About 6.9 million Americans misused prescription opioids in 2025, down from 8.5 million in 2021, and 4.0 million had an opioid use disorder, according to SAMHSA’s 2025 National Survey on Drug Use and Health. Drug overdose deaths fell to a predicted 66,478 in the 12 months ending May 2026, down 11.5% in a year, though only 15.7% of people with opioid use disorder received medication treatment.
Painkiller Addiction in the US 2026 – Introduction
Painkiller addiction in the US looks different in 2026 than it did at the peak of the opioid crisis. Fewer people misuse prescription opioids, and far fewer die. SAMHSA’s 2025 survey, released July 27, 2026, counts 6.9 million people who misused prescription opioids in the past year, or 2.4% of people aged 12 and older. That is down from 3.0% in 2021. The CDC’s final data show overdose deaths of every kind fell 26.2% in 2024, the largest one-year drop in at least a decade.
The gains are real, but they are slowing and uneven. Most overdose deaths now involve illicit fentanyl, not prescription pills, although the two categories overlap. Treatment lags: of the 4.0 million people with opioid use disorder, fewer than one in six received a medication such as buprenorphine, methadone, or naltrexone. This report uses federal data from SAMHSA and the CDC. Survey figures measure self-reported misuse, and overdose figures come from death certificates, so the two cannot be compared directly.
Interesting Facts about Painkiller Addiction in the US
PRESCRIPTION OPIOID MISUSE IN THE PAST YEAR (MILLIONS, AGES 12+)
2021 ████████████████████████████████████████ 8.5
2024 ████████████████████████████████████ 7.6
2025 ████████████████████████████████ 6.9
| Fact | Latest Data |
|---|---|
| People who misused prescription opioids, 2025 | 6.9 million (2.4% of people aged 12+) |
| Prescription opioid misuse, 2021 | 8.5 million (3.0%) |
| People with an opioid use disorder, 2025 | 4.0 million |
| Share of those receiving medication for opioid use disorder | 15.7% (623,000 people) |
| Overdose deaths, 2024 (final CDC data) | 79,384 (rate 23.1 per 100,000) |
| Overdose deaths, 2025 (provisional) | 69,973 |
| Predicted overdose deaths, 12 months ending May 2026 | 66,478 (-11.5%) |
| Overdose death rate involving natural and semisynthetic opioids, 2024 | 2.3 per 100,000 (from 2.9) |
| Overdose death rate involving synthetic opioids such as fentanyl, 2024 | 14.3 per 100,000 (from 22.2) |
The survey numbers show a steady decline. Prescription opioid misuse fell by 1.6 million people between 2021 and 2025, a drop of about 19%, which is our calculation from SAMHSA’s published counts. Prescription pain relievers are still the most commonly misused prescription drugs, according to SAMHSA’s survey methodology notes. The 2025 survey also counted 44.6 million people with a substance use disorder, so painkillers are one part of a much larger problem.
The death data show the larger shift. The rate of overdose deaths involving prescription-type opioids, which include oxycodone, hydrocodone, and morphine, fell 20.7% in 2024, from 2.9 to 2.3 per 100,000. Deaths involving synthetic opioids such as fentanyl fell 35.6%, from 22.2 to 14.3, but that rate is still more than six times higher. Fentanyl, not pills, drives most opioid deaths, a point the sections below explain.
Prescription Opioid Misuse in the US in 2026
PRESCRIPTION OPIOID MISUSE AND HEROIN USE, 2025 (THOUSANDS, AGES 12+)
OPIOID MISUSE (ALL) ████████████████████████████████████████ 7,080
PRESCRIPTION OPIOID MISUSE ██████████████████████████████████████ 6,881
PRESCRIPTION MISUSE AND HEROIN USE ██ 382
| Measure (2025 NSDUH) | Figure |
|---|---|
| Misused prescription opioids in the past year | 6.9 million (2.4%) |
| Change since 2021 | From 8.5 million (3.0%) |
| People who misused any opioid | About 7.08 million |
| Prescription opioid misuse, share of all opioid misuse | 97.2% |
| Prescription opioid misuse and heroin use together | About 382,000 (5.4% of opioid misusers) |
| Prescription opioid misuse in 2024 | 7.6 million |
| Past-month prescription pain reliever misuse (SAMHSA summary) | About 2.0 million |
Data Source: Substance Abuse and Mental Health Services Administration, 2025 National Survey on Drug Use and Health (released July 27, 2026); 2024 NSDUH annual national report
Nearly all opioid misuse in the survey involves prescription drugs. About 97.2% of the roughly 7.08 million people who misused opioids misused prescription opioids, and 5.4% also used heroin. The 2025 survey interviewed more than 60,000 people, and it counts misuse, meaning use without a prescription, in greater amounts than prescribed, or for the feeling it causes. It does not measure addiction, which is a separate diagnosis.
The trend runs in one direction. The estimate fell from 8.5 million in 2021 to 7.6 million in 2024 and 6.9 million in 2025. Survey estimates carry a margin of error, so a single year’s change is less reliable than the multi-year slope. About 2.0 million people reported misusing a prescription pain reliever in the past month, according to SAMHSA’s summary of past-month use, which gives a sense of how many are misusing regularly.
Opioid Use Disorder and Treatment Gaps in the US in 2026
PEOPLE WITH OPIOID USE DISORDER, 2025 (MILLIONS) AND TREATMENT
OPIOID USE DISORDER (PAST YEAR) ████████████████████████████████████████ 4.0
RECEIVED MEDICATION FOR OUD ██████ 0.623
| Measure (2025 NSDUH) | Figure |
|---|---|
| Past-year opioid use disorder | 4.0 million |
| Received medication for opioid use disorder | 623,000 (15.7%) |
| Did not receive medication (our calculation) | About 3.4 million (84.3%) |
| People with any substance use disorder | 44.6 million (15.3%) |
| People with a drug use disorder | 26.0 million |
| Needing treatment who received any treatment | 7.6 million (16%) |
Data Source: SAMHSA, 2025 National Survey on Drug Use and Health (July 2026)
Four million people met the criteria for an opioid use disorder in 2025, and 623,000 received a medication to treat it. That is 15.7%. The remaining 84.3%, about 3.4 million people, received no medication, which is our subtraction. Medications such as buprenorphine, methadone, and naltrexone are the standard treatments, and the gap between need and access is the main unfinished work in the crisis.
The gap is not limited to opioids. Of 44.6 million people with any substance use disorder, only 16% of those who needed treatment received any, which comes to 7.6 million. SAMHSA changed how it classifies opioid use disorder in 2024, so comparisons with years before 2024 should be made with care. For the most current counts, use the 2025 figures in this report rather than older published totals.
Overdose Deaths in the US in 2026
US DRUG OVERDOSE DEATHS BY YEAR
2022 ████████████████████████████████████████ 107,941
2023 ██████████████████████████████████████ 105,007
2024 █████████████████████████████ 79,384
2025 (PROV.) ██████████████████████████ 69,973
12 MO TO MAY 2026 (PRED.) ████████████████████████ 66,478
| Period | Overdose Deaths | Notes |
|---|---|---|
| 2022 (final) | 107,941 | Peak period |
| 2023 (final) | 105,007 | |
| 2024 (final) | 79,384 | Rate 23.1 per 100,000, down 26.2% |
| 2025 (provisional) | 69,973 | About 12% below 2024 (our calculation against the final count) |
| 12 months ending March 2026 (predicted) | 67,798 | -12.3% from 77,306 |
| 12 months ending May 2026 (predicted) | 66,478 | -11.5% from 75,094 |
| Average per day, latest period (our calculation) | About 182 |
Data Source: CDC National Center for Health Statistics, Data Brief No. 549 (January 29, 2026) and the provisional drug overdose dashboard (updated October 14, 2026)
Deaths have fallen for three straight years since the 2022 peak of 107,941. The final count for 2024 was 79,384, and provisional data put 2025 at 69,973. The CDC’s latest predicted figure, 66,478 for the 12 months ending May 2026, works out to about 182 deaths a day. The CDC recommends predicted counts because they adjust for deaths still under investigation, and provisional figures can change when final data arrive.
The pace of improvement has slowed. The 2024 decline was 26.2%, while the 2025 decline was about 12% and the latest 12-month decline 11.5%. A drop of that size is still large, but it is less than half the 2024 pace. Fewer than 67,000 deaths a year is also still about 62% of the 2022 peak.
Prescription Opioids Versus Fentanyl in Overdose Deaths in 2026
OVERDOSE DEATH RATES BY OPIOID TYPE, 2024 (PER 100,000)
SYNTHETIC (FENTANYL ETC.) ████████████████████████████████████████ 14.3
NATURAL/SEMISYNTHETIC (PILLS) ██████ 2.3
METHADONE ██ 0.9
| Measure | Figure |
|---|---|
| Synthetic opioid overdose death rate, 2024 | 14.3 per 100,000 (-35.6%) |
| Natural and semisynthetic opioid death rate, 2024 | 2.3 per 100,000 (-20.7%) |
| Methadone death rate, 2024 | 0.9 per 100,000 (-10.0%) |
| Synthetic opioid deaths, 2024 | 47,735 |
| Preventable deaths involving natural and semisynthetic opioids, 2024 (National Safety Council) | 6,738 (-23%) |
| Opioid-involved deaths, 12 months ending March 2026 (predicted) | 42,524 (from 51,207) |
| Synthetic opioid deaths, 12 months ending March 2026 (predicted) | 35,976 (from 44,782) |
| Opioids as share of all overdose deaths, March 2026 (our calculation) | About 62.7% |
Data Source: CDC NCHS Data Brief No. 549; CDC provisional dashboard (August 2026 release); National Safety Council Injury Facts analysis of CDC data
Prescription-type opioids cause a minority of opioid deaths. The death rate for synthetic opioids, mainly illicitly made fentanyl, was 14.3 per 100,000 in 2024, more than six times the 2.3 for natural and semisynthetic opioids. The National Safety Council counted 6,738 preventable deaths involving the second category in 2024, compared with about 45,917 involving fentanyl. The categories overlap, since many deaths involve more than one drug, so the numbers should not be added together.
Opioids are still involved in most overdose deaths, though less than before. In the 12 months ending March 2026, predicted opioid-involved deaths were 42,524, down from 51,207, and synthetic opioid deaths were 35,976, down from 44,782. Opioids account for about 62.7% of the 67,798 total, by our calculation. The drop of about 17% in opioid deaths is larger than the 12.3% drop in all overdose deaths, which means the decline is concentrated in opioids.
Overdose Trends and State Differences in 2026
YEAR-OVER-YEAR CHANGE IN OVERDOSE DEATHS (%)
2024 (FINAL) ████████████████████████████████████████ -26.2
2025 (PROVISIONAL, OUR CALC.) ████████████████████ -11.9
12 MO TO MAR 2026 ██████████████████ -12.3
12 MO TO MAY 2026 █████████████████ -11.5
| Measure | Figure |
|---|---|
| 2024 change in the overdose death rate | -26.2% (from 31.3 to 23.1) |
| 2025 change (provisional, our calculation vs. final 2024) | About -11.9% |
| 12 months ending March 2026 | -12.3% |
| 12 months ending May 2026 | -11.5% |
| Jurisdictions where predicted deaths still rose (March 2026 data) | 7, including New Mexico (+28.3%) |
| New York, 12 months ending May 2026 | About 3,650 deaths, down about 8% |
| New York, earlier two-year decline | More than 40% |
Data Source: CDC NCHS provisional overdose data and Data Brief No. 549; state figures from the CDC dashboard as reported by Medical Daily
The national decline hides local differences. Predicted deaths still rose in seven jurisdictions in the CDC’s March 2026 data, led by New Mexico at 28.3%. New York shows the broader slowdown: its deaths fell about 8% in the latest year, after a drop of more than 40% over the prior two years. In New York, synthetic opioids were involved in roughly six in ten deaths, and those deaths still fell about 13.5%.
Policy decisions will shape the next numbers. The Drug Enforcement Administration says cartels are adapting to crackdowns on precursor chemicals and moving other substances into the supply. Funding for treatment and for naloxone, the overdose reversal drug, also affects the trend, and observers have warned that policy changes could reverse some gains. The data through May 2026 show continued decline, but the rate of improvement is well below the 2024 pace.
Frequently Asked Questions
How many Americans misuse prescription painkillers in 2026?
SAMHSA’s 2025 National Survey on Drug Use and Health estimates 6.9 million people aged 12 and older misused prescription opioids in the past year, or 2.4% of that population. That is down from 8.5 million in 2021.
How many people have an opioid use disorder?
About 4.0 million people aged 12 and older had an opioid use disorder in the past year, according to the 2025 survey.
How many people get treatment for opioid addiction?
Of the 4.0 million with opioid use disorder, 15.7%, or 623,000 people, received medication for it in the past year.
How many people die from overdoses each year in the US?
The final count for 2024 was 79,384. Provisional data put 2025 at 69,973, and the CDC predicts 66,478 for the 12 months ending May 2026.
Are overdose deaths going down in 2026?
Yes. Predicted deaths for the 12 months ending May 2026 were 11.5% below the previous year. The pace of decline has slowed from 26.2% in 2024 to near 12%.
Do prescription painkillers or fentanyl cause more overdose deaths?
Fentanyl and other synthetic opioids cause far more. In 2024 their death rate was 14.3 per 100,000, compared with 2.3 for natural and semisynthetic opioids such as oxycodone and hydrocodone. Many deaths involve more than one drug.
What are natural and semisynthetic opioids?
This CDC category includes prescription drugs such as morphine, codeine, hydrocodone, and oxycodone. It is the closest official category to prescription painkillers.
Which states have rising overdose deaths in 2026?
The CDC’s March 2026 data showed predicted deaths still rising in seven jurisdictions, including New Mexico, where they rose 28.3%.
Where can someone get help for painkiller addiction?
SAMHSA runs a free, confidential national helpline at 1-800-662-4357, available around the clock. A doctor or pharmacist can also discuss treatment options, including medications for opioid use disorder. Check samhsa.gov for current contact details.
Disclaimer: The data research report we present here is based on information found from various sources. We are not liable for any financial loss, errors, or damages of any kind that may result from the use of the information herein. We acknowledge that though we try to report accurately, we cannot verify the absolute facts of everything that has been represented.
