Overdose Deaths Fell Nationwide in 2025. Arizona Went the Other Way.

Margarita Macías has watched her son, Marck Martinez, overdose again and again at their home near Phoenix. Her message to him hasn’t changed: if he wants help, she will help. She is one of the families in a July New York Times investigation into Arizona’s deaths, which Axios Phoenix summarized under a headline that says the whole thing: Arizona overdose deaths surged while the nation’s fell.

The national overdose decline is a trend, not a rescue, and Arizona just showed us the difference.

The national numbers are real and they are good. The CDC’s National Center for Health Statistics counted about 69,973 overdose deaths in 2025, almost 14% fewer than the 81,313 in 2024, the third straight yearly drop. But the Associated Press reported that Arizona, Colorado and New Mexico all rose by 10% or more. The Arizona Public Health Association put Arizona’s number at 2,988 deaths, up from 2,531: an 18% jump. Deaths involving fentanyl and similar synthetic opioids rose about 33%. Methamphetamine and other stimulants rose more than 15%. Cocaine rose about 70%.

Read that list again: nothing fell. The AZPHA report documents the rise but does not explain it, and we won’t pretend to either. What the data does show is a mixed supply. Polo Ruiz, the DEA’s special agent in charge in Phoenix, told KTAR in January that “there’s an increase in the methamphetamine-related overdoses to include meth and fentanyl combinations,” and that “there’s no real reversal or life-saving medication for meth overdoses.” He is right about the meth. There is no naloxone for it. But when fentanyl is in the same pill or the same line, naloxone reverses the fentanyl part and buys the minutes everything else needs.

That has a practical consequence most intake forms still miss. If you use stimulants and have never thought of yourself as someone who needs naloxone, the Arizona numbers say the supply doesn’t care how you think of yourself. And if you work in a program, this week’s move is small: add one question to intake (“any stimulant use in the last 30 days?”) and make a yes trigger the same naloxone handoff your opioid clients already get, along with fentanyl test strips and a conversation about not using alone.

Here is what is still yours tonight. Narcan has been sold over the counter since 2023, and SAMHSA’s September award included $34.6 million to train first responders and communities on overdose reversal. The tool exists. The distance between the tool and Marck’s house is what’s killing people.

His mother’s sentence is a better policy memo than most of what Arizona has produced: if you want help, I can help you. The job now is to make sure that when Marck says yes, something is open.