The story of Hamilton County, Ohio, which includes Cincinnati, is the story of much of the nation in 2025. Deaths from drug overdoses have fallen sharply, offering hope the crisis will further ease.
As in many communities ravaged by the opioid crisis, users are adapting to an evolving illicit drug supply dominated by potent fentanyl and often mixed with other synthetic drugs. Lifesaving antidotes flood the streets, and teams swoop in to offer services to people who have overdosed, the Washington Post reports.
For outreach worker Sarah Coyne of the Hamilton County Quick Response Team, the trends are gratifying but bittersweet. She focuses on users deemed high priority because they have overdosed repeatedly. Coyne, a 35-year-old mother of two who struggled with addiction more than a decade ago, has spent years building trust with wary users. At first, many cursed her or slammed doors in her face.
She spends hours on the phone or in person with people manacled to addiction or with worried family members. Sometimes, she is the only one to visit clients in the hospital — or go to funerals when they fatally overdose. Coyne estimates she has attended two dozen in the past year and a half.
Across the nation, drug deaths fueled primarily by illicit fentanyl reached staggering heights by 2023, topping 100,000 for the third straight year. In the 12-month period ending in August, deaths had decreased by more than 20 percent from the same period the previous year, according to provisional state data published by the Centers for Disease Control and Prevention.
Government officials, researchers and public health organizations have puzzled over the reasons but speculate a decline in deaths represents a confluence of factors that vary regionally.
The Biden administration made Narcan, a nasal spray version of the overdose-reversal medication naloxone, available without a prescription and broadened access to medications to treat opioid addiction. Officials touted crackdowns on Mexican criminal groups that manufacture fentanyl and Chinese companies that supply them with chemicals needed to make the opioid.
President Trump has emphasized a tough-on-crime approach to the illicit fentanyl trade — and on Saturday imposed steep tariffs on Canada and Mexico, claiming they are not doing enough to stop the flow of drugs into the United States. A White House official told reporters that tariffs might be lifted when Americans “stop dying” from fentanyl.
Health departments and community groups that focus on drug abuse worry they might face slashed federal funding as part of the administration’s quest to overhaul spending.
The lethal force of fentanyl has so diminished the population of users that there aren’t as many people left to succumb to drugs, some experts say. That is happening at the same time that the number of new opioid users is plummeting, said Tse Yang Lim, an epidemiologist at the Harvard T.H. Chan School of Public Health, who led a team that predicted the decline in overdose deaths.
According to the estimate, by 2030, the nation could still record more than 50,000 opioid deaths each year, roughly the number of Americans killed during the Vietnam War.
“Just because overdose deaths are declining, it isn’t necessarily a sign of success,” Lim said. “We can’t take credit for the fire going out if it goes out because the house has burnt down.”