A new analysis is taking a closer look at what may be driving a reported drop in drug overdose deaths in the United States.
The Centers for Disease Control and Prevention reported a 13.9% decrease in overdose deaths in 2025. In response, Dr. Jeffrey Singer, a senior fellow at the Cato Institute, published an analysis examining possible reasons behind the decline.
Singer argues policymakers in Washington may try to take credit, but he says there is little evidence that enforcement strategies, such as targeting traffickers or increasing drug interdiction, are responsible.
He notes that if those efforts were significantly limiting supply, drug prices would likely rise. Instead, he writes that illicit markets continue to produce cheaper, more potent and easier-to-transport substances.
Singer points instead to several other factors, including shifts in how drugs are used, expanded harm-reduction efforts and increased access to naloxone, an overdose-reversal medication.
National surveys support broader behavioral changes. The federally funded Monitoring the Future survey has documented substantial long-term declines in adolescent use of cigarettes, alcohol and many illicit drugs.
Singer also cites research suggesting some users are moving away from injection drug use toward smoking substances, which may carry a lower overdose risk. A CDC study found that by 2022, smoking had surpassed injection as the most commonly documented method of drug use in overdose deaths, while injection-related deaths declined.
Additional research published in 2024 in the International Journal of Drug Policy found that people who inject fentanyl face a higher risk of overdose compared to those who primarily smoke it. Studies in San Francisco similarly found that users who switched from injecting heroin to smoking fentanyl described a slower onset, which may reduce overdose risk.
Public health efforts have also expanded in recent years. Many states now allow the distribution of fentanyl test strips, and some have authorized overdose prevention centers, although they are federally prohibited. The Food and Drug Administration has also approved over-the-counter sales of naloxone nasal spray, making the medication more widely available.
Singer says these combined factors may be playing a significant role in the decline.
While a drop in overdose deaths is welcome news, Singer says it’s important to keep the broader context in mind. The total number of deaths remains close to 2019 levels, figures that were considered high even before the most recent surge.
