Trust for America Health released the 2025 Pain in the Nation report, an annual report focused on alcohol, drug, and suicide deaths.

The main point: The report found that deaths due to drug overdose and alcohol are down nationally, following two decades of rapid increases. But the progress is uneven across population groups and at risk due to current and proposed federal budget cuts, workforce reductions, and agency reorganization.

The findings: Over 20o,000 Americans still died due to alcohol, drug overdose, and suicide in 2023, twice the rate of such deaths 20 years ago.

• Overdoses: In 2023, 105,007 Americans died from drug overdoses, 4% lower than 2022 (and provisional data shows a 27% decrease in 2024). However, in 2023, white people were the only racial/ethnic group that experienced a statistically significant decrease in overdose deaths. Overdose death rates were highest among American Indian/Alaska Native (AI/AN) people, adults 35-54, Black people, and males.
• Alcohol: In 2023, 47,938 Americans died from alcohol-induced causes, with the rate of alcohol-induced mortality decreasing 7% from 2022-2023. This built on a 6% reduction the year prior and crossed nearly all demographic and geographic groups. But rates were highest among AI/AN people, adults 55-74, adults 35-54, and males.
• Suicide: The suicide mortality rate remained unchanged from 2022 to 2023, with 49,316 Americans dying by suicide in 2023. Rates were highest among AI/AN people, males, and adults 75+.

Recommendations: The report calls for sustained investment in prevention and harm reduction programs and includes recommendations on actions federal and state policymakers should take, such as:

• Bolstering investment in public health and behavioral health systems and injury and violence prevention programs
• Improving programs to track emerging trends by geographic, demographic, and drug type metrics
• Focusing on underlying drivers of substance use disorder (SUD) through early intervention and prevention policies, including expanding resiliency and substance use prevention programs in schools and increasing access to social and mental health services for children and families
• Maximizing harm reduction strategies and SUD treatment
• Bolstering the continuum of crisis intervention programs and expanding the mental health and SUD treatment workforce