Arkansas Overdose Deaths Are Falling. Here Is Why I'm Not Relaxing Yet

Last week the state's drug director shared numbers I have been waiting a long time to see. Arkansas had 365 confirmed drug overdose deaths in 2025, down from 438 in 2023.

That is good news. Every one of those numbers is a person who is still here.

But in the same report, he said two new opioids that are stronger than fentanyl turned up in Arkansas this year. So I want to talk plainly about both halves of that story, and what it means if someone in your house in Fayetteville, Springdale, Rogers or Bentonville is using.

What the new Arkansas numbers show

The figures come from Arkansas drug director Thomas Fisher, who shared them with Axios Northwest Arkansas on October 22. The count does not include deaths from alcohol poisoning alone.

A few details stood out to me:

• People 35 and older made up 78% of Arkansas overdose deaths in 2025.
• Fentanyl was involved in 41% of deaths in people under 35, compared with 21% in people 35 and older.
• Methamphetamine was involved in 53% of deaths in people 35 and older, compared with 35% in people under 35.

Fisher said that while a lot of prevention work has focused on young people, more public awareness and treatment options are needed for adults 35 and older. I agree with him. A lot of the people dying in this state are parents, workers and grandparents, not just teenagers at parties.

Why deaths are falling, and why nobody is sure

Arkansas is part of a national trend. Science News reports that U.S. overdose deaths were running around 111,000 a year at the peak in mid-2023 and had fallen to under 71,000 a year by the end of 2025. Opioid deaths specifically fell from 81,806 in 2022 to 44,564 in 2025.

You might assume Narcan is the main reason. A study published October 21 in JAMA suggests otherwise.

Researchers looked at emergency medical services records from 5,324 EMS agencies between May 2020 and December 2025. After May 2023, nonfatal opioid overdoses were 32.7% below what earlier trends predicted. Naloxone use dropped too, by 21.3%. In other words, it looks like fewer overdoses were happening in the first place, not that more people were being revived.

The study's authors are careful to say it did not test what caused the drop. Their leading guess is a change in the illicit drug supply. Writing in STAT on October 23, they pointed to research showing fentanyl became more diluted and harder to find as deaths fell.

Narcan still saves lives every day. The researchers say so themselves. But this matters for one reason: if the drop is mostly about the supply, it can turn around. Dr. Michael Barnett, one of the authors, told Science News that "a supply-driven decline can reverse," and that traffickers can adapt by finding new chemical sources or turning to more potent synthetic opioids.

The new drugs showing up anyway

That is exactly what Arkansas is seeing at the edges.

• Cychlorphine, a highly potent synthetic opioid, was tied to two Arkansas overdose deaths in the first half of 2026, one in central Arkansas and one in southwest Arkansas. It also turned up in two other cases where drugs were tested for prosecution.
• Carfentanil, a drug used in veterinary medicine to sedate very large animals, was involved in four fatal overdoses in Arkansas this year, all in central Arkansas.

"Once is enough to sound the alarm," Fisher said about cychlorphine. I wrote earlier about cychlorphine and why fentanyl test strips can miss it.

Gas station products are changing too. On October 21, San Francisco health officials reported a death from MGM-15, a semi-synthetic opioid made from a kratom compound and estimated to be up to 50 times more potent than morphine. The tablets the person took did not list kratom or 7-OH on the package, and MGM-15 has also been found in products sold as "cat's claw." MGM-15 is now a federal Schedule I drug.

And the regular street supply is not simple anymore. A federal study found six or more additives in street fentanyl samples, including sedatives that Narcan cannot reverse.

What this means for Northwest Arkansas families

Most of these new-drug deaths were reported in central and southwest Arkansas. But drugs travel up I-49 just like everything else, and pills and powders do not come with honest labels.

Here is what I would do this week if someone you love uses opioids:

1. Keep naloxone (Narcan) in the house and in the car. It is sold over the counter. Health officials say to give it to anyone who appears to be overdosing and to call 911. With very strong opioids, a second dose may be needed.
2. Don't treat falling numbers as permission. A lighter supply one month can be a stronger one the next.
3. Talk about treatment, not just safety. The National Institute on Drug Abuse says people with opioid use disorder who are treated with buprenorphine or methadone are less likely to die or to overdose than those who are not treated. It also says fewer than 1 in 5 people with opioid use disorder get these medicines.
4. Skip detox by itself. The CDC says detox alone, without medication, is not recommended for opioid use disorder because it raises the risk of going back to use, overdose and overdose death. I explain the difference in medical detox vs. Suboxone treatment.

If meth is the main problem, I will be honest with you: Suboxone is a medicine for opioid addiction. I will still talk with you and help you figure out where to turn.

Talk to me while things are calmer

The best time to start treatment is not in the middle of a crisis. It is now, while the numbers are moving in the right direction and you have a little room to think.

At my clinic, you see me every visit. You take your first Suboxone dose in the office with me, so we can get the timing right and avoid precipitated withdrawal. Scheduled visits are $200, and if you need me after hours, it is $300. I don't bill insurance. Your records are protected under HIPAA and the federal 42 CFR Part 2 privacy rule.

I don't run an inpatient detox, and I don't dispense methadone. If that is what you need, I will tell you and help you find it.

I have been on the other side of addiction myself, so I know how hard the first call is. I answer my own phone, day or night. Call 479-856-1505. If you want to know what happens first, the first visit page walks through it, and the cost page has the plain numbers.