the return of carfentanil, a synthetic opioid originally developed as a tranquilizer for large animals such as elephants. Authorities say carfentanil is now appearing in street pills and has been linked to a growing number of overdose deaths. In Michigan alone, the Department of Health and Human Services confirmed 11 deaths tied to carfentanil between January and June 2025.
Law enforcement agencies also warned the public about unusually colored fentanyl appearing in multiple states. Authorities in Louisiana described “green fentanyl,” which ranges from light to dark green and can resemble sidewalk chalk, gel or tar. Officials warned it could easily be mistaken for less potent drugs.
Days after Omaha police warned about “purple fentanyl,” authorities in Johnson County, Missouri, reported seizing the substance as well. Officials say the purple coloring is likely a marketing tactic rather than an indicator of a specific chemical mixture.
In some cases, purple fentanyl may be mixed with lidocaine, a local anesthetic that does not respond to naloxone, meaning Narcan may be ineffective in reversing its effects.
“The purple color is likely a marketing ploy to attract more users,” the Johnson County Sheriff’s Office said in a social media post.
The FDA also issued warnings in 2025 about substances being marketed as legal supplements or wellness products. That includes tianeptine, sometimes referred to as “gas station heroin,” which has been linked to comas, respiratory depression and death. Despite not being approved for any medical use, tianeptine products are often sold online, at gas stations and in convenience stores under names such as Tianaa, Zaza, Neptune’s Fix, Pegasus and TD Red.
The agency has also recommended classifying 7-hydroxymitragynine, or 7-OH, as a controlled substance. The compound is a concentrated byproduct of kratom that binds to opioid receptors and has a high potential for abuse. The FDA emphasized the recommendation targets synthetic or concentrated forms of 7-OH — not natural kratom leaf products.
“Vape stores are popping up in every neighborhood in America, and many are selling addictive products like concentrated 7-OH,” FDA Commissioner Dr. Marty Makary said. “7-OH is an opioid that can be more potent than morphine. We need regulation and public education to prevent another wave of the opioid epidemic.”
Concerns about unregulated products also surfaced in South Dakota, where Attorney General Marty Jackley announced indictments against five smoke shops accused of selling illegal drug products. Among the items cited were mushroom chocolate bars labeled with a “proprietary mushroom blend” and disclaimers stating they were not FDA-approved.
In late 2024, the FDA warned consumers to avoid edibles containing Amanita muscaria mushrooms, concluding the compounds “do not meet the safety standard for use in food and may be harmful.”
Meanwhile, nicotine products continue to evolve. The World Health Organization estimates more than 100 million people worldwide now vape. Nicotine pouches are also gaining popularity, particularly among teens. A University of Southern California study of more than 10,000 high school students found teen use of nicotine pouches nearly doubled from 3% in 2023 to 5.4% in 2024.
As authorities track the changing drug landscape, researchers are making progress in understanding addiction and recovery.
Several studies published this year linked extreme stress, anxiety and depression with a higher risk of developing substance use disorder. Other research identified a brain circuit associated with alcohol relapse, focusing on activity in the paraventricular nucleus of the thalamus.
“This brain region just lit up in every rat that had gone through withdrawal-related learning,” said Hermina Nedelescu of Scripps Research. “It shows us which circuits are recruited when the brain links alcohol with relief from stress.”
Researchers are also exploring whether medications developed for other purposes could help treat addiction. A study published in JAMA Psychiatry found that semaglutide, the active ingredient in Ozempic, reduced alcohol cravings, lowered the number of drinks consumed and decreased episodes of heavy drinking. The findings build on earlier research suggesting similar medications may help treat opioid use disorder.
Marijuana also remained in the spotlight in 2025. New research suggests the risks of medical cannabis may outweigh the benefits for many conditions. Clinical benefits were found primarily in FDA-approved cannabinoid medications for limited uses, such as chemotherapy-related nausea, appetite loss in HIV/AIDS patients and certain pediatric seizure disorders.
For many other conditions, including chronic pain, evidence remains insufficient, and cannabis is not recommended as a first-line treatment.
President Donald Trump also signed an executive order directing federal agencies to expedite the reclassification of marijuana from Schedule I to Schedule III under the Controlled Substances Act. The administration said the move is intended to expand research into marijuana and CBD, not to legalize the drug.
Despite advances in research and treatment options, access to care remains a major challenge. A recent study found that most U.S. adolescents with cannabis use disorder do not complete treatment. Researchers analyzing data from more than 40,000 adolescents found only about 35% finished treatment programs.
Emily’s Hope continues working to close that gap, providing treatment scholarships that have helped 260 people access care.
