Overdose Prevention in 2025: Hope, Action, and Awareness

Susanna Marrs RN, BSN, CARN
11 hours ago
4 min read

Introduction

There's real progress to celebrate this National Recovery Month. The CDC reports that U.S. overdose deaths decreased by nearly 27% in 2024 compared with 2023. That momentum is encouraging, but the drug supply keeps changing, which means prevention has to keep evolving too.

How to Recognize and Respond to an Overdose

Opioid overdoses can look different from person to person, but common warning signs include slowed or stopped breathing, extreme sleepiness or unresponsiveness, and skin that looks pale or bluish.

Call 911 immediately
Give naloxone if it's available
Place the person on their side in the recovery position
Stay until help arrives

Most states also have Good Samaritan laws that protect people who call for help during an overdose.

Naloxone in 2025: Easier to Get, Simple to Use

Naloxone is a life-saving medicine that quickly reverses opioid overdoses by restoring normal breathing. It works against all opioids, including Fentanyl. In 2023, the FDA approved naloxone nasal spray (Narcan®️4mg and RiVive™️️ 3mg) for over-the-counter sales, meaning it now can be purchased without a prescription at many pharmacies, health departments, and community programs.

When using naloxone, follow the instructions on the package. If the person does not respond within 2-3 minutes, give another dose. Keep in mind: more than one dose may be needed when stronger opioids like Fentanyl are involved.

Naloxone will not hurt someone if opioids are not present, so when in doubt, give it. Always call 911 after using naloxone and stay with the person until help arrives.

Myth-Buster: Naloxone Still Works with Fentanyl

A common myth is that naloxone should not be used if fentanyl is involved. This is not true. Naloxone works against all opioids, including fentanyl. Because fentanyl is very strong, sometimes more than one dose may be needed. Repeat every 2-3 minutes if the person does not respond. When in doubt, give it. Always call 911 after giving naloxone and continue rescue breathing until help arrives.

Emerging Challenges in 2025: Fentanyl + Xylazine + Others

The drug supply is constantly changing, which makes overdose prevention more complicated. In 2025, several new threats are shaping the landscape.

Fentanyl and xylazine: Xylazine is a veterinary sedative often mixed with fentanyl. Naloxone should still be given, because opioids are involved, but it does not reverse xylazine itself. Rescue breathing and medical care is critical in these cases.
Medetomidine: This is another veterinary tranquilizer that has been detected in overdose cases, including clusters in Chicago. Like xylazine, it is not reversed by naloxone, so emergency care is essential.
Nitazenes: Nitazenes are synthetic opioids that can even be stronger than fentanyl. Naloxone can still work against them, but multiple doses may be needed.

Because these substances are appearing in more communities, it's more important than ever to recognize overdose symptoms, call 911, and stay with the person until help arrives.

Community Prevention Strategies: What Works Right Now

Even as new threats appear, we know that certain prevention strategies save lives. Communities across the country are using these approaches with success:

Naloxone distribution: Making sure naloxone is available in homes, schools, libraries, and community centers helps bystanders act fast when overdose occurs.
Education and training: Teaching people how to recognize the signs of overdose and how to give naloxone empowers entire communities.
Medications for opioid use disorder (MOUD): Treatments like buprenorphine and methadone reduce the risk of fatal overdose and support long-term recovery.
Fentanyl test strips: These simple strips let people check drugs for fentanyl before use, reducing surprise overdoses.
Harm reduction programs: Syringe services, safe use education, and peer support programs connect people to care and cut down on health risks.

When these strategies are combined, naloxone access, education, treatment, and harm reduction, communities see real progress in reducing overdose deaths.

Overdose Action Plan for 2025

Having a simple plan makes it easier to act quickly in an emergency. Here are four key steps everyone should know:

Carry naloxone and make sure friends, family, or coworkers know where it is and how to use it.
Know the signs of overdose: slowed or stopped breathing, unresponsiveness, or bluish skin.
Give naloxone right away if you suspect an overdose. If there is no response within 2-3 minutes, give a second dose.
Call 911 and stay with the person until help arrives. Provide rescue breathing or chest compressions if needed.

With these simple steps, anyone can make a difference between life and death.

Conclusion

Overdose prevention in 2025 is about more than a single medication. It's about awareness, quick action, and community support. While the drug supply continues to change, the tools that save lives remain the same: recognizing an overdose, using naloxone, calling 911, and supporting recovery. This National Recovery Month is a reminder that progress is possible. With compassion, education, and a commitment to harm reduction, every one of us has the power to protect lives and bring hope to our communities.

References

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Centers for Disease Control and Prevention. (2025, June 11). Lifesaving naloxone. https://www.cdc.gov/stop-overdose/caring/naloxone.html

Centers for Disease Control and Prevention. (2024, April 2). What to do if you think someone is overdosing. https://www.cdc.gov/stop-overdose/response/index.html

Centers for disease Control and Prevention. (2024, May 2) 5 things to know about naloxone. https://www.cdc.gov/overdose-prevention/reversing-overdose/about-naloxone.html

U.S. Food and Drug Administration. (2023, March 29). FDA approves first over-the-counter

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U.S. Food and Drug Administration. (2023, July 28). FDA approves second over-the-counter naloxone nasal spray product. https://www.fda.gov/news-events/press-announcements/fda-approves-second-over-counter-naloxone-nasal-spray-product

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Centers for Disease Control and Prevention. (2024, May 8). Reverse opioid overdose to prevent death. https://www.cdc.gov/overdose-prevention/reversing-overdose/index.html

Centers for Disease Control and Prevention. (2024, May 16). What you should know about xylazine. https://www.cdc.gov/overdose-prevention/about/what-you-should-know-about-xylazine.html

Nham, A., et al. (2025). Overdoses involving medetomidine mixed with opioids-Chicago, Illinois, May 2024. MMWR Morbidity and Mortality Weekly Report, 74 (15). https://www.cdc.gov/mmwr/volumes/74/wr/mm7415a1.htm

Kariisa, M., et al. (2023). Illicitly manufactured fentanyl-involved overdose deaths with and without xylazine. MMWR Morbidity and Mortality Weekly Report, 72 (26). https://www.cdc.gov/mmwr/volumes/72/wr/mm7226a4.htm

Zhu, D. T., et al. (2025). Fentanyl-xylazine overdose deaths in the USA, 2018-2023. Injury Prevention. https://injuryprevention.bmj.com/content/early/2025/04/01/ip-2024-045596

National Institute on Drug Abuse. (2022, January 11). Naloxone DrugFacts. https://nida.nih.gov/publications/drugfacts/naloxone

Substance Abuse and Mental Health Services Administration. (2025, June 20). Overdose prevention and response toolkit (PEP23-03-00-001). https://library.samhsa.gov/sites/default/files/overdose-prevention-response-kit-pep23-03-00-001.pdf

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