Everyone Else Landed the Plane

Overdose deaths have fallen across America for three straight years. New Mexico recorded the nation’s largest increase for the second year in a row. The state did not run out of money. It never built the system required to turn money into fewer deaths.

America is finally bending the overdose curve.

Deaths fell nearly 14 percent in 2025, the third consecutive annual decline and the lowest national total since 2018. Rhode Island, New York, North Carolina, Alabama and Vermont each cut deaths by at least 25 percent. Only seven states moved in the wrong direction.

New Mexico did not merely miss the national improvement. Its overdose deaths rose 21.7 percent—the largest increase in the country, for the second straight year. The state’s overdose death rate remains more than twice the national rate and is 9 percent higher than it was a decade ago.

This is not a one-year spike inside an improving record. New Mexico has continued losing ground while most of America has learned how to save more people.

The question is no longer whether New Mexico has a crisis.

The question is why New Mexico cannot get it done when other states can.

What worked elsewhere

No single policy produced the national decline. Researchers point to several forces working together: changes in the illicit fentanyl supply, fewer people beginning to use drugs, wider access to addiction medication and a dramatic expansion of naloxone in homes and communities.

The better-performing states built systems around those advantages.

They connected prescription-monitoring information directly to clinical records. They expanded access to buprenorphine and methadone, which reduce the risk of fatal opioid overdose. They used Medicaid, telehealth and care navigation to reach people in areas without enough providers. They collected current data, identified people at risk and connected them to help before the next overdose.

Missouri offers a visible example. Its overdose deaths fell 26 percent from 2023 to 2024, while St. Louis City cut deaths by 41 percent. Opioid settlement money helped distribute 639,000 naloxone kits through mail delivery, vending machines and hundreds of new community partnerships.

Missouri chose an intervention, built a network around it, funded it at scale and measured the result.

New Mexico has not done those things statewide.

A different drug crisis

New Mexico is also fighting a more complicated battle than the word “opioid” suggests.

Methamphetamine was involved in 58 percent of the state’s 775 overdose deaths in 2024. Fentanyl appears in more than two-thirds of 2025 deaths. Those figures can overlap because people increasingly die with more than one drug in their system.

This is a polysubstance crisis.

Naloxone can reverse the opioid component of an overdose. It cannot reverse methamphetamine toxicity. Buprenorphine and methadone can treat opioid-use disorder, but there is no comparable medication for methamphetamine addiction.

New Mexico therefore needs more than an opioid program. It needs a coordinated system capable of confronting the entire drug mixture: law enforcement disrupting supply, clinicians treating complicated addictions, community workers keeping people connected to care and current data showing where the danger is changing.

That system requires money.

New Mexico had it.

The money was there

In 2017, then-Attorney General Hector Balderas entered New Mexico into litigation against companies accused of helping fuel the opioid crisis. Settlements with six entities—including Walmart, CVS, Walgreens and Kroger—are expected to bring approximately $885 million to New Mexico over sixteen to eighteen years.

The money is divided among state government, local governments and outside counsel. Payments began in 2023 and will continue into the late 2030s. Under the settlement rules, the public share can support treatment, naloxone, diversion programs, first-responder training, data collection and workforce development for addiction professionals.

The settlement is only one source.

Gov. Michelle Lujan Grisham says New Mexico has invested more than $1.5 billion in law enforcement, behavioral health, addiction treatment and public safety. The Legislature has provided $843.5 million in one-time behavioral-health funding since 2022. Rural health programs include $196 million through the Rural Health Care Delivery Fund and another $211.5 million in first-year federal Rural Health Transformation money.

Those figures should not simply be added together. They cover different periods, may overlap and come with different rules. They are controlled by different agencies and levels of government.

But they establish one fact beyond dispute: New Mexico’s failure is not the product of having no resources.

The state had fuel. It never built the cockpit.

No one has the controls

Money entered New Mexico through separate channels. Agencies created separate programs. Counties received separate allocations. Law enforcement, public health, behavioral health and rural healthcare continued operating in separate lanes.

No one was placed in command of the entire mission.

There is no single statewide strategy connecting drug interdiction, treatment, harm reduction, workforce development and overdose data. The major funding streams do not share a common set of measures. No public dashboard shows where all the money went or what happened afterward. No named official is accountable for reducing overdose deaths by a stated amount and date.

Sen. Larry Scott of Hobbs said it plainly during a July legislative hearing: New Mexico has no strategic plan and no agency or individual ultimately responsible for developing a statewide program.

That is not a shortage of funding. It is a shortage of leadership.

The consequences appear in every funding stream.

The State Auditor found that local governments had spent only $15 million of approximately $110 million in settlement money received over three years. Fifteen counties and seven municipalities reported spending nothing. Fewer than half the governments surveyed had a written spending plan.

Local officials cited provider shortages. But they also cited uncertainty over what the money could legally buy and a lack of collaboration with the state.

If counties did not understand the rules, the state should have explained them. If small governments lacked grant writers or addiction specialists, the state should have provided regional assistance. If officials feared creating programs that would disappear when funding ended, the state should have built sustainable positions around payments continuing into the late 2030s.

Instead, the proposed fix is legislation in January 2027—four years after payments began.

The landing gear is still down because nobody has the stick.

Shortages became excuses

New Mexico does face severe personnel shortages.

Thirty-two of its thirty-three counties are designated health-professional shortage areas. The Legislative Finance Committee reported that 65 percent of practicing physicians were considering leaving. Only about one in five University of New Mexico medical graduates remains in the state, compared with roughly half nationally.

Police departments describe a similar cycle. Vacancies create mandatory overtime and burnout. When departments must triage, specialized and proactive units are among the first capabilities cut. Narcotics work is both specialized and proactive.

These problems are real. They are also not new.

More importantly, the settlement money is expressly authorized to support workforce development for addiction professionals, first-responder training, diversion programs and treatment for people involved in the criminal-justice system. Payments lasting sixteen to eighteen years provide time to train clinicians, counselors, peer-support workers and specialized officers—and build retention incentives around those positions.

Yet New Mexico cannot publicly show how much settlement money has gone toward recruiting or retaining the people it says it cannot find. That does not necessarily mean nothing was spent. It means the state requires no comprehensive public expenditure reporting capable of answering the question.

The personnel shortage became an explanation for inaction instead of the target of the investment.

The wrong kind of urgency

New Mexico can move quickly when its leaders choose to.

After declaring a public-safety emergency around Española, the governor issued thirteen orders authorizing up to $9.75 million across local law enforcement and National Guard operations. Those orders established spending ceilings, not proof that the full amount was spent.

The only published disbursement accounting covered approximately $1.79 million. About 46 percent went to cameras, license-plate readers, drones and a Clearview AI facial-recognition subscription. Another 32 percent went to overtime.

Equipment may help law enforcement. But cameras do not recruit narcotics detectives, retain addiction counselors, prescribe treatment or guide an overdose survivor into long-term care.

The Legislature’s own evaluators later reported that crime rates for Española and Rio Arriba County had not been reported since the operation began. Outstanding warrants remained steady, dispatch calls increased and evaluators found no measurable result from the broader operation.

New Mexico demonstrated urgency. It did not demonstrate a strategy.

Proof inside New Mexico

The state does not need to look only to Missouri for evidence that improvement is possible.

San Juan County reported fatal overdoses falling from 47 in 2023 to 16 in 2025—a 66 percent decline associated with sustained multi-agency task-force work. A New Mexico county moved with the national trend while the state moved against it.

Rio Arriba County offers a different example. Its health department used 911 records and community input to place free naloxone in high-risk locations. After the program began, overdose-related calls fell from an average of 28 per month to 16. An early county analysis found overdose deaths falling 45 percent during its comparison window.

The program costs approximately $100,000 a year.

Those results do not prove the naloxone program caused the entire decline. County officials appropriately described an association and acknowledged that other factors may have contributed.

But Rio Arriba did what statewide leadership has failed to do. It identified a problem, used local data to place an intervention, measured what happened and continued supporting what appeared to work.

New Mexico has working parts. It does not connect or scale them.

Leadership owns the landing

On June 25, the governor’s office acknowledged that New Mexico led the nation in rising overdose deaths for the second straight year while deaths fell nationally.

Twenty days later, the State Auditor reported approximately $95 million in local settlement money sitting unspent.

Those two findings describe the same failure.

New Mexico has a polysubstance crisis in a state short of doctors, nurses, counselors and specialized police. It has no statewide strategy connecting enforcement, treatment, harm reduction and workforce development. Its major funding streams do not share common measures. It cannot publicly show how much settlement money is being used to retain the people it says it lacks. No single official owns the outcome.

The money matters because it proves the state had choices.

New Mexico could have issued statewide guidance before the first settlement checks arrived. It could have created recruitment and retention incentives for the hardest places to staff. It could have supplied small counties with planning assistance. It could have required common performance measures, published every expenditure and expanded the local programs producing better numbers.

Instead, money arrived before the operating structure. Shortages became excuses. Programs remained scattered. Responsibility dissolved across agencies.

The rest of the country has shown that overdose deaths can fall. Counties inside New Mexico have shown that they can fall here.

New Mexico did not run out of fuel. It left the landing gear down, scattered the instruments across separate agencies and never put one person in the pilot’s seat.

Failure at this altitude is not an accounting problem.

It is killing people.

Endnotes

1. National Center for Health Statistics, “U.S. Overdose Deaths Decrease for Third Consecutive Year in 2025,” Centers for Disease Control and Prevention, May 13, 2026, https://www.cdc.gov/nchs/pressroom/releases/20260513.html; Arizona Public Health Association, Drug Overdose Trends in the United States and Arizona, June 2026, https://azpha.org/wp-content/uploads/2026/06/Final-AZPHA-Report-Drug-Overdose-Trends-in-the-US-v-AZ-2026.pdf.

2. Tim Henderson, “As National Death Rate Dips, Some States Did Better Than Others,” Stateline, July 23, 2026, https://stateline.org/2026/07/23/as-national-death-rate-dips-some-states-did-better-than-others/.

3. National Center for Health Statistics, “U.S. Overdose Deaths Decrease for Third Consecutive Year in 2025”; Centers for Disease Control and Prevention, “Provisional Drug Overdose Death Counts,” National Vital Statistics System, accessed July 26, 2026, https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.

4. University of Missouri–St. Louis, “Addiction Science Team’s Research Shows Overdose Deaths Declining in Missouri for Second Straight Year,” October 6, 2025, https://blogs.umsl.edu/news/2025/10/06/addiction-science-team-report-shows-overdose-deaths-declining-in-missouri-for-second-straight-year/; Rebecca Rivas, “Missouri Drug Overdose Deaths Drop for Second Straight Year,” St. Louis Public Radio, October 16, 2025, https://www.stlpr.org/health-science-environment/2025-10-16/missouri-significant-drop-drug-overdose-deaths-second-straight-year.

5. New Mexico Department of Health, “SUMHEP Dashboard—Executive Summary,” September 23, 2025, https://www.nmhealth.org/publication/view/general/9363/; New Mexico Department of Health, “Increased Drug Overdose Activity in Northern New Mexico,” Health Alert Network, September 2025, https://www.nmhealth.org/news/awareness/2025/9/?view=2275.

6. New Mexico Legislative Finance Committee, Opioid Settlement Update, 2026, https://www.nmlegis.gov/handouts/ALFC 051424 Item 15 - Hearing Brief - Opioid Settlement Update.pdf; Patrick Lohmann, “New Mexico Local Governments Lag in Spending Opioid Settlement Funds, New Report Finds,” Source New Mexico, July 16, 2026, https://sourcenm.com/2026/07/16/new-mexico-local-governments-lag-in-spending-opioid-settlement-funds-new-report-finds/.

7. National Opioid Settlement, Exhibit E: List of Opioid Remediation Uses, accessed July 26, 2026; New Mexico Office of the State Auditor, Opioid Settlement Funds Advisory, March 2024, https://www.osa.nm.gov/wp-content/uploads/2024/03/Opioid-Advisory.pdf.

8. New Mexico Legislative Finance Committee, Behavioral Health Investments, June 18, 2026, https://www.nmlegis.gov/Entity/LFC/Documents/Health_And_Human_Services/behavioral health investment update 2026 June.pdf; New Mexico Legislative Finance Committee, Health Note: Rural Health Care Delivery Fund, January 2026, https://www.nmlegis.gov/Entity/LFC/Documents/Program_Evaluation_Reports/TAB C.pdf; New Mexico Health Care Authority, “Rural Health Transformation,” accessed July 26, 2026, https://www.hca.nm.gov/rht.

9. Larry Scott, remarks before the New Mexico Legislative Finance Committee, July 20, 2026; New Mexico Legislative Finance Committee, Health Note: Rural Health Care Delivery Fund, January 2026.

10. New Mexico Office of the State Auditor, Government Accountability Office Review of Local Government Opioid Settlement Funds, July 2026; Lohmann, “New Mexico Local Governments Lag in Spending Opioid Settlement Funds.”

11. New Mexico Legislative Finance Committee, Health Note: Rural Health Care Delivery Fund, January 2026; New Mexico Legislative Finance Committee, LegisStat: Healthcare Access, May 2026, https://www.nmlegis.gov/Entity/LFC/Documents/LegisStat Healthcare Access, May 2029.pdf.

12. Office of the Governor of New Mexico, Executive Orders 2025-358 through 2026-058; Daniel J. Chacón, “State Has Disbursed Nearly $1.8 Million for Northern New Mexico Public Safety Emergency,” Santa Fe New Mexican, November 18, 2025.

13. New Mexico Legislative Finance Committee, Program Evaluation: Emergency Public Safety Operations in Albuquerque and Española, June 2026.

14. Region II Narcotics Task Force, annual overdose statistics for San Juan County, 2023–2025.

15. Rio Arriba County Health and Human Services Department, “RAC Naloxbox Initiative,” accessed July 26, 2026; Region One, Behavioral Health Regional Investment Act Proposal for Fiscal Years 2027–2029, submitted May 26, 2026; Rio Arriba County, Naloxone Enhanced Supply and Training Program, USAspending Award No. H79TI084563, accessed July 26, 2026.

16. Office of the Governor of New Mexico, “Governor Issues Statement on DEA’s Failure to Seize Thousands of Fentanyl Pills in New Mexico,” June 25, 2026, https://www.governor.state.nm.us/newsroom/release-governor-issues-statement-on-dea-s-failure-to-seize-thousands--100004561; New Mexico Office of the State Auditor, Government Accountability Office Review of Local Government Opioid Settlement Funds, July 2026; Lohmann, “New Mexico Local Governments Lag in Spending Opioid Settlement Funds.” governor.state.nm