After rising for decades in the United States, opioid overdose deaths have been declining dramatically since 2023, with the annual rate of fentanyl overdose deaths dropping by more than a third by the end of 2024. What’s behind this sudden decline? In this Policy Forum, Kasey Vangelov and colleagues evaluate the evidence for an international supply shock in fentanyl in 2023 and conclude that it could be responsible for the steep decline in overdose deaths. Studying the ups and downs of an illegal drug economy is difficult, but the researchers use data from several sources, including a spike in U.S.-based Reddit users’ reports of a fentanyl drought in mid-to-late 2023. Fentanyl seized during this period shows a concurrent decline in purity and seizures themselves fell during the period, despite being an intense focus of law enforcement. In Canada, supply indicators of fentanyl precursors from China declined at the same time. Together, this evidence indicates that supply disruption may be behind the drop off in fentanyl deaths. “The incentive to restore the illicit fentanyl trade will persist as long as there is demand for the drug …” Vangelov et al. write, adding that “…it may be wise to use the current drought as an opportunity to ramp up the prevention and treatment programs that have evidence of decreasing demand.”
Science
Did the illicit fentanyl trade experience a supply shock?
8-Jan-2026