Arizona Is Going the Wrong Way: Why Our State’s Overdose Deaths Climbed 17% While the Rest of America’s Fell

On Tuesday, May 13, the CDC released provisional overdose data for the 12 months ending December 2025. The national numbers are the best they have been in seven years: an estimated 69,973 deaths, down 13.9% year-over-year, the third straight annual decline, and back near pre-pandemic levels for the first time since 2019.

It is genuinely historic news. It is also not Arizona’s news.

While 42 states and D.C. saw declines, eight states recorded increases — and the three with the largest jumps are all in the Southwest. Arizona climbed 17.31%, New Mexico 21.30%, and Colorado more than 10%. KJZZ and ABC15 led with it. The national press, focused on the headline decline, mostly buried it.

For anyone in recovery in Arizona, or anyone with a family member in active use, the story behind the divergence matters more than the divergence itself.

What changed, and what didn’t

Across the country, the supply has shifted in ways that have probably saved lives: less fentanyl per dose, more naloxone available over the counter since March 2023, and loosened methadone rules effective October 2024. Treatment availability has expanded in much of the East and Mid-Atlantic. Rhode Island, North Carolina, New York, Alabama, and Vermont each dropped 25% or more.

The Southwest did not get the same combination of factors. Researchers and front-line harm reduction workers point to three things that distinguish Arizona’s trajectory.

Polysubstance use is harder to reverse. Methamphetamine plus fentanyl has been the dominant Southwest pattern for several years. Naloxone reverses the opioid; it does not address the stimulant component, and it does nothing about the cardiovascular events that meth can trigger. CDC counts a death involving both as an opioid overdose, but the clinical reality is harder to interrupt than a fentanyl-only event.

A new adulterant is showing up here first. On May 12, the DEA expanded its advisory on cychlorphine — a synthetic opioid up to ten times more potent than fentanyl, first identified at the agency’s Miami laboratory in April 2024. It has now been confirmed in 26 samples and associated with at least 25 fatal overdoses, distributed across Atlanta, South Florida, Chicago, Houston, North Carolina, and California. Reversal often requires multiple doses of naloxone. After China placed nitazene analogues under generic control in July 2025, cychlorphine appears to be filling the gap.

Treatment access has not caught up. Arizona still ranks 49th of 51 for behavioral health access, and fewer than 1 in 20 Arizonans with opioid use disorder receive medications like buprenorphine or methadone. The AHCCCS Secure Behavioral Health Residential Facility RFP released May 12 — covered in yesterday’s newsroom — is the most consequential supply-side step in years, but it is a multi-year build. Right now, in May 2026, the people in active use in Maricopa, Pima, and Yavapai counties do not yet have those beds.

The federal harm reduction reversal sits underneath all of it

On April 24, SAMHSA sent a letter to federal grant recipients prohibiting the use of federal dollars for fentanyl and xylazine test strips, sterile syringes, and pipes distributed to the public. The Kentucky Harm Reduction Coalition lost a $400,000 grant after distributing 48,465 test strips in the first quarter of FY 2026 alone. STAT News called it “a clear shift away from harm reduction.”

The timing is the problem. Test strips do not prevent every overdose, but they let people make a different decision once they see what is in front of them — and they are one of the few interventions that has any traction at all against an adulterated supply. Pulling federal funding for them, just as the supply gets more dangerous in three states in particular, is the wrong move at the wrong time. The American Society of Health-System Pharmacists filed formal opposition on April 30.

For Arizona’s increase specifically, the supply got harder and the safety net got smaller in the same six-week window. Both directions of that change show up in a 12-month rolling average with a lag. The full effect of the April test-strip decision will not be visible in CDC data until the August 2026 release.

What this means, practically, if you’re navigating this in Arizona right now

The data is a snapshot, not a sentence. Three things that matter today.

First, carry naloxone, and carry more than one dose. With cychlorphine confirmed in the regional supply and methamphetamine compounding the picture, single-dose reversal is no longer a safe assumption. Arizona pharmacies dispense it over the counter, and many community organizations still distribute it for free. If you are not sure where to get it nearby, our Naloxone resources page lists current Maricopa, Pima, and rural-county distribution points.

Second, if you or a family member is thinking about treatment, the wait list is your enemy. The treatment gap in Arizona is real, but the time between “I’m ready” and “I have an appointment” is the most dangerous interval in any recovery story. Rize’s Find Help tool is built specifically to compress that interval — matching by insurance, services, location, and current bed availability in a few minutes rather than the typical multi-day phone-tree process.

Third, the news is genuinely good for most of the country, and that matters too. The factors that drove the national decline — more naloxone, more buprenorphine prescribers, looser methadone rules, harm reduction infrastructure — are policy choices that work. Arizona’s divergence is a story of those same choices arriving here later and unevenly, not a story of recovery being impossible. The same things that lowered overdose deaths in Rhode Island can lower them here.

The same things that lowered overdose deaths in Rhode Island can lower them here.

Why this matters for people in recovery

A 17% increase is a number on a CDC dashboard. It is also someone’s son, sister, neighbor, or self. The right response is not panic, and it is not despair. It is the patient, unglamorous work of getting more naloxone into more hands, more buprenorphine into more prescribers’ practices, more people connected to treatment in the days they ask for it rather than the weeks. Arizona is building the supply side — the AHCCCS RFP is real, the opioid settlement dollars are real, the harm-reduction community has not stopped. The job between now and then is bridging the gap.

If you or someone you love is in crisis right now, call or text 988 (the Suicide & Crisis Lifeline) or 1-800-662-HELP (4357) for SAMHSA’s National Helpline. Both are free, confidential, and available 24/7.

If you are looking for a treatment match in Arizona, our Find Help tool takes about five minutes and is built for moments like these.