Arizona is moving the wrong way: what a +17% overdose year means for our launch state

The headline number from the CDC’s April 15 release was the kind that finally felt like progress: roughly 70,231 projected drug overdose deaths for the 12 months ending November 2025, a 15.9% drop from the prior year and the second consecutive year of decline. Forty-five states fell. Five states went up. Arizona is one of those five — and, as the Arizona Capitol Times reports, it posted the largest increase of any state, roughly +17% for the 12 months ending September 2025.

For families currently searching for help in Phoenix, Tucson, Flagstaff, or anywhere else in the state, that gap between the national curve and our local one is what actually matters.

What the Arizona data says

Maricopa County’s Focus on Fentanyl dashboard tells the rest of the story. Across 2024, fentanyl was involved in roughly 59% of the county’s fatal overdoses. Methamphetamine was involved in roughly 67%. Those numbers add to more than 100 because — increasingly — they describe the same death.

The polysubstance pattern is not new, but it is sharper here than in most of the country. Synthetic-opioid death rates fell faster nationally in 2024 than stimulant rates did, and where fentanyl pulled back, stimulant adulteration (and now medetomidine — the CDC HAN dropped April 14, 2026) kept the overall surface area lethal. Arizona’s methamphetamine market is larger and more durable than most states’, and the curve here has bent later than the national one.

What changed in the policy stack this year

Three things are reshaping the on-the-ground response in Arizona at the same time the curve refuses to bend.

First, naloxone supply. Under the Hikma settlement, AHCCCS opted to receive 6,599 units from Hikma Pharmaceuticals — each unit containing two nasal doses — with a first shipment expected in September 2026, according to AHCCCS’s published SOR program page. The Amneal settlement adds 33,714 units over four years, beginning the same month. That is meaningful supply for a state that consistently ranks 49th out of 51 for behavioral-health access.

Second, settlement-fund mechanics. The One Arizona Agreement sends 56% of national-settlement money to the 15 counties and 91 cities and towns and 44% to the state — about $526 million for the state over 18 years. The county-level allocations are not all “spent” in the same way; a city or county can use settlement money for treatment access, prevention, harm-reduction, recovery housing, or law-enforcement-adjacent priorities. A practical effect of that flexibility is that two cities a county apart may be funding very different things this year.

Third, federal posture. SAMHSA’s April 24 letter restricts federal grant money for fentanyl, xylazine, and medetomidine test strips, sterile syringes, sterile water, and overdose hotlines. Naloxone is preserved. The new 2026 National Drug Control Strategy, released May 4, calls for “increased naloxone availability” and “improved drug testing to guide treatment decisions” in the same paragraph that the federal grant money for those drug-checking tools has just been pulled. The contradiction is real and it is local. AHCCCS State Opioid Response funds will keep flowing; the harm-reduction supply that those funds were paying for in some counties will now have to be paid for from settlement money or local budgets.

What it changes for someone looking for help

The single most useful thing for a family member, peer, or person directly affected to know right now is that the supplies people most need to stay alive in the gap between active use and treatment are still available in Arizona — they are just being paid for from a different pot. Naloxone is still being distributed by AHCCCS, by Maricopa County Public Health, by recovery community organizations, by harm-reduction nonprofits, by some pharmacies. Fentanyl test strips are still legal, still distributed by some county and community programs, and increasingly being paid for through settlement money rather than federal grants. The map of who-distributes-what has shifted; the map of what-is-available has not contracted as sharply as the federal letter alone suggests.

Fentanyl test strips are still legal, still distributed by some county and community programs, and increasingly being paid for through settlement money rather than federal grants.

The opposite is also true. There is no single, current, reliable, public list of every place in Arizona where you can pick up naloxone or test strips today. The fragmentation is itself part of the problem.

Why the curve is bending later in Arizona than nationally

Two structural reasons stand out. The first is supply. National fentanyl interdiction does not change the Phoenix–Nogales–I-10 corridor evenly — Arizona’s proximity to the southwest border keeps the drug supply more durable here than in most states. The second is treatment access. Fewer than 1 in 20 Arizonans with opioid use disorder receive medications like buprenorphine or methadone, by AHCCCS’s own published estimates. When treatment is harder to start and easier to lose, the survival benefit of the national medication-for-opioid-use-disorder expansion arrives later.

Methamphetamine compounds both. There are no FDA-approved medications for stimulant-use disorder, and the most evidence-based intervention — contingency management — has been shown cost-effective even at the SAMHSA $750 incentive cap but is still rare in Arizona. Maricopa County has invited proposals for it; the actual program count remains thin.

Why this matters for people in recovery

If you live in Arizona and you are looking for help — for yourself or for someone you love — the national overdose decline does not yet describe the road in front of you. It does describe what is possible. Arizona has more settlement money to deploy this year than it has had since the One Arizona Agreement was signed, two new naloxone shipments arriving in September, and a state Medicaid program (AHCCCS) accepted at 97% of in-state treatment facilities. The pieces of a working response exist; they are just not yet connected by anything other than a phone tree, a screenshot in a Facebook group, or a zip code search on a federal database that does not always know what is open.

That gap is the one we are building Rize Recovery to close — starting in Arizona.

If you or someone you love is struggling, the 988 Suicide & Crisis Lifeline is available 24/7. SAMHSA’s National Helpline (1-800-662-HELP) is free, confidential, and provides referrals to local treatment. The Arizona Opioid Assistance and Referral Line is 1-888-688-4222.