Addiction News Weekly Episode 1.1

In This Episode:

Episode Transcript

00:00 Welcome to Addiction News Weekly by rehab.com, where we break down the biggest stories in addiction, recovery and public health. This week we are looking at declining overdose deaths, a shifting drug supply, and rising concerns around the herbal substance known as kratom.

Overdose Deaths Are Declining

00:24 Recent data shows that overdose deaths in the United States are beginning to decline. According to a recent update from the American Medical Association, quote, recent declines in opioid related overdose deaths represent meaningful progress. However, the organization says that the crisis is still ongoing.

00:43 Researchers at the Penn Leonard Davis Institute report a similar trend. They estimate overdose deaths have fallen from their peak by roughly twenty five to twenty seven percent in recent years.

00:55 However, even with that decline, the scale remains significant. Tens of thousands of people are still dying each year, or roughly two hundred per day.

01:06 Researchers involved in that analysis also warn that addiction policy has not kept pace with these changes, describing current efforts as fragile and incomplete.

A Shifting and Unpredictable Drug Supply

01:19 And even as deaths decline, what is actually in the drug supply is becoming more unpredictable.

01:26 Recent reporting from NPR says that new street drugs are emerging even as overdose deaths fall, pointing to a supply that is continuing to shift rather than to stabilize.

01:37 According to that report, many of these substances are synthetic and constantly changing, which makes them harder to track and regulate.

01:46 At the same time, analysis from The Washington Post suggests that changes in the fentanyl supply itself might be contributing to the decline in overdose deaths.

01:55 But that same analysis also points to a more complicated reality. The drug supply is not simply becoming less dangerous. It’s becoming more variable. Instead of a single substance, people are often exposed to mixtures such as opioids, combined with stimulants or other synthetic compounds, sometimes without clear labeling or awareness.

02:14 Public health officials have warned that this kind of polysubstance use increases the risk of overdose, and also makes treatment more difficult because responders are not always dealing with one drug and are dealing with combinations that can affect the body in different and often unpredictable ways.

02:31 And for people using these substances, there’s often no reliable way to know what they are taking or how strong it is.

Rising Concerns About Kratom

02:42 This complexity is also showing up in specific substances that are now drawing more attention.

02:49 Reporting from the Guardian highlights a sharp rise in kratom related poisoning in the United States. According to that report, cases have increased significantly over the past decade, with poison control centers seeing a steady rise in calls linked to kratom exposure.

03:06 But the reporting also points to an important distinction. Many of the more serious cases are not tied to traditional plant based kratom. Instead, they are associated with synthetic or altered versions that can be more potent and less predictable. This has made the conversation around kratom even more complicated.

03:24 Some policymakers are calling for stricter regulation or outright bans, while others argue that kratom can still play a role as a lower risk alternative if properly regulated.

03:37 The result is an ongoing debate about how to approach a substance that sits somewhere between treatment supplement and potential risk.

Expert Analysis with Dr. Sylvie Stacey

03:47 So while overdose rates are declining, the bigger picture remains complicated. To help us break down why overdose deaths are dropping and what people are missing, we asked rehab dot com medical officer Doctor Sylvie Stacey.

04:01 It’s encouraging to see these numbers moving in the right direction. For years it it felt to me and my colleagues like we were fighting this battle, but not making progress. So seeing a twenty five percent drop in deaths feels like really a big relief. But we can’t jump to the conclusion that this decline is already a victory.

04:23 Losing around two hundred people every day to preventable overdoses is still a national emergency. And it’s not just a single factor that’s causing the numbers to decrease. It’s really a combination of efforts finally coming together to make a difference.

04:38 One of these factors is that we’ve made naloxone far more accessible. You can get it in libraries and bars and even in vending machines in some locations.

04:48 Another factor is that changes in regulations have made it much easier for doctors and other medical providers to prescribe buprenorphine. A lot of the hurdles that used to make doctors hesitate, or even refuse to prescribe medication for opioid use disorder. They’re now gone.

05:05 There are far more patients now who can access medications in a primary care office. Instead of needing to go to a specialized clinic or a treatment center.

The Polysubstance Problem

05:16 But there is a major misunderstanding about why the drug supply is changing.

05:22 Some people think the decline in overdose deaths means the drugs are getting safer. But what’s actually happening is that the supply is just becoming more erratic. We’re seeing a shift toward polysubstance use, where fentanyl is mixed with stimulants or other additives, many of which don’t respond to naloxone.

05:42 I’ve treated many patients who thought they were using just fentanyl, but they were also using other drugs like Xylazine. I’ve also treated patients who thought they were using Non-opioid street drugs, not realizing that it was actually adulterated with fentanyl.

5:58 Our standard treatment protocols in medicine have had a tough time keeping up with the changes in the illicit drug supply.

Why This Progress Is Fragile

06:06 We also need to to watch how policy is evolving as it relates to overdose deaths. Right now, I’d say our success is is almost fragile because it relies heavily on temporary grants and emergency funding. We need to move away from treating this like it’s a temporary problem and start treating it like, like a permanent part of our healthcare infrastructure.

06:32 We should be looking closely at how we regulate emerging substances and adulterants before they lead to increases in overdose deaths.

06:42 We all want to see a long term trend in fewer overdoses, and not just a brief dip in the numbers. So we can’t let these new statistics make us feel overconfident or like the hard work is over.

Conclusion

06:56 And those are the top stories in the news. For more, please visit rehab dot com. We’ll be back next week.

Sources in This Episode

  1. American Medical Association. April 10, 2026: National Advocacy Update. AMA. Published April 10, 2026. Accessed April 21, 2026. https://www.ama-assn.org/health-care-advocacy/advocacy-update/april-10-2026-national-advocacy-update
  2. Levins H. Experts warn addiction policy is weak despite falling overdose deaths. Leonard Davis Institute of Health Economics, University of Pennsylvania. Published February 19, 2026. Accessed April 21, 2026. https://ldi.upenn.edu/our-work/research-updates/experts-warn-addiction-policy-is-weak-despite-falling-overdose-deaths/
  3. Mann B. Drug overdose deaths drop sharply in the U.S. even as new street drugs emerge. NPR. Published April 12, 2026. Accessed April 21, 2026. https://knpr.org/2026-04-12/drug-overdose-deaths-drop-sharply-in-the-u-s-even-as-new-street-drugs-emerge
  4. Quinones S. Opioid overdose deaths are plummeting due to supply restrictions. The Washington Post. Published April 6, 2026. Accessed April 21, 2026. https://www.washingtonpost.com/opinions/2026/04/06/opioid-overdose-deaths-drug-supply-addiction/
  5. Kratom poisonings increase. The Guardian. Published April 13, 2026. Accessed April 21, 2026. https://www.theguardian.com/us-news/2026/apr/13/kratom-poisonings-increase
Dr. Sylvie Stacy
By Dr. Sylvie Stacy
Published on April 21, 2026