A Turning Point in the Overdose Crisis — and the Work Still Ahead

Overdose remains the leading cause of death among Americans ages 18 to 45.
It’s a heartbreaking reality — and one that demands both our attention and our action.

But for the first time in over a decade, there’s a sign of progress. National data show the overdose fatality rate decreased by 4% between 2022 and 2023. This represents the first national decline since 2018 and reflects encouraging momentum in prevention, harm reduction, and treatment efforts across the country. That small but significant decline is proof that evidence-based prevention and treatment programs work. When we invest in proven solutions, we can save lives.

Progress, but Not for Everyone

While the overall rate of overdose deaths declined, the data reveals a deeper truth: not every community is seeing the same progress.

In fact, overdose death rates increased among Black individuals (up 3%) and Native Hawaiian/Pacific Islander individuals (up 39%) during the same period. These disparities point to systemic inequities — from access to quality care and culturally competent providers to economic and geographic barriers that make prevention and recovery more difficult.

This uneven progress underscores a central reality: we cannot claim victory while some communities are being left behind.

What’s Driving the Crisis

Even with this progress, the toll remains staggering. In 2023, 105,007 people died from an overdose in the United States — and 76% of those deaths involved opioids, primarily synthetic opioids like fentanyl. Fentanyl continues to drive the crisis, particularly as it infiltrates counterfeit pills and unregulated substances. In 2023, the non-methadone synthetic opioid overdose death rate was nearly eight times higher than those involving natural/synthetic opioids and nearly 19x higher than those involving heroin. 

But overdose is not only about opioids — it’s about broader patterns of substance use and mental health challenges across the country. According to provisional data from the 2024 National Survey on Drug Use and Health (NSDUH) more than 48 million people over the age of 12 live with a substance use disorder. 

And yet, only 1 in 5 of those who need treatment receive it.

Among those with opioid use disorder, just 17% receive medications to treat it, and among those with alcohol use disorder, only 2.5% receive medication-assisted treatment.

These are gaps we can — and must — close.

The Interconnected Nature of Addiction and Mental Health

The data also reminds us that substance use and mental health are deeply intertwined. About 1 in 12 adults (8%) live with both a mental illness and substance use disorder.

Young adults, multiracial individuals, and American Indian/Alaska Native communities are disproportionately affected.

This connection reinforces what those on the front lines already know: addressing the overdose crisis means addressing the full continuum of care — from prevention to treatment to mental health support.

Building on What Works

Where prevention and treatment programs are funded and implemented equitably, lives are being saved. Community-based initiatives, harm reduction strategies, and evidence-based treatment options like medication for opioid use disorder (MOUD) are making measurable impact. But the challenge — and opportunity — is scaling these efforts nationwide.

At Shatterproof, we’re committed to turning this progress into lasting change by:

• Expanding access to quality care through tools like Treatment Atlas, the first national platform helping people find evidence-based addiction treatment.

• Preventing substance use disorder before it starts through caregiver resources like our Caregiver’s Guide to Shatterproof Families.

• Advocating for policy change to fund proven, life-saving interventions and close treatment gaps.

• Supporting communities disproportionately affected by addiction and overdose.

A Moment for Hope — and Action

The data shows progress — but it also shows precisely where more work is needed.
Every number in these reports represents a life, a family, a community. Behind every statistic is someone’s child, parent, or friend.

Ending the overdose crisis will take all of us — evidence and humanity working together.