The Rest of the Country's Overdose Deaths Are Falling. Arizona's Aren't. Naloxone Is Doing the Work the Numbers Don't Show.

CDC’s latest provisional data put national overdose deaths at 69,973 for 2025 — down 13.8 percent from 81,313 the year before, a third consecutive year of decline from the 2022 peak of nearly 108,000. That is the headline most of the country gets to read with relief. Arizona doesn’t get to read it that way.

While the nation’s overdose curve bent down again, Arizona’s bent up — and the gap between those two lines is the story Phoenix providers need to be tracking right now.

KTAR News reported Arizona overdose deaths rose roughly 17 percent year-over-year even as the national rate fell by nearly the same margin in the opposite direction — one of a small handful of states, alongside New Mexico and Colorado, moving against the national trend. A more recent trailing-twelve-month snapshot reported by Filter Magazine shows Arizona’s rate of increase has since slowed to roughly 8.2 percent — still rising, but at about half its earlier pace, while New Mexico (up 27.1 percent) and Colorado (up 14.2 percent) continue accelerating. Arizona is decelerating badly instead of improving well.

Dr. Martín Celaya, who chairs the Bureau of Assessment and Evaluation at the Arizona Department of Health Services, points to what’s actually killing people: “the combination that is most common in those substances is meth and fentanyl.” Roughly 90 percent of Arizona’s overdose deaths now involve more than one substance — not a single-drug crisis anymore but a polysubstance one, which is a harder pattern to screen for and a harder one to treat, since a patient using both stimulants and opioids doesn’t fit neatly into either drug class’s standard treatment pathway. “Some cases folks just don’t know what they’re consuming,” Celaya added — a reminder that a meth supply increasingly cut with fentanyl means people who think they’re avoiding opioids entirely may not be.

The part of this that’s actually working

Here’s the number that should sit next to the bad one, not replace it: Arizona’s overdose reversals — naloxone doses that brought someone back — nearly doubled, from roughly 2,500 in 2024 to more than 4,000 in 2025. Scott Greenwood, who runs Sonoran Prevention Works — by its own account the largest naloxone distributor in the country that isn’t a government agency — credits that distribution work directly for the jump in reversals. Deaths rose. Reversals rose faster. That is not a contradiction; it’s what it looks like when a genuinely worse drug supply meets a harm reduction infrastructure that is, in fact, catching more of the falls.

Part of why Arizona’s supply keeps getting worse instead of better sits just up the interstate. DEA’s Rocky Mountain Field Division — covering Colorado, Utah, and Wyoming — seized 3.2 million fentanyl pills in the first half of 2026 alone, roughly one in six fentanyl pills seized nationwide, officials describing the I-25/I-70 corridor as a fentanyl “super highway.” Arizona sits downstream of that same Mountain West trafficking network, on I-10 and I-40 rather than I-25, but drawing from an overlapping supply base — which is one reason a national decline in overdose deaths doesn’t automatically translate into a regional one when the regional supply chain is still this saturated.

That infrastructure has real money behind it, at least for now. Arizona’s Attorney General announced $10 million in opioid settlement funds in June — $2 million each to five county sheriff’s offices — specifically to fund treatment connections for people leaving incarceration, one of the highest-risk windows for a fatal overdose. That’s a fraction of the roughly $1.194 billion Arizona has secured toward an eventual $1.215 billion in total opioid settlement dollars over 18 years. Where the rest of that money goes, and how much of it follows Sonoran Prevention Works’ model instead of funding programs that look good on a grant application but don’t move a reversal number, is the thing worth watching out of Phoenix for the rest of this year.

That’s a fraction of the roughly $1.194 billion Arizona has secured toward an eventual $1.215 billion in total opioid settlement dollars over 18 years.

If you’re a provider or case manager in Arizona reading your own polysubstance patients through this data: the naloxone-carries-through message still applies even when the drug is meth-plus-fentanyl rather than opioids alone, because the fentanyl half of that mix is still what a reversal drug can act on. Keep naloxone accessible for stimulant users too — “it’s not an opioid problem” is exactly the assumption Celaya’s data says is costing lives.