The Department of Health and Human Services (HHS) released two new reports it says highlight how actions across President Trump’s two terms to reduce opioid prescribing, combat illicit fentanyl, and strengthen treatment and recovery have led opioid deaths to fall:

1. A new analysis from the Office of the Assistant Secretary for planning and evaluation (ASPE) examining the record-low age-adjusted death rate in 2025 and role of the decline in overdose deaths
2. A new Health Affairs Forefront article on progress in reducing prescription opioid exposure and expanding treatment

The findings:

• The ASPE report found that declines in unintentional injury mortality made the largest contribution to the age-adjusted death rate decline (30%). Approximately 73% of that decline came from a decline in unintentional drug overdoses, and nearly all of the overdose decline was concentrated among deaths involving synthetic opioids.
• The HHS officials’ Health Affairs Forefront article found that since 2015, retail pharmacy prescription opioid exposure has fallen significantly, including the number of opioid prescriptions dispensed, total morphine milligram equivalents (MMEs) dispensed, and the number of patients receiving prescription opioids. At the same time, the number of patients filling prescriptions for buprenorphine or naltrexone has increased substantially, and prescription counts for these medications have risen more modestly.

What they’re saying: HHS credits efforts including Trump signing the SUPPORT Act in 2018 and reauthorization in 2025; an administration plan to reduce opioid prescription fills by one-third in three years; the Drug Enforcement Administration (DEA) proposing to lower 2019 manufacturing quotas for frequently misused opioids; closing the border; DEA’s Fentanyl Free America initiative and supply chain efforts; and the Great American Recovery Initiative.

But: Addiction experts say the factors are far more complicated than one administration’s policies.

• The decline in overdose deaths started years ago and continued downward, likely deserving credit from both the Trump and Biden administrations.
• This administration slashed funding for harm reduction efforts, which some experts say have contributed to the declining overdose deaths, as well as several other substance use-related agencies and programs. Experts agree that closing the border is not something that helped.
• Experts also emphasize that impending Medicaid cuts from HR 1 could reverse a lot of the progress that has been made when it comes to addiction treatment.