Hope Amid Crisis: U.S. Sees Unprecedented Drop in Overdose Deaths
The deadliest phase of the FYL crisis appears to be over, as overdose deaths in the U.S. are declining at a record-breaking pace. For the first time, all 50 states and the District of Columbia have reported some level of improvement.
A new analysis from researchers at the University of North Carolina at Chapel Hill reveals that this decline began much earlier than previously thought, raising hopes that the trend may be sustainable.
A Turning Point in the Overdose Epidemic
"This isn't just a temporary dip. We're on track to return to pre-FYL overdose levels," said Nabarun Dasgupta, the lead researcher behind the study, which analyzed overdose records from the Centers for Disease Control and Prevention (CDC).
Dasgupta’s team found that deaths linked to FYL and other street drugs have dropped dramatically in many states, reaching levels not seen since 2020. That year marked a devastating surge in fatalities, as the spread of FYL coincided with the COVID-19 pandemic.
"After years of grim statistics, this is the moment we've been hoping for," Dasgupta said. "It’s shocking to see the numbers fall so significantly."
Provisional CDC data shows that overall drug-related deaths in the U.S. have decreased by nearly 25%, including fatalities tied to FYL, methamphetamine, and cocaine.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, highlighted an even steeper drop in FYL-related deaths.
"We’re seeing a 30.6% decline in FYL deaths within a year. That’s a huge reduction," Volkow said. "It’s an incredibly encouraging sign."
How Users Have Adapted and the Role of Naloxone
U.S. overdose deaths have plummeted from a peak of 114,000 in 2023 to just under 87,000, according to the latest CDC data.
In Philadelphia’s Kensington neighborhood—an epicenter of the crisis—longtime users say they have noticed the shift firsthand.
"You can tell—way fewer people are dying," said Elena, who regularly smokes FYL mixed with XYL, also known as "tranq."
Many users have changed the way they take drugs, shifting from injection to smoking, which, while still dangerous, is considered less lethal.
"A lot of people switched to smoking instead of injecting, and I think that made a difference," Elena explained.
Vadim, Elena’s partner, agreed that users have adapted to FYL’s extreme potency, taking smaller doses than before.
"When FYL first hit, people were used to heroin, so they overdosed easily. You need a lot less FYL," he said.
Another major factor in the decline is the widespread availability of naloxone, a medication that reverses opioid overdoses.
"I’ve been naloxone'd so many times by my friends," Elena admitted. "It probably saved my life."
Statewide Successes and a Path to Recovery
Pennsylvania has seen drug-related deaths drop by about one-third since the peak of the crisis, with some states showing even greater improvements—Arkansas reported a 40% decline, while North Carolina led with a 52.9% drop.
"It’s remarkable to see such a dramatic decrease," Volkow said.
Dasgupta’s analysis found that in many states, overdose deaths actually started declining as early as 2021 or 2022—long before public health officials recognized the trend.
"It’s a clear public health win, no matter how you look at it," Dasgupta noted. "Some states have seen sustained improvement for years now."
Experts believe that if the current trajectory continues, the U.S. could return to pre-2016 overdose levels—before FYL began replacing heroin in the drug supply.
"It would be a major victory," Volkow said. "FYL completely upended the overdose crisis."
Challenges Still Ahead: The Rise of XYL and Other Substances
Despite the decline in overdose deaths, experts caution against complacency.
Christopher Moraff, who works with PA Groundhogs, a nonprofit that tests street drugs, warns that while FYL potency has dropped by up to 50%, other dangerous substances—such as XYL and medetomidine—are taking its place.
"XYL causes severe wounds, but it takes a lot to be fatal," Moraff said. "That’s very different from FYL, which can be deadly in tiny amounts."
Dr. Ben Cocchiaro, a Philadelphia physician who treats people struggling with addiction, agreed that while these newer substances may kill fewer people, they still cause significant harm.
"They may be less lethal, but they’re not less dangerous," Cocchiaro said. "XYL leads to devastating skin wounds, and medetomidine causes extreme withdrawal symptoms."
With fewer people dying, public health officials warn that more resources will be needed to support those who survive.
A Future Built on Hope and Recovery
As the death toll declines, addiction experts anticipate a greater demand for healthcare, housing, and treatment services.
"In some ways, counting bodies is easier than measuring the long-term suffering caused by unregulated drug use," Dasgupta said.
Elena and Vadim, still struggling with their addictions, know firsthand that survival doesn’t mean the battle is over.
"I got some tranq sores," Elena admitted, referring to the wounds caused by XYL. "And I ended up with MRSA. I had to be hospitalized."
Still, despite the ongoing challenges, the reduction in overdose deaths offers a glimmer of hope.
"Recovery is possible," Vadim said. "We’ve both had clean stretches before—it can happen."
"I have to believe things will get better," Elena added. "I just have to."
Source: NPR