Overdose Deaths Decline Across the U.S. as Indian Country Reports Fewer Fatalities

By Joe Morey

Rez Life Weekly Editor

Drug overdose deaths across the United States are falling at a pace not seen in decades, and officials in Indian Country say tribal communities are also seeing fewer fatalities, a shift many attribute to expanded access to the overdose-reversing drug naloxone, known as Narcan, and a reduced flow of fentanyl into local communities.

According to provisional data from the Centers for Disease Control and Prevention, overdose deaths declined between 24 and 27 percent nationwide compared to the previous year. Projections for the full 2025 calendar year suggest deaths could fall by as much as 34 percent, reaching the lowest levels since 2019.

In Indian Country, tribal law enforcement and health officials say the downward trend is being felt at the community level.

On January 15, St. Croix Tribal Police Chief Donnie Holmes reported that 2025 marked the first year since 2010 in which the St. Croix Tribe recorded zero overdose deaths.

“This achievement reflects the coordinated efforts of multiple organizations and community members working proactively to prevent substance misuse and support wellness,” Holmes said.

Holmes credited a wide network of partners, including the St. Croix Tribal Health Clinic, the Wings of Migizi Program, the Opioid Abatement Taskforce, the Opioid Response Plan, the Reintegration Program, the Aanji-Bimaadiziwin Healing Center, along with first responders, prevention partners, families, elders and community members.

“This accomplishment demonstrates the strength of our community and the impact of early intervention, prevention, and collaboration,” Holmes said. “Together, we are saving lives and building a healthier future for our people.”

In Sawyer County, which encompasses the Lac Courte Oreilles Reservation, Sheriff Doug Mrotek said his office is also seeing a noticeable decline in overdose deaths.

“There is a noticeable downward trend in our county,” Mrotek said in an interview. “The tribe is furnishing a lot of Narcan as well as the county’s Health and Human Services department, and that has contributed to saving lives, but we also have to acknowledge the enhanced law enforcement from our two agencies as well as the shut down of the southern border.”

Mrotek said cooperation between county and tribal law enforcement has increased, and he credited Lac Courte Oreilles Police Chief Susie Taylor for maintaining close communication.

“There has been a lot of proactive enforcement,” Mrotek said. “Because of our combined efforts, drug distributors are more careful and more reluctant to bring fentanyl into our county.”

He added that the result has been fewer fatal overdoses and less fentanyl circulating locally.

“There is definitely a lot less overdose deaths as well as fentanyl in the area,” Mrotek said.

An Associated Press analysis by Mike Stobbe reported that overdose deaths peaked at nearly 110,000 in 2022, dipped slightly in 2023, and then dropped sharply by 27 percent in 2024 to approximately 80,000 deaths, the largest one-year decline ever recorded. The most recent CDC data, which runs through August 2025, estimates that roughly 73,000 people died from overdoses in the 12-month period ending in August, down about 21 percent from the prior year.

“Overall I think this continues to be encouraging, especially since we’re seeing declines almost across the nation,” Brandon Marshall, a Brown University researcher who studies overdose trends, told the Associated Press.

CDC officials reported that overdose deaths fell in 45 states, though they cautioned that reporting delays mean some numbers may change as more data becomes available.

While fentanyl remains the dominant driver of overdose deaths, accounting for roughly 70 percent of fatalities, CDC data shows the synthetic opioid has experienced its first sustained decline in more than two decades.

Narcan availability cited as a key factor

Public health experts nationwide have pointed to expanded access to naloxone as a major reason overdose deaths are falling. Billions of dollars from opioid lawsuit settlements have been used to distribute the medication widely, often free of charge, through health clinics, tribal programs, first responders and community outreach efforts.

According to CDC officials, increased availability of naloxone is one of several likely contributors to the sustained decline, along with expanded addiction treatment and changing patterns of drug use.

Border enforcement and fentanyl supply debated

Some medical professionals and law enforcement officials say changes in drug supply, including increased border enforcement, may also be playing a role.

Dr. Raul Garcia, an emergency room physician and medical director in central Washington, said he has seen a dramatic shift in fentanyl overdoses in recent months.

“I will tell you something that I haven’t said publicly yet and it deserves to be said,” Garcia said. “We were seeing 10 to 12 overdoses a day and we are seeing maybe one or two. Sometimes we go three days without seeing an overdose of fentanyl.”

Garcia said he believes stricter federal border enforcement has reduced the availability of fentanyl.

“So closing our borders and doing the things that he is doing, I am 100 percent behind,” Garcia said. “It really has made America better in the healthcare system, in the war against drugs.”

Asked whether fentanyl was being replaced by other drugs, Garcia said methamphetamine remains easier to produce domestically.

“We have seen maybe a slight increase in methamphetamines,” he said. “But the significant drop in fentanyl overdoses is the most significant thing.”

Researchers caution that while supply disruptions may influence trends, causation is difficult to prove. According to the Associated Press report by Stobbe, experts have offered multiple overlapping explanations, including naloxone access, treatment expansion, fewer new drug users, and changes in international drug manufacturing.

A recent study cited by the AP suggests regulatory changes in China may have reduced access to precursor chemicals used to make fentanyl, while another theory links overdose spikes to pandemic stimulus payments that ended in 2021.

“I personally think it’s more complicated,” said Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco. “Those partial explanations layer on other trends.”

Cautious optimism in Indian Country

Despite the encouraging data, public health officials warn that overdose deaths remain well above pre-pandemic levels and that Native communities continue to face disproportionate risks tied to poverty, trauma and limited access to care.

Still, tribal leaders say the recent decline shows that sustained prevention efforts, community collaboration and rapid overdose response can save lives.

For communities like St. Croix and Lac Courte Oreilles, the shift represents more than statistics.

It represents people still alive.