Deaths caused by drug overdose decreased in the U.S. by 30,000 last year, marking the largest one-year decline in drug-related deaths.

Around 80,000 people died from an overdose last year, according to provisional Centers for Disease Control and Prevention data, down 27% from 110,000 in 2023. The largest previous one-year drop was 4% in 2018, according to the agency’s National Center for Health Statistics.

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Every state except Nevada and South Dakota saw a decrease in drug overdose deaths. Some of the biggest decreases were in Louisiana, Ohio, Virginia, and West Virginia, which have been hit hard by the opioid epidemic.

The CDC has been collecting data on overdose deaths for 45 years. More than 1 million people in the U.S. have died of opioid-related overdoses since 1999, according to data from Congress.

Experts believe the decrease can be attributed to the rising availability of the overdose-reversing drug naloxone, increased treatment for drug addiction, as well as the impact of billions of dollars from settlements with opioid companies. 

Naloxone has become widely available, due in part to the production of over-the-counter versions that don’t require prescriptions.

Drug manufacturers, distributors, and pharmacy chains have settled multiple lawsuits with state and local governments for prescribing painkillers that were a main driver of overdose deaths in the past. More than $50 billion has come out of it, with most of it required to be used to fight addiction.

Another large settlement between the Sackler family, who owns OxyContin maker Purdue Pharma, could be approved this year, with the company having to pay up to $7 billion.

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Overdose deaths remain higher than they were before the COVID-19 pandemic. The CDC said that overdoses are still the leading cause of death for people between the ages of 18 and 44 years old, “underscoring the need for ongoing efforts to maintain this progress.”

“We’re still at very high levels of overdose,” Dr. Daniel Ciccarone, a professor at the University of California, San Francisco, whose research has focused on illicit drug trends in the US, said. “We need steady pressure. To the degree that we stop paying attention or take our foot off the gas pedal, we will see a reversal.”