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The Guardian’s analysis finds that even as US overdose deaths fell in 2024, the crisis deepened in pockets of the country, with some counties surging up to 120% and seven states reversing course by early 2025. The CDC had hailed a 27% drop—more than 81 lives saved daily—yet roughly 220 people still died each day last year. Shifts in fentanyl (and, in places, methamphetamine) and geography best explain the uneven map. Experts applaud naloxone but question its measured impact, and fault slow, incomplete surveillance that obscures local spikes and hinders targeted prevention and treatment.

Prepared by Olivia Bennett and reviewed by editorial team.