Overdose Deaths Are Falling Everywhere in America Except Arizona

Every national chart this year tells the same encouraging story: overdose deaths are down roughly 12 to 14 percent, continuing a decline from 2023’s peak. Arizona’s chart runs the opposite direction. The state’s overdose deaths climbed from 2,531 in 2024 to 2,988 in 2025 — a 17.8 percent increase in the same year the rest of the country improved. Arizona’s death rate, 43.5 per 100,000, now sits at roughly twice the national average.

Every other state is proof the crisis is tractable. Arizona is the exception nobody’s national headline accounts for.

Talk to the people doing outreach on Phoenix and Tucson sidewalks and one variable comes up before policy or supply ever does: heat. “We’re like in the epicenter of the worst of it,” Tom Langdon Hill, training director at Certified Community Health Specialists’ Foundation, told KOLD News 13. “The concrete can be nearly 150 degrees, and that’s what they’re cuddling up next to — if you add drugs to that?” His organization has personally reversed overdoses for 700 people in the past year alone.

In Pima County, fentanyl and methamphetamine now account for 80 percent of drug deaths, and nearly half of this year’s 36 heat-contributed deaths also involved an overdose. “Every single year for the last five years, as soon as June, July, and August hit, the number of our overdose deaths go up by about 7 to 8 percent,” said Mark Person, public program manager at the Pima County Health Department. The mechanism is physiological, not mysterious: heat already strains heart rate, breathing, and sweating, and stimulants or opioids amplify all three. “A person may prolong the amount of time they’re out here without really realizing they’re overheating,” Person said.

None of this shows up in a national overdose chart, because national charts average across fifty states, and Arizona’s outlier status gets absorbed into the good news everywhere else. If you’re building a policy response, that’s not the story. Arizona’s naloxone access, cooling-center placement, and outreach funding need to be sized to a state where the crisis is getting worse, not to the country where it’s getting better — and right now, the money and the messaging are both calibrated to the national curve.