WASHINGTON — Prescription opioid dispensing has declined significantly over the past decade, while prescriptions for medications used to treat substance use disorders have increased, according to a new federal analysis examining trends that coincide with a recent decline in overdose deaths.
The Trump administration says overdose deaths have fallen to their lowest level in a decade. A new analysis from the Office of the Assistant Secretary for Planning and Evaluation examines preliminary CDC data showing an age-adjusted overdose death rate of 689.2 deaths per 100,000 people in 2025.
An accompanying report, Two Opioid Policy Trends Are Moving in the Right Direction: Sustaining a Decade of Progress, examined pharmacy dispensing data from March 2015 through March 2026. Researchers found that, after adjusting for population changes:
- Opioid prescriptions dispensed fell to 45% of their March 2015 level.
- The total dosage of opioids dispensed fell to 35% of the baseline.
- The number of patients receiving prescription opioids through retail pharmacies fell to 50% of the baseline.
- The number of patients filling retail prescriptions for buprenorphine or naltrexone, medications used to treat substance use disorders, rose to 218% of the baseline.
Researchers caution that declining prescription opioid use alone does not explain the recent drop in overdose deaths.
“Earlier in the epidemic, diverted prescription opioids could be a relatively cheap and accessible source for nonmedical use. In the past dozen years, the economics of the market reversed as prescription opioids became more costly and difficult to obtain while illicit opioids—especially fentanyl—became cheaper, more potent, and easier to obtain,” the researchers wrote.
They said restricting access to prescription opioids can reduce unnecessary exposure, but some people may turn to illicit opioids instead, where the risk of overdose is higher.
The report describes the decline in prescription opioid dispensing as progress in reducing exposure and preventing misuse, but not as the only explanation for recent death trends.
Researchers also emphasized the role of public safety and efforts to disrupt the illicit drug supply. They warned that when the supply of illicit synthetic opioids remains readily available, fentanyl can remain inexpensive and highly potent, potentially limiting the effect of prescription policies on overdose deaths.
Despite the recent decline in deaths, federal officials are warning about the emergence of drugs that may be even more potent than fentanyl.
Cychlorphine may be up to 10 times more potent than fentanyl, according to federal officials. Standard fentanyl test strips cannot detect the drug, and an overdose may require multiple doses of naloxone, also known by the brand name Narcan, to reverse its effects.
The Drug Enforcement Administration warns that drug trafficking organizations frequently change the chemical formulas of illicit drugs to create substances that are more potent, addictive and profitable.
Earlier this year, the White House Office of National Drug Control Policy issued a national drug threat notice for cychlorphine, reporting that the drug had been linked to at least 55 deaths. It has been identified in states across all four U.S. Census regions, with the highest prevalence reported in Ohio, Texas and Tennessee.
