Arizona overdose deaths surge amid national decline

The big picture: Overdose deaths hit an all-time high in Arizona last year at 43.5 per 100,000 people, the Times wrote last week.

• The U.S. as a whole has seen a marked decrease since the pandemic after several decades of rising deaths.

Threat level: Pills historically dominated Arizona's illicit opioid market, but two years ago were largely replaced by powdered fentanyl.

• Because the amount of fentanyl the powder contains can vary wildly, it creates a higher risk for overdoses, with one longtime user telling the Times, "you would overdose instantly if you weren't careful."
• Powder use spiked among people not used to using it, so many haven't had time to adapt.
• Extreme heat, homelessness and meth use fuel the problem — overdoses peak in the hottest months, and 80–90% of fentanyl users also use meth, ASU professor Raminta Daniulaityte told the Times.

Between the lines: The shift from pills to powdered fentanyl happened earlier in most of the country, with Arizona and New Mexico lagging behind other states.

• The two Southwestern states now have the highest rates of overdose deaths in the lower 48 states, and saw the biggest increases last year.

By the numbers: In Maricopa County, total drug overdoses jumped to 2,406 last year from 2,069 in 2024, per public health department data.

• More than two-thirds of the overdoses were from opioids, with fentanyl causing the overwhelming majority.
• However, 85% of overdose deaths involved more than one drug.

1 promising sign: There's a glimmer of hope — nonfatal overdoses through mid-June were lower in Maricopa County this year than the same period in 2025, and drug deaths through March lagged last year's numbers.

• "It's possible the crisis has begun to ebb," the Times wrote.

• Yes, but: It takes months to classify many drug deaths, so we won't have a full picture until after summer, the Times noted.

The intrigue: The reasons for the national decline are still up for debate, the Times wrote.

• "Epidemic curves can only go up for so long," University of Washington research professor Caleb Banta-Green told the paper.

Zoom in: The biggest problems facing Arizona related to overdoses are fentanyl powder, increased meth use and an uptick in synthetic substances in drug mixtures, said Teresa Manygoats, bureau chief and state director for chronic diseases at the Arizona Department of Health Services.

• New Mexico and Nevada are experiencing overdose death increases as well, she told Axios, and the department is working to understand what's causing it.
• The state doesn't have much information to share, but Manygoats said she expects to have more in a couple months after the counties wrap up some work they're doing.