Families across the United States will gather this week and many will notice one more person at the table. Someone is present because they received treatment when they needed it. Someone survived because a neighbor carried naloxone. Someone got another chance because their community offered care without judgment. This year’s progress in overdose prevention is visible in living rooms, kitchens and community halls where people who might not have been here a year ago are seated.
Provisional federal data reflects this shift. The Centers for Disease Control and Prevention (CDC) reported a 24.5 percent decline in predicted overdose deaths in the twelve months ending in April 2025 compared with the prior year. These numbers represent thousands of lives saved. The crisis remains severe, but the direction of the trend has changed because coverage strengthened, treatment access expanded and harm reduction reached people before tragedy did.
Thankful for care that works
Evidence on medications for opioid use disorder is consistent. A 2024 CDC analysis found that buprenorphine and methadone reduce overdose and all-cause mortality for people with opioid use disorder. A 2023 review from New York’s Office of Addiction Services and Supports reported that long- term treatment with these medications' cuts mortality by about half. Yet gaps remain. In 2022, an estimated 9.4 million adults needed opioid use disorder treatment. About 55 percent received some form of care and only one in four received medication. Much of the progress seen this year reflects clinicians, clinics and policymakers who expanded access, simplified prescribing and removed barriers such as prior authorization.
Thankful for care that reaches people where they live and work
Care is reaching people in ways that match daily life. Telehealth and mobile treatment units now serve people who live far from traditional services. A 2023 study of more than 90,000 Medicaid beneficiaries in Kentucky and Ohio found that people who began buprenorphine through telemedicine were more likely to stay in treatment for at least 90 days with no increase in nonfatal overdose risk compared with in person starts. These gains matter in rural and small town regions where transportation, childcare and workforce shortages make in person care difficult. Mobile units supported by federal and state grants deliver medications for opioid use disorder, wound care, vaccinations and referrals directly to shelters and community gathering points.
Primary care settings now play a larger role. Federally qualified health centers, rural health clinics and community health centers integrate medications for opioid use disorder into routine care. This brings treatment to places patients already trust and supports long term engagement. Behind every telehealth visit, mobile unit stop and primary care appointment is a person who did not have to choose between a shift at work or a long commute and the treatment that keeps them alive.
Thankful for naloxone in more hands
Naloxone continues to prevent fatal overdoses. A 2025 systematic review found that community naloxone distribution programs reduce opioid overdose deaths and support high rates of successful reversals. Modeling in Rhode Island shows that expanding naloxone distribution using opioid settlement funds could cut annual opioid overdose deaths by up to nine percent and by nearly one third when paired with strategies that increase the likelihood an overdose is witnessed. Broader naloxone availability in workplaces, schools, libraries, public buildings, transportation hubs and vending machines contributed to the national decline in deaths.
Naloxone now reaches people through many channels. Employers add it to first aid kits. Schools train staff and students. Libraries and transit agencies stock it with automated external defibrillators. Community groups distribute it through outreach and mobile units. These efforts translate directly into lives saved.
Thankful, but not finished
Progress is real but fragile. Tens of thousands still die each year, synthetic drugs like nitazenes continue to spread and deep racial and geographic inequities persist. Only one in four adults who need opioid use disorder treatment receive medication and adolescents remain especially underserved.
Gratitude this Thanksgiving sits alongside responsibility. The reforms, coverage, community partnerships, mobile care, telehealth and widespread naloxone access that helped more people reach this holiday can be strengthened or reversed. Keeping those seats filled will require continued bipartisan commitment, sustained funding and attention to the communities most affected.
More families get to share a meal instead of planning a preventable memorial. That is the measure that matters most.
