For a few years, the news about fentanyl in Texas read like one long emergency. So when the numbers finally started moving in the other direction, many families felt something they had not felt in a while: a small measure of hope. Texas drug deaths fell in 2024, and that decline has largely carried into 2025.
If someone you love is using, though, a falling statewide number raises a harder and more personal question. Does any of this actually change the risk in your own home? The honest answer is that a state average tells you very little about one person. A trend describes thousands of people at once. It is not a forecast for the individual you are worried about tonight. This article walks through what the data really shows, why deaths are dropping, and why the trend, encouraging as it is, is not a reason to wait.
What the numbers actually show
The recent progress is real. Texas drug-related fatalities fell in 2024 from their 2023 peak, a decline of roughly 13 percent statewide. The national picture points the same direction. According to provisional data from the Centers for Disease Control and Prevention, overdose deaths kept falling through 2025, with about 73,000 deaths in the twelve months ending August 2025, a drop of roughly 21 percent. The pace of that improvement has slowed, though, which is a reminder that progress is neither automatic nor guaranteed.
Context is where families find a realistic sense of the risk, and the dip follows a long and punishing climb. According to the Texas Department of State Health Services, the state’s drug poisoning deaths rose 68 percent between 2019 and 2024, and in 2023 drug poisoning was the leading cause of injury-related death for Texans between the ages of 24 and 69. Over the longer arc, the state has lost more than 76,000 lives to drug overdoses since 1999. The recent decline is a welcome bend in a line that had climbed for years. It is not a return to safety, and it is not the same as the crisis being over.
Why the numbers are falling
Several forces appear to be working together, and understanding them explains both the good news and its limits.
The biggest single factor is wider access to naloxone, the medication that can reverse an opioid overdose. Texas expanded distribution through its statewide “One Pill Kills” campaign, an online naloxone locator map, and free naloxone vending machines and dispensers rolling out across all 254 counties. When more naloxone reaches the people and places where overdoses happen, more overdoses are survived. There is also more funding behind the response than a decade ago, including roughly 1.6 billion dollars Texas is receiving from legal settlements with pharmaceutical companies, directed to overdose response teams and education.
The local data make the effect concrete. In Travis County, home to Austin, accidental fentanyl deaths fell from 279 in 2023 to 179 in 2024 and to 111 in 2025, a decline county officials credit largely to naloxone reaching the community. That is genuine, life-saving work.
There is an important limit, though, and it is easy to miss inside the good news. Naloxone reverses an overdose in the moment. It does not treat addiction. As our Austin team has written about why Narcan alone is not enough, surviving an overdose is not the same as recovering from a substance use disorder. A reversal buys time. What a family does with that time is what changes the outcome, and many people are reversed more than once before anything about their situation actually changes.
What a statewide number cannot tell you
A state average is not a personal forecast, and reading it as one can be a costly mistake. A few realities sit underneath the headline.
First, the scale is still enormous. Even in a year when deaths fell, thousands of Texans died, and on an average day about five Texans still die from fentanyl. Second, the trend is uneven and can wobble. Earlier in 2025, some national analyses flagged Texas among a small group of states showing a short-lived uptick before the broader decline resumed. Improvement does not move in a straight line, and a good year does not guarantee the next one.
Third, fentanyl is not the whole story here. As the Federal Reserve Bank of Dallas has noted, only about 34 percent of Texas overdoses between 2019 and 2023 involved fentanyl, well below the national figure near 62 percent. Methamphetamine and cocaine play a large role in Texas, and the state continues to see rising stimulant use. Increasingly, deaths involve more than one substance at once. Polysubstance patterns, where fentanyl is mixed with a stimulant, are growing, and newer additives such as xylazine, an animal tranquilizer that naloxone does not reverse, have begun turning up in the supply in parts of the country. A person who believes they “only” use stimulants is not protected, because the supply itself is unpredictable and often contaminated without the buyer’s knowledge. Overdose burden also varies county to county, so the trend where you live may look nothing like the state as a whole.
Signs the trend may not apply in your home
Instead of watching the state number, watch the person. These are signs that risk may be rising for someone you love:
- Using alone, or needing more of a substance to feel the same effect
- Taking pills that did not come from a pharmacy, or buying anything through social media
- Pulling away from family, work, or daily routines
- A recent overdose, a near miss, or an unexplained hospital visit
- Mixing substances, or mixing substances with alcohol
- Growing secrecy about money, sleep, or where they have been
No single item on this list is proof of anything, and it is not a diagnostic checklist. But if several are present at once, the statewide decline is simply not the number that matters for your family. Your own steady observation is better information than any chart.
What families can do right now
Worry without a plan tends to curdle into paralysis, so it helps to have a few concrete first steps that do not require anyone’s permission.
Keep naloxone in the home and learn how to use it. It is available across Texas at pharmacies, community organizations, and through the state’s distribution program, and it is safe to give even if you are not certain an overdose involves opioids. Learn the signs of use and of an overdose, so you can respond rather than freeze. Our guide on the signs it may be time for an intervention lays out what to look for and how to think about timing.
Start a calm conversation, not a confrontation. The first talk does not need to solve anything. It needs to open a door, and leading with worry and love rather than accusation keeps that door open. If you expect resistance, our guide on how to talk to someone who refuses help can help you prepare. Finally, get a professional read on the situation, since a clinician can help you understand how serious things are and what a realistic next step looks like.
Why waiting for the numbers, or for "rock bottom," is the wrong strategy
There is a long-standing idea that a person has to hit rock bottom before help can work. It is not true, and with fentanyl and contaminated stimulants in the supply it can be fatal. Rock bottom, too often, is an overdose. Waiting for someone to lose everything before you act does not make treatment more likely to succeed. It only removes chances along the way.
Deciding when to act should be based on a person’s trajectory, not on a public statistic and not on a dramatic collapse. We have written before about the real cost of waiting, and the core of it is simple: the earlier a family acts, the more options everyone has.
Acting early does not mean staging an ambush. A professional intervention is a planned, supported, and compassionate process. At Crosswell Interventions we use a five-phase approach, the Crosswell Method, built around connection rather than pressure:
- Listening. We begin by understanding the family system and the person’s story before any plan is made.
- Invitation. We bring the person toward help rather than cornering them, so the conversation feels like an open door instead of a trap.
- Planning. Every practical and clinical detail is prepared in advance, so nothing is left to chance when emotions are high.
- Treatment transition. We move from the conversation to actual care, including safe transport and placement, closing the gap where good intentions often fall apart.
- Ongoing family support. Recovery is a family process, not a single day, so the work continues after treatment begins.
How Crosswell Interventions helps Texas families
We provide clinician-led drug and alcohol intervention services across Texas, from the first worried phone call through treatment placement and family coaching. Our work is trauma-informed and family-centered, and our goal is to help families act on a clear read of their own situation rather than on a headline. If you are ready to think through next steps, our guide on how to stage an intervention walks through what has changed and what still works.
Frequently Asked Questions
Are fentanyl deaths going up or down in Texas right now? Down overall. Texas drug deaths fell in 2024, and the decline has largely continued through 2025, although the pace has slowed and short-term upticks can still happen. The long-run picture remains serious, since deaths rose sharply from 2019 through 2024 before this recent improvement.
Does a lower death rate mean my loved one is safer? No. A statewide average measures a whole population, not one person. Individual risk depends on what someone is using, how, how often, and whether the supply is contaminated. Thousands of Texans still die each year even as the rate falls.
Should we wait to see if things improve on their own? Waiting is the most common regret families describe. Because fentanyl and contaminated stimulants make any single use unpredictable, delaying often narrows a family’s options rather than widening them.
Is naloxone enough to keep someone safe? Naloxone can reverse an opioid overdose, and it saves lives. It does not treat addiction, it does nothing for a stimulant-only overdose, and newer additives such as xylazine do not respond to it. It is a critical safety tool, not a substitute for treatment and support.
What is polysubstance use, and why does it matter? Polysubstance use means more than one drug is involved, either because a person uses several substances or because the supply is mixed without their knowledge. It matters because it makes overdoses harder to predict and to reverse, and because a person who thinks they are avoiding opioids may still be exposed to fentanyl.
My loved one lives in a different Texas city than I do. Can we still help? Yes. Distance complicates the logistics but does not prevent a family from acting. A professional interventionist can coordinate planning, the conversation, transport, and placement across cities, so that being in different places does not become a reason to delay.
A final thought
The drop in Texas fentanyl deaths is worth acknowledging. It represents thousands of people who are alive today because of naloxone, education, and years of hard community work. But a trend describes a population, not a promise to any one family. If you are watching someone you love and feeling that quiet, persistent worry, that feeling is more reliable than any statewide chart. The direction of the state’s numbers does not change what your own eyes are telling you, and it does not have to set the timeline for what you do next.
About the Author
Will Crosswell is a Licensed Clinical Social Worker (LCSW), Licensed Chemical Dependency Counselor (LCDC), and EMDR-trained clinician with more than ten years of experience helping families navigate addiction and mental health crises. His clinical training in trauma-informed care and family systems work informs the Crosswell Method’s approach to mental health intervention specifically. Crosswell Interventions is independent and does not accept referral fees from treatment facilities.
