Good news first: we saw something remarkable happen in 2024. Overdose deaths in the United States dropped by nearly 27% compared to the year before. That means thousands of families didn’t lose a loved one to overdose. It’s proof that when we work together—communities, healthcare providers, and policymakers—we can save lives.

But we’re not out of the woods yet. The drugs on the street keep changing, and too many people still can’t get the help they need when they’re ready for it. If you’re trying to understand what’s happening with substance use disorders right now, or if you’re looking for help for yourself or someone you care about, here’s what you need to know.

The Drug Crisis Is Still Evolving

Fentanyl Remains the Biggest Threat

Even though fewer people died from overdoses in 2024, fentanyl is still driving most of them. This synthetic opioid is incredibly powerful and shows up in drugs people don’t expect it to be in. The good news is that naloxone (Narcan) can reverse fentanyl overdoses, and medications like buprenorphine and methadone can help people recover from opioid addiction.

New Dangerous Additives

Drug dealers are mixing more dangerous substances into street drugs. Veterinary sedatives like xylazine (sometimes called “zombie drug”) and medetomidine are showing up more often. These are particularly scary because:

• They don’t respond to naloxone the way opioids do
• They can cause severe skin wounds
• People might still look unconscious even after getting naloxone

If you suspect someone has overdosed, still give them naloxone, but also provide rescue breathing and get emergency help right away.

Fake Pills Targeting Young People

Counterfeit pills that look exactly like Adderall, Xanax, or prescription painkillers are being sold through social media. Many contain fentanyl, and young people think they’re getting “safe” prescription medication. Parents and teens need to know that any pill not from a licensed pharmacy could be deadly.

The Treatment Gap Is Still Too Wide

Here’s a hard truth: only about 1 in 5 people who need help for substance use disorders actually get it. And it’s not always because they don’t want help—sometimes they don’t realize they need it, or they can’t find it when they’re ready.

Getting Help Is Especially Hard in Rural Areas

If you live in a rural area, you probably already know how hard it can be to find mental health and addiction treatment. There simply aren’t enough counselors, doctors, and treatment programs to meet the need. The good news is that some recent changes are making treatment more accessible:

• Any doctor can now prescribe buprenorphine (a medication that helps with opioid addiction) without special training
• You can start buprenorphine treatment through telemedicine in many cases
• More programs are offering same-day treatment starts

Mental Health and Addiction Often Go Together

About 8% of American adults deal with both a substance use disorder and a mental health condition at the same time. Unfortunately, many people get treatment for one but not the other, which makes recovery much harder. The best programs treat both together or have strong partnerships to make sure nothing falls through the cracks.

What Families Should Watch For

Marijuana Use Is Increasing

More people are using marijuana than before—about 22% of Americans 12 and older used it in the past year. While many people don’t see marijuana as problematic, it can cause issues, especially when used with alcohol or nicotine, or when it interferes with work, school, or relationships.

Other Drugs Are Trending Up Too

Hallucinogens (like LSD, mushrooms, and MDMA) are being used more often, and mixing different drugs increases risks. It’s important for treatment programs and families to talk openly about all substances, not just the “hard drugs.”

Youth Nicotine Patterns Are Shifting

Good news: fewer students are using e-cigarettes than in years past. Concerning news: nicotine pouches are becoming popular with young people, and they can be just as addictive as cigarettes or vapes.

What Actually Works in Treatment

Start with Medication When Appropriate

For opioid use disorders, medications like buprenorphine and methadone are lifesavers. They reduce cravings, prevent withdrawal, and give people a chance to rebuild their lives. The most effective programs can start people on these medications right away, not after weeks of waiting.

Make Naloxone Normal

Every family, workplace, and community should have naloxone available and know how to use it. It’s as important as knowing CPR. And remember—even if someone seems to have taken drugs mixed with xylazine or other sedatives, still give naloxone and provide rescue breathing.

Address the Whole Person

Addiction rarely happens in isolation. Trauma, mental health conditions, poverty, and social isolation all play roles. The best treatment addresses all of these factors, not just the substance use.

Measure What Matters

Success in recovery looks different for different people. While abstinence is one goal, reduced use, better relationships, stable housing, and improved physical and mental health are all meaningful victories worth celebrating.

Meet People Where They Are

The most effective programs don’t require people to jump through hoops before getting help. They offer services with as few barriers as possible and understand that recovery is a process, not a one-time event.

A Message of Hope

The dramatic drop in overdose deaths in 2024 shows us what’s possible when we combine compassion with evidence-based approaches. Communities that expand access to treatment medications, distribute naloxone widely, and support harm reduction services are saving lives.

If you or someone you love is struggling with substance use, know that help is available and recovery is possible. Treatment works, people recover, and families heal.

The landscape of addiction and recovery continues to change, but one thing remains constant: every person deserves compassion, dignity, and access to care when they’re ready for it. Whether you’re taking the first step toward recovery or supporting someone who is, you’re not alone in this journey.