America’s overdose decline is real. Arizona is the exception.

The Centers for Disease Control and Prevention released provisional 2025 overdose data on May 13, and the headline is, by every honest reading, good news: an estimated 69,973 Americans died of a drug overdose in the twelve months ending in December 2025, down 13.9% from the previous year. That is the third straight annual decline — the longest sustained drop in U.S. drug-overdose mortality in decades — and the lowest count since October 2019, before the pandemic-era surge.

It is also, for anyone working on access to treatment in Arizona, a sobering map. The decline was broad-based: fentanyl, cocaine, and methamphetamine deaths all fell year-over-year, according to the AJMC analysis of the NVSS release. Oregon dropped 35.4%. North Carolina, 34.0%. New York, 32.1%. Alabama, 28.2%. Most states recorded double-digit declines. Two states moved against the tide: New Mexico (+21.3%) and Arizona (+17.3%).

That gap is the story.

What the national decline is actually measuring

The provisional NVSS data is what statisticians call a leading indicator of a system slowly correcting itself. Researchers attribute the decline to a combination of factors: wider naloxone distribution, expanded access to medications for opioid use disorder, shifts in how people use drugs, and the cumulative effect of billions of dollars in opioid settlement money beginning to reach communities. None of those mechanisms is mysterious. None is invisible to people inside recovery.

What the headline number cannot show is the floor. Sixty-nine thousand nine hundred and seventy-three deaths is still nearly two hundred families a day learning that someone they love is not coming home. The decline matters. So does the absolute level.

Why Arizona is moving the other direction

Arizona’s 17.3% increase did not arrive overnight. The same state-level NVSS file showed Arizona in the rising column in earlier 2026 quarterly releases. The most plausible drivers — none of them new to anyone working in Arizona behavioral health — are interlocking. The state is geographically positioned between the highest-volume fentanyl trafficking corridor in the country and a treatment-capacity gap that has been documented for years. AHCCCS coverage is broad on paper but uneven in matching the right person to the right facility at the right time. And yesterday’s KJZZ audit raised real questions about how settlement dollars are being deployed: the state Department of Corrections may have unlawfully spent $50.9 million of opioid settlement money on inmate hepatitis-C treatment without documenting the IV-opioid connection the agreement requires.

The audit story is bigger than its dollar figure. Arizona’s One Arizona Agreement directs up to $1.215 billion in settlement funds over eighteen years into addiction treatment and prevention infrastructure. How that money is allocated, how quickly, and to which evidence-based interventions is — at the state level — the single largest lever Arizona has to bend its own curve. When the largest single use of those funds is in question, the cost is measured in months of programmatic delay during a period when the rest of the country is making real ground.

What’s coming that may make Arizona’s situation harder

On May 12, the DEA issued a public safety advisory warning that the illicit drug supply is increasingly being cut with substances — cychlorphine, nitazenes, medetomidine, xylazine — that either cannot be reversed by naloxone or require multiple doses to counter. Cychlorphine alone is approximately 10 times as potent as fentanyl in vitro. The supply chain is adapting faster than the harm-reduction system can keep pace. Meanwhile, SAMHSA’s April 24 guidance letter restricted federal funds from supporting test strips and sterile-syringe programs that have, for several years, served as the front line of overdose prevention in Arizona’s larger counties.

In short, the rest of the country is benefiting from a maturing harm-reduction infrastructure at the same moment the federal government is moving to dismantle it — and Arizona’s settlement-funded version of that infrastructure is still being designed.

Why this matters for people in recovery

Two things can be true at once. The national overdose decline is real. And for an Arizonan who lost someone in 2025 or is trying to find treatment for themselves or a family member today, the headline does not describe the state of the world they live in. The states that moved the most in 2025 were the states that made it materially easier for someone in crisis to find the right level of care, the right insurance match, and the right medication within the days — not weeks — that actually matter. Rize was built for the part of that problem Arizona has not yet solved.

Rize was built for the part of that problem Arizona has not yet solved.

If you or someone you love is looking for treatment in Arizona, Rize’s facility-matching tool will surface facilities that accept your insurance, fit your clinical needs, and have current bed availability. If you are in immediate crisis, call or text 988 for the 988 Suicide & Crisis Lifeline, or 911 for emergency services. SAMHSA’s national helpline remains available at 1-800-662-HELP (4357), free and confidential, 24/7.

The decline is the direction. Closing the gap is the work.

— The Rize Recovery Newsroom