While drug overdose deaths have been falling in the U.S., the rate in Arizona has been rising.

The stats: Arizona’s overdose death rate is nearly twice the national average. It is the only state where drug deaths are above their post-COVID peak. The drug death rate in Arizona last year overtook the rate in West Virginia, once the center of the opioid crisis.

The details: Potential reasons for this include a local shift in the drug supply, combined with the widespread use of methamphetamine, high temperatures, and homelessness in the region.

The opioid supply has shifted over the past few years from predominantly counterfeit pills to mostly powdered fentanyl. Powdered fentanyl is particularly dangerous because of its higher variability and potential for extreme potency. This shift happened in much of the country years ago.
The heat in the area has compounded the dangers of the supply shift. Based on Maricopa County medical examiner data, when the daily high in Phoenix crossed 110 degrees, drug deaths in the county increased by 40%, and on days when the temperature reached 115, drug deaths nearly doubled. In 2025, over half of heat-related deaths in Maricopa County involved drugs.
The widespread use of methamphetamine adds to the dangers. The combination of heat and meth can be deadly. Meth raises body temperature and heart rate, and its effects are heightened by heat exposure, lack of sleep, and dehydration.
The large homeless population in the area feels the pressures of heat and meth particularly acutely. Individuals experiencing homelessness have few options to escape the heat and often use meth to stay vigilant. Displacement from homeless encampments has further heightened risk, driving people to new, untested drug sources. And advocates are concerned that a new city parks ordinance that restricts provision of medical care and food in city parks could worsen the problem.