Sixty-nine thousand, nine hundred and seventy-three. That’s the number of people who died of a drug overdose in the United States in 2025.
69,973 people is enough to fill every seat in Yankee Stadium and Madison Square Garden at the same time and still have folks get turned away at the door. It is more than the populations of Portland, Maine, Canton, Ohio, or Gary, Indiana. If you break up unintentional injury deaths into its component parts, it’s enough to be the 7th leading cause of death in the US in 2025, and the leading cause of death among those between the ages of 25 and 44.
And yet, we offer begrudging gratitude because those 69,973 overdose deaths were 11,340 deaths fewer than the year before, and almost 38,000 fewer than the year before that. The cause and effect behind that steep decrease in overdose deaths is hard to identify and even harder to explain, but it’s safe to say that the drop was due to a combination of factors including a changing drug supply, increased access to treatment and recovery services, the work of harm reduction organizations, and adaptations by people who use drugs in the ways they use.
I wish that I could say I was confident that overdose deaths would continue to decrease in the coming years, but I can’t. The actions being taken at all levels of government in this country make such optimism very difficult.
At the federal level, the last 18 months have been a masterclass from the Trump administration on how to disrupt and destroy drug user health infrastructure. Roughly half of staff at the Substance Abuse and Mental Health Services Administration have been cut since the start of 2025, while the White House tried (and failed) to slash roughly $2 billion in congressionally appropriated funding and to eliminate the agency in its entirety. The Centers for Disease Control and Prevention have seen their overdose and infectious disease programs gutted by reductions in force grant cancellations, and an ever growing list of what they cannot do or say rooted in fidelity to politics rather than evidence based best practices.
In states and cities across the country, we are seeing a backlash against harm reduction interventions that are proven to prevent transmission of infectious disease, reduce overdose deaths, and get more people with substance use disorders to enter treatment. In its place, we are seeing the resuscitation of the war on drugs playbook that ignited and inflamed the overdose crisis in the first place, with sky high mandatory minimum sentencing for the possession of emerging drugs, abstinence-only treatment that doesn’t show results for people with opioid use disorders, and the institution of ineffective forced substance use disorder treatment at a time when millions who want treatment can’t get it.
There is no silver bullet to ending the overdose epidemic in the United States — no one policy solution that will protect our loved ones or ourselves from being touched by this crisis. But there are policies that will ensure that the overdose crisis never abates and that trap us in an endless loop of avoidable loss and suffering that turns International Overdose Awareness Day into Groundhog Day year after year after year.
If our nation’s drug policies don’t treat people who use drugs like human beings who deserve agency and consideration, we will not end the overdose crisis.
If we insist on an abstinence-only substance use disorder treatment framework that treats addiction to alcohol and marijuana the same way it treats addiction to opioids and stimulants, we will not end the overdose crisis.
If we hamper life-saving research and destroy families by criminalizing drugs to the greatest extent possible and filling our prisons with disproportionately Black, Latino, and people experiencing poverty with substance use disorders, we will not end the overdose crisis.
If we do not address all of the root causes of substance use disorder in this country ranging from untreated mental illness and domestic violence to unaffordable housing and the inability for millions to earn a living wage, we will not end the overdose crisis.
On this International Overdose Awareness Day, it is important that we honor those we have lost to addiction and substance use not just by holding their memory close, but by working to avoid the systemic failures that facilitated their passing. We cannot arrest our way out of the overdose crisis, nor can we compel millions of Americans to sobriety against their will at a time when our treatment centers are already underfunded and overcapacity.
Recovery from substance use disorder has many pathways and our approach to substance use must reflect this. If we create systems that view complete abstinence from all illicit substances as the only acceptable outcome for an interaction between a person who uses drugs and our nation’s healthcare and justice systems, then we will have built a factory whose primary products are relapse, disenfranchisement, and death.
The only path forward is the one that massively increases support for all aspects of our nation’s behavioral health and substance use infrastructure from prevention and treatment to recovery and harm reduction. It’s the path that invests not just in those of us who live with a substance use disorder, but in the communities to which they belong. It’s the path that does not condition a person’s intrinsic value based on whether or not they use drugs, but rather treats their humanity as the only prerequisite to care.
