After peaking at more than 100,000 deaths a year during the COVID-19 pandemic, drug overdose deaths in the United States have declined sharply over the past two years, according to a new report from the University of Minnesota School of Public Health (SPH). While the national overdose death rate fell nearly 30% between 2022 and 2024—the largest two-year decline in decades—the analysis shows the crisis is far from over, particularly for people with lower levels of education and certain racial and ethnic groups.

The report, conducted by SPH’s State Health Access Data Assistance Center (SHADAC), examined national and state trends in overdose deaths involving fentanyl, prescription opioids, cocaine, and methamphetamine to examine differences across various demographic groups. SPH researchers also used newly available data from the Centers for Disease Control and Prevention (CDC) to conduct one of the first national analyses of overdose deaths by education level. Key findings from SHADAC’s analysis of national drug overdose trends between 2022 and 2024, include:

• U.S. overdose deaths declined nationwide. The overall U.S. drug overdose death rate fell 29% between 2022 and 2024, driven largely by a 37% decline in fatal overdoses involving fentanyl and related synthetic opioids.
• People with lower levels of education experienced disproportionately high overdose death rates. Researchers found that people with a high school diploma or less accounted for roughly twice as many fatal drug overdoses as would be expected based on their share of the population.
• Racial and ethnic disparities remain substantial. American Indian or Alaska Native people had fentanyl overdose death rates more than twice the national average and methamphetamine overdose death rates more than three times the national average. Black people had cocaine overdose death rates nearly three times the national average.
• Older adults were the only age group to see increases in some overdose deaths. While overdose death rates declined across nearly every age group, fatal cocaine and methamphetamine overdoses continued to rise among adults ages 65 and older.

“The overall decline in overdose deaths is encouraging,” said Colin Planalp, associate director for emerging health policy issues at SHADAC and lead author of the report. “This progress is likely the result of multiple factors including expanded access to treatment and naloxone, more responsive public health interventions, changes in drug use, and shifts in the illicit drug supply. Despite these encouraging trends, this report underscores that the burden of the overdose crisis remains far from equal. The new education data reveal that people with a high school diploma or less to experience a disproportionately high share of overdose deaths, while longstanding disparities persist for Black people and American Indian or Alaska Native communities. These findings can help policymakers and public health leaders better focus prevention and treatment efforts where they are needed most.”

The report also examined state-level trends, finding that Minnesota continued to fare better than the nation overall. Minnesota’s overdose death rates for fentanyl, prescription opioids, cocaine, and methamphetamine were all significantly lower than the U.S. rates. Fatal overdoses involving fentanyl, prescription opioids, and methamphetamine also declined significantly in Minnesota between 2022 and 2024.

The report emphasizes that continued tracking of overdose trends and disparities can help policymakers and public health leaders identify emerging threats and target prevention and treatment efforts where they can have the greatest impact.