A Historic Decline in Overdose Deaths

On May 14, 2025, a groundbreaking announcement from the CDC reported a staggering 27% drop in overdose deaths for the year 2024. This was a monumental shift after over three decades of relentless increases, claiming over a million American lives and projecting another million deaths in the years to come. Each month over the past year has seen a decline in overdose fatalities, with the most dramatic reductions occurring among those linked to illicit fentanyl, an opioid infamous for its high potency and ease of production.

Government Response Raises Concerns

However, on the same day, Robert F. Kennedy Jr., the new Secretary of Health and Human Services, failed to mention this significant success during his congressional testimony. Alarmingly, his agency's latest policy manifesto, "Making America Healthy Again," did not mention opioids once. Instead, it suggested dismantling the CDC and other key organizations integral to tackling the overdose epidemic. As these proposals move through Congress, the potential for reversing hard-won progress looms large.

Ignoring the Crisis

As a former CDC scientist for nearly thirty years, I've been critical of how the agency has previously managed the opioid epidemic, yet tearing down these protective institutions is not the answer, especially now that we're beginning to see positive outcomes. The current administration's indifference towards this leading cause of death among young adults indicates a troubling trend away from effective interventions.

Key Initiative Shows Promise

One initiative contributing to this decline has been the increased availability of naloxone, a lifesaving opioid overdose antidote. Between 2021 and 2023, naloxone prescriptions from pharmacies doubled, complemented by widespread distribution from harm reduction organizations. The FDA's approval of over-the-counter naloxone nasal spray in March 2023 marked a pivotal moment, with 20 million doses dispensed by year’s end. The downturn in overdose death rates began shortly after the nasal spray became accessible.

Funding Cuts Threaten Future Gains

Yet, just weeks after taking office, Kennedy proposed drastic funding cuts to naloxone programs and plans to eliminate the National Institute on Drug Abuse (NIDA), which has been vital in developing the nasal version of naloxone and researching less addictive pain management options. Moreover, the Substance Abuse and Mental Health Services Administration (SAMHSA) — a key player in treatment funding — faces potential abolishment.

CDC's Role in Overdose Prevention at Risk

The CDC's Division of Overdose Prevention, despite its recent success in reporting a notable decline in deaths, is also marked for dismantling. With warnings of a potential seven-fold increase in overdoses from the formidable opioid carfentanil, the future of overdose prevention hangs precariously in the balance.

A Shifting Focus on Addiction Treatment

The new budget strategy aims for a radical reshaping of human health agencies, framing federal employees as 'villains' in their own right. Kennedy's own vision, as expressed in his 2024 documentary, emphasizes the establishment of 'healing farms' for addiction treatment — an approach that prioritizes hard work and re-parenting over conventional medical interventions.

A Warning from History

In public health, we learn that victories can be fleeting. Back in 2000, our efforts had successfully eradicated measles transmission in the U.S., only to see a resurgence due to misinformation in recent years, reminiscent of the current fight against the overdose crisis. History teaches us that progress must be protected, or the potential for a renewed crisis can swiftly return.