Chicago and Cook County saw another steep decline in fatal opioid overdoses last year, records show, four years after a recent peak in such cases during the height of the COVID-19 pandemic.
2025 brought a 40% drop in deaths attributed to narcotics overdoses from the prior year, according to statistics from the Cook County medical examiner’s office. As of this week, the medical examiner’s office found 683 people died of opioid overdoses last year in Cook County, with 500 of those recorded in Chicago.
Pending toxicology test results in 180 other cases will likely bump the total up more. Three years earlier, in 2022, Cook County recorded 2,001 fatal opioid overdoses, according to the medical examiner’s office.
Public health officials were quick to credit outreach efforts by community organizations and the continued, expanded distribution of overdose-reversal medications Narcan and Naloxone for the decline.
“There are a number of evidence-based interventions that we have deployed at scale over the past three to four years, particularly after we saw the high-water mark of 2021 with over 1,400 overdoses,” Dr. Miao Jenny Hua, deputy commissioner for the Chicago Department of Public Health, told the Tribune in an interview this week.
The city’s and county’s outreach efforts have expanded to include testing illicit street narcotics for their ingredients and potency, and making overdose-reversal medications more widely available in areas where opioid use is most common.
“We’ve really extended the work of drug-checking, which used to be somewhat underground work, but with tremendous, tremendous public health relevance and value,” Hua said. “That’s a line of work that we’re really glad to see happen.”
Data shows opioid deaths remain most common in three ZIP codes that cover most of Chicago’s West Side, the longtime epicenter of the local narcotics trade where gun violence and drug sales often go hand-in-hand.
However, those neighborhoods have also seen the largest declines in opioid fatalities in recent years.
In 2021, the neighborhoods of Little Village, North Lawndale, Austin, East and West Garfield Park and Humboldt Park recorded 311 fatal opioid overdoses, records show. Last year, those same neighborhoods saw 96 opioid fatalities — a nearly 70% decline in four years.
The medical examiner’s office said, too, that more than 80% of 2025’s overdose deaths involved fentanyl, the synthetic opioid largely produced by Mexican drug cartels that’s 100 times more potent than morphine.
Nationally, fatal opioid overdoses surged after the onset of the COVID-19 pandemic, with deaths cresting in 2022 and 2023, records show. Like Chicago, other major cities across the country, including New York and Philadelphia, saw major drops in fatal opioid overdoses last year.
A drop in cases around the country has generated speculation about the production side of the fentanyl trade, including whether drug cartels were purposefully dropping the strength of their product. Federal authorities have said it could also signal issues in the making of the substance.
A report from the U.S. Drug Enforcement Administration released in 2025 said much of the fentanyl trafficked into the United States was less potent than in recent years past, “consistent with indicators that many Mexico-based fentanyl cooks are having difficulty obtaining some key precursor chemicals.”
However, the decline in fentanyl potency has opened the door for other illicit narcotics to be introduced.
“The downward trend in fentanyl purity does not mean that street-level fentanyl is less dangerous,” the report stated. “Drug dealers in the United States continue to adulterate fentanyl with various animal tranquilizers (such as xylazine), anesthetics (such as ketamine), and other synthetic opioids (such as nitazenes).”
In a statement to the Tribune, Todd C. Smith, special agent in charge of the DEA’s Chicago Field Division, noted nearly a half-ton of fentanyl powder was recovered by local DEA agents in 2025.
“While recent overdose data shows encouraging signs, this crisis is far from over,” Smith said. “Over the past year, we have seized nearly two million fentanyl pills and 915 pounds of fentanyl powder across Illinois, Indiana and Wisconsin. Maintaining momentum requires sustained enforcement, strong partnerships and continued prevention through public health, education and community outreach.”
On the local level, records show the Chicago Police Department has carried out more drug arrests in recent years, too, especially on the West Side in CPD’s Harrison (11th) District where several open-air drug markets operate 24 hours a day.
CPD officers last year made 1,962 arrests related to the sale or possession of heroin, records show. More than 60% of those arrests — nearly 1,200 — occurred in the Harrison District, roughly bounded by Division Street, Roosevelt Road, Western and Cicero avenues.
Seven years ago, the Police Department launched its Narcotics Arrest Diversion Program, which steers low-level drug offenders toward treatment instead of incarceration, provided they meet certain criteria. In 2025, 1,387 people were entered into the program, up from 926 people in 2024, according to a CPD spokesperson.
Municipalities across suburban Cook County have experienced sizable drops in opioid deaths, too. Between 2020 and 2024, Cicero, Harvey and Maywood saw a combined 301 opioid deaths, according to records from the county medical examiner’s office.
Last year, though, those three accounted for 25 opioid deaths.
Dr. Kiran Joshi, chief operating officer of the Cook County Department of Public Health, stressed that even with the continued decline in opioid deaths, “each one is a tragedy and our goal is to prevent them entirely.”
“It’s absolutely critical that we sustain the efforts that we put into place to prevent overdoses because we do not want to go backwards,” Joshi told the Tribune.
In suburban Cook County, more than 46,000 Naloxone kits have been distributed since 2020, Joshi said. In that time, nearly 200 doses were administered to people experiencing an overdose.
“Public health, good public health, requires partnership and we’re very fortunate in suburban Cook County to have really long-lasting, deep relationships with a number of partners across the suburbs,” Joshi said.
