Thanksgiving 2025: Overdose Death Trends in the United States and What We Are Thankful For

This Thanksgiving, gratitude goes beyond food, family, and a long weekend. For those working in addiction medicine, emergency care, or toxicology, it also means recognizing the hopeful decline in overdose death trends in the United States.

New CDC provisional overdose data reveal that predicted drug overdose deaths in the U.S. have decreased significantly for the first time in many years. Early estimates suggest about 76,516 drug overdose deaths in the 12 months ending in April 2025, a 24.5% drop compared to the previous year[1].

Additionally, preliminary national statistics indicate that overdose deaths in 2024 fell by nearly 27% compared with 2023, marking the largest one-year decline in modern surveillance history[2].

These advances in overdose death rates are more than just numbers. They represent tens of thousands of people who are still here to share a meal, a conversation, or a second chance.

So this Thanksgiving, as we recognize the decline in overdose deaths in 2025, here is exactly what we are thankful for.

1. Thankful for a historic decline in overdose deaths

We are first and foremost thankful for the measurable decline in overdose deaths in 2025 and the trend that began in 2024:

• CDC predicts 76,516 overdose deaths in the 12 months ending in April 2025, a 24.5% decrease compared with the previous year[1].

• Provisional figures for 2024 show nearly a 27% drop in overdose deaths compared with 2023, with many states seeing double-digit declines[2,3].

• Independent analyses confirm month-over-month decreases in overdose deaths across multiple demographic groups, even as inequities persist[4].

These are the numbers that now define the headline overdose death trends in the United States. They are not a declaration of victory, but they are strong evidence that coordinated public health and clinical action can save lives at scale.

2. Thankful for stronger opioid overdose prevention efforts

We are also thankful for the opioid overdose prevention efforts that have helped bend the curve:

• Expanded access to medications for opioid use disorder (MOUD), such as buprenorphine and methadone, including low-threshold and telehealth models

• Better integration of addiction treatment into emergency departments, primary care, and hospital discharge planning

• Use of settlement and public health funds to support evidence-based treatment and recovery services rather than purely punitive responses

These opioid overdose prevention efforts are reflected in the underlying CDC provisional overdose data, which show broad declines in opioid-involved deaths in many jurisdictions while highlighting where progress is slower[1–4].

This Thanksgiving, we are thankful for every clinician, program leader, and policymaker who chose to make overdose prevention part of their daily, often invisible, work.

3. Thankful for harm reduction and naloxone access

The current decline in overdose deaths in 2025 would be difficult to imagine without large-scale harm reduction and naloxone access.

We are thankful that:

• Naloxone is increasingly available in communities, sometimes over the counter, often free through standing orders and community programs

• People at risk for overdose, as well as their families, peers, and service providers, are more likely to carry and use naloxone

• Harm reduction programs distribute fentanyl test strips, safer-use education, and linkage to treatment as part of a continuum rather than a fringe activity

CDC and other organizations highlight harm reduction and naloxone access as central contributors to improved overdose death trends in the United States[1,2,8].

This Thanksgiving, we are thankful for every outreach worker, peer supporter, pharmacist, and community organizer who has turned harm reduction from an argument into infrastructure.

4. Thankful for the role of poison control centers

Overdoses do not happen only in statistics or headlines. They unfold in homes, workplaces, schools, and hospitals. In all of those places, the role of poison control centers is crucial.

Across the country:

• A network of accredited poison centers provides 24/7 coverage via the Poison Help line (1-800-222-1222) and digital services[5–7].

• Their mission is to reduce poisonings and the harm they cause by ensuring expert consultation is always available, no matter where a person lives [5,7].

• The National Poison Data System (NPDS) aggregates millions of human exposure cases each year, providing near real-time surveillance of toxic exposures, including overdoses [5,6]

In practice, the role of poison control centers includes:

• Triage of overdoses that can be safely managed at home, preventing unnecessary emergency department visits

• Real-time recommendations for complex inpatient overdose management and toxicant-specific antidotes

• Detection of novel trends in drug use, contamination, and emerging toxic threats that may shape future overdose death trends in the United States

This Thanksgiving, we are thankful for every specialist in poison information, pharmacist, nurse, and medical toxicologist who has spent a holiday shift on the phone, supporting patients and clinicians they will never meet in person.

5. Thankful for medical toxicology public awareness

Data, algorithms, and guidelines only matter if people can understand and use them. That is why public awareness of medical toxicology is so important.

We are thankful that an increasing number of platforms are working to turn:

• complex overdose mechanisms

• bedside toxicology decision-making

• antidote indications and dosing

• and evolving CDC provisional overdose data

into clear, practical resources for clinicians, trainees, patients, and families.

MedicalToxic.com is one such platform. We are thankful that we have the opportunity to:

• publish blogs that make overdose death trends in the United States understandable beyond technical reports

• Share case studies and case series that illuminate real-world toxicology decision-making

• post news and explainer pieces linked to CDC provisional overdose data and national policy changes

• develop clinically focused apps and calculators that support poisoning and overdose management in poison centers, emergency departments, and hospital settings

In that sense, MedicalToxic.com is part of a growing ecosystem of public awareness about medical toxicology, where expertise is not confined to textbooks but is translated into tools that help prevent and manage real toxic exposures.

6. Thankful for patients, families, and people with lived experience

Not every driver of overdose death trends in the United States can be found in a dataset. A great deal of the most important work happens in quiet, personal spaces:

• A person who returns to treatment after multiple prior attempts

• A family that learns to recognize overdose signs and keeps naloxone at home

• A peer who supports others in recovery groups, shelters, or harm reduction settings

We are thankful for every person with lived experience who has turned their story into advocacy, peer support, or education. Their insights shape programs, policies, and clinical practice in ways that ultimately influence the decline in overdose deaths in 2025.

7. Thankful, but not finished

This Thanksgiving, we are genuinely thankful for improved overdose death trends in the United States, but we are not finished.

Even with this decline in overdose deaths in 2025:

• Tens of thousands of people still die from overdoses each year[1–4].

• Overdose remains a leading cause of death among adults in their most productive years

• Significant disparities persist across age groups, racial and ethnic communities, and geographic regions[2,4,8]

To sustain and deepen this progress, we will need to:

• Protect and expand funding for overdose surveillance, treatment, and opioid overdose prevention efforts

• Strengthen the role of poison control centers and NPDS as essential public health infrastructure

• Embed harm reduction and naloxone access into routine healthcare and community life

• Continue investing in medical toxicology public awareness so that sound toxicology knowledge is widely accessible

If we treat this year’s numbers as an excuse to move on, the curve will likely bend upward again. If we treat them as proof that compassionate, evidence-based action works, then this Thanksgiving may mark the beginning of a lasting shift in how we understand and respond to overdose.