What Drove Down America’s Fentanyl Deaths?
Fentanyl-related deaths in the United States began declining significantly in mid-2023, dropping nearly 50% by late 2025, with a parallel decrease seen in Canada. Researchers suggest this decline may be linked to a supply-side disruption in Chinese production of fentanyl precursor chemicals, which are essential for manufacturing the drug in North America. The timing and pattern of the reduction point to China's potential role in unintentionally or deliberately constraining the illicit fentanyl supply, offering a possible avenue for U.S.-China cooperation or tension in drug control efforts.
- ▪Fentanyl-related deaths in the U.S. fell nearly 50% between mid-2023 and September 2025, dropping from a peak of 111,000 to 73,000 annual overdose deaths.
- ▪The decline in overdose deaths coincided with a constriction in fentanyl supply in both the U.S. and Canada, suggesting a common source in the drug's production chain.
- ▪China produces the precursor chemicals used to manufacture fentanyl in Mexico and Canada, giving it a pivotal role in the availability of the drug in North America.
- ▪The reduction in deaths began after the end of the pandemic’s peak stressors, ruling out post-COVID behavioral normalization as the primary cause.
- ▪A potential crackdown by Chinese authorities on precursor chemical manufacturers may have contributed to the drop in fentanyl availability and overdose deaths.
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What Drove Down America’s Fentanyl Deaths?China Might Have—but Wouldn’t Want Washington to Know Peter Reuter, Jonathan P. Caulkins, and Keith Humphreys April 30, 2026 In an air cargo inspection warehouse, Los Angeles, May 2024 Mike Blake / Reuters PETER REUTER is Distinguished University Professor in the School of Public Policy and Department of Criminology at the University of Maryland.JONATHAN P. CAULKINS is H. Guyford Stever University Professor of Operations Research and Public Policy at Carnegie Mellon University’s Heinz College.KEITH HUMPHREYS is Esther Ting Memorial Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University. More by Peter Reuter More by Jonathan P.
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