'It's scary to think I could have died': How Americans are coming back from fentanyl addiction

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Tim Mansel Kayla says she became "instantly addicted" to fentanyl as a teenager

Kayla first tried fentanyl as a troubled 18-year-old, growing up in the US state of North Carolina. "I felt like literally amazing. The voices in my head just completely went silent. I got instantly addicted," she remembers. The little blue pills Kayla became hooked on were probably made in Mexico, and then smuggled across the border to the US - a deadly trade President Donald Trump is trying to crack down on. But drug cartels aren't pharmacists. So, Kayla never knew how much fentanyl was in the pill she was taking. Would there be enough of the synthetic opioid to kill her? "It's scary to think about that," Kayla says, reflecting on how she could have overdosed and died at any moment. In 2023, there were over 110,000 drug-related deaths in the US. The march of fentanyl, which is 50 times more potent than heroin, seemed unstoppable. But then came a staggering turnaround. In 2024, the number of fatal overdoses across the US fell by around 25%. That's nearly 30,000 fewer deaths – dozens of lives saved every day. Kayla's state, North Carolina, is at the forefront of that trend.

Why fatal overdoses have fallen so sharply

One of the explanations is a commitment to harm reduction. This means promoting policies that prioritise drug users' health and wellbeing rather than criminalising people - a recognition that in an era of