The Real Reason for the Drop in Fentanyl Overdoses

"From 2003 to 2022, annual overdose deaths in the United States rose from less than 26,000 to nearly 108,000-becoming the leading nonmedical cause of death, surpassing car accidents and gun violence combined. In Canada, overdose deaths increased almost tenfold in the same period. In both countries, the surge in deaths was supercharged by "synthetic" opioids such as fentanyl, the ultra-potent, lab-made narcotic that has come to dominate the supply of hard drugs."

"Then, sometime in 2023, something miraculous happened: Death rates started dropping. In Canada, opioid-overdose deaths declined 17 percent in 2024, then continued falling sharply in the first six months of 2025 (the most recent months for which data are available). In America, preliminary data indicate that total drug deaths fell from their peak of just shy of 113,000 in the year ending August 2023 to about 73,000 in the year ending August 2025."

"Although the numbers are still too high, the public-health community has responded to the decrease with jubilation-and confusion. Overdoses had been rising inexorably for 20 years. What changed? A new paper, published earlier this month by a group of drug-policy scholars in the journal Science, presents a novel theory. The paper's authors attribute the reversal not to any American or Canadian policy, but to a sudden fentanyl "drought," which they say may have its causes not in North America, but in China."

For two decades the United States and Canada experienced a sharp rise in overdose deaths, with US annual fatalities increasing from under 26,000 in 2003 to nearly 108,000 in 2022 and Canadian deaths rising almost tenfold. Synthetic opioids, especially fentanyl, became dominant in the illicit supply and drove the surge. Beginning in 2023 both countries saw notable declines in overdose deaths, with Canada falling 17 percent in 2024 and US preliminary counts dropping from about 113,000 to roughly 73,000 by August 2025. Some analyses attribute the reversal not to domestic policies but to a sudden fentanyl "drought" possibly linked to disruptions in supply from China, implying supply-side forces rather than policy changes largely drove recent decreases.

Read at The Atlantic