RALEIGH, N.C. (WTVD) — Fentanyl Awareness Day is being observed Wednesday with new data showing a decline in fentanyl-related deaths — and overall overdose deaths — across North Carolina.
An update from the NCDHHS shows overall overdose deaths in the state fell by 34% between 2023 and 2024, the first decline since 2019. Fentanyl-related deaths peaked at just over 3,300 in 2022 and have declined to fewer than 1,500 last year, according to state data from the Office of the Chief Medical Examiner.
Advocates say the progress is a good sign — but they’re clear the fentanyl crisis is far from over.
“We now have over 20,000 fentanyl victims in North Carolina, and the families, the victims families have said enough,” Barb Walsh of Cary said.
Walsh lost her daughter, Sophia, to fentanyl in August 2021. Since then, she’s worked with lawmakers to push for changes and founded the Fentanyl Victims Network of North Carolina to help families navigating similar losses.
“So the deaths are still occurring and it may be less, but those families will not take any comfort in knowing that their loved one was not saved,” Walsh said.
That decline in fentanyl-related deaths is part of a broader drop in overdose deaths across the state. According to NCDHHS, overdose deaths involving all drugs fell from more than 4,400 in 2023 to fewer than 3,000 in 2024.
Walsh credited the progress in part to expanded access to naloxone, a drug used to reverse overdoses, and increased public awareness.
“They’re saying the word fentanyl out loud. They’re talking about the life naloxone. They’re elevating the public discussion about naloxone and fentanyl victims. Deaths More importantly, it is treating the victims and their families with dignity and respect,” she said.
Despite the improvement, Walsh said continued efforts are critical.
“It is not time yet to stop talking about trying to save lives together. The work the government is doing, the opioid settlement funds, law enforcement, district attorney’s harm reduction groups, public health, the families who have started nonprofits, all of you, all of us are needed in order to save lives,” she said.
State officials say counties showing the most progress are those using funds from a $1.4 billion opioid settlement, which requires adherence to specific guidelines and reporting standards to access the money.
While the latest data shows a significant decline, advocates say continued coordination across agencies and communities will be key to sustaining the progress.
North Carolina saw infant mortality hit a record low and overdose deaths fall 34% in 2024, driven by Medicaid expansion and increased naloxone distribution.
North Carolina’s infant mortality rate hit an all-time low and overdose-related deaths plummeted in 2024, the N.C. Department of Health and Human Services announced Monday.
A new report shows the infant mortality rate dropped 8.7% from 6.9 to 6.3 deaths per 1,000 births, with the number of deaths decreasing from 828 in 2023 to 770 in 2024. Infant mortality is traditionally defined as the death of an infant before their first birthday.
Drug overdose deaths fell 34%, from 4,442 deaths in 2023 to 2,934 deaths in 2024, the first decline in fatal overdoses since 2019.
State leaders say expanding Medicaid across North Carolina, coupled with more distribution of overdose-reversal medications, drove the nosedive in deaths. But racial disparities persist, and officials say their work isn’t finished.
“We are encouraged by the declines in overdose-related deaths and infant mortality rates in North Carolina, which coincide with recent investments in our health system,” Dr. Kelly Kimple, the director of DHHS’ Division of Public Health, wrote in the report. “However, other trends show that there is still work to be done, and our department remains committed to improving health outcomes for everyone who calls North Carolina home.”
Here’s what the report found.
Infant mortalities drop, but racial disparities persist
State officials say progress on infant mortality was driven by a nearly 15% decrease in neonatal deaths, meaning more babies are surviving “the earliest and most vulnerable” weeks of life.
And two years after North Carolina became the 41st state to expand Medicaid, state leaders say more than 700,000 patients gained access to the critical care they needed, including maternal and infant care.
“This historic decline highlights how Medicaid expansion continues to improve health outcomes for children and families in North Carolina,” the report states.
But as infant mortality rates dropped across the state, rates among non-Hispanic Black infants remained nearly three times higher than among non-Hispanic white infants, according to the report.
Of the 770 infant deaths in 2024, more than 40% were Black children, the report stated. But the mortality rate among Black infants also saw a slight decrease, dropping from 340 deaths in 2023 to 315 in 2024.
“It’s absolutely egregious that we have babies dying as a result of their race or ethnicity in a state like North Carolina where we have excellent care and community-based services,” said Dr. Dorothy Cilenti, a clinical professor at the UNC-Chapel Hill’s Department of Maternal and Child Health and the associate dean of public health practice. “There’s absolutely no reason.”
The report said state officials will continue to target these “unacceptable” disparities through initiatives like the “I Gave Birth” campaign — a collaboration among 48 hospitals and providers to improve postpartum care in the first six to eight weeks after childbirth — and programs for maternal mental health.
Cilenti said it’s “exciting” to see the improving data, which she said is likely due to factors like better practices in childbirth and more investment in women’s health, like a drop in smoking rates during pregnancy.
But keeping infant mortality rates low can only be done by considering the “upstream” inequities of motherhood, Cilenti said, like making a livable wage, having access to healthy food and affordable housing and helping mothers balance breastfeeding with their job — all factors that improve a family’s health.
She said there must be state-wide willingness and attention to bring the mortality rates down in order for the trend to continue.
“It has to be political will,” Cilenti said. “This has to remain a priority. There has to be a complete intolerance for preventable deaths.”
Overdose deaths decrease in 2023
The state in 2024 saw its biggest decline in overdose deaths since 2019, the report states, including a sizable decrease in opioid-related overdose deaths, which fell 38.3%, from 3,656 in 2023 to 2,254 in 2024.
These rates decreased most significantly among Hispanic and Black residents, according to the new data.
State officials attributed the drop to Medicaid expansion and prevention efforts like increased access to naloxone or NARCAN, a fast-acting medication used to reverse overdoses. In 2024, DHHS distributed more than 150,000 doses of reversal medications to organizations across the state.
“As Attorney General, I held big opioid drug companies accountable for their roles in sparking an addiction epidemic that harmed communities across the state, and we secured $1.5 billion to reinvest in those communities to help folks get the care they need while keeping drugs off the streets,” Gov. Josh Stein wrote in the report. “Medicaid expansion is also enabling more people to get the health care they need. This sharp decline in overdose-related deaths is a clear demonstration of the investments North Carolina has made to keep people safe and healthy.”
Total deaths decrease across
NC Deaths in North Carolina declined for the third year in a row after hitting a peak during the pandemic. The state reported 106,603 deaths in 2024, a roughly 1% decrease from 2023 and a steep drop from 118,040 deaths in 2021.
Deaths in the Triangle saw only slight changes in 2024, according to DHHS data. Wake County deaths decreased only nominally, but deaths increased in Orange County by about 8%, from 1,626 in 2023 to 1,769 in 2024.
In Durham County, deaths decreased by about 4%, from 3,954 in 2023 to 3,793 in 2024.
Two people from Lee County were arrested Thursday after being accused of selling fentanyl with a child present, deputies said.
Lee County deputies said an investigation found that 32-year-old Felipe Jaimes Jr. and 39-year-old Leemary Davila Rosado were working together to sell and deliver fentanyl in Lee County.
According to deputies, the pair had their child present with them while they were delivering the drugs.
The two were each charged with:
4 counts of trafficking fentanyl
3 counts possession with intent to sell and deliver fentanyl
3 counts of exposing child to controlled substnace
2 counts of felony conspiracy
3 counts of possession of drug paraphernalia
During their first court appearances, both Jaimes and Rosado were given a $2 million bond each.
An analysis of state health data shows that opioid overdose hospitalizations have decreased by more than 20% in the last year, marking two consecutive years of declining emergency department visits in North Carolina.
An analysis of state health data shows that opioid overdose hospitalizations have decreased by more than 20% in the last year, marking two consecutive years of declining emergency department visits in North Carolina.
“I’m excited to see the decreases continue,” says Tyler Yates, State Opioid Coordinator with DHHS’ Division of Mental Health, Developmental Disabilities, and Substance Use Services. “Not long after the action plan was put into play in 2017, we saw some decreases right away and then COVID happened. Overdose deaths skyrocketed.”
More than 99% of students were not involved in a reportable crime on campus, said Michael Maher, chief accountability officer for the North Carolina Department of Public Instruction. Most schools reported only zero to five criminal offenses at their school last year, he said.
Criminal offenses went down again in North Carolina schools during the 2024-25 school year, with another significant drop in offenses for weapon possession, new data shows.
The North Carolina Department of Public Instruction released the latest public school crime statistics during the State Board of Education meeting on Wednesday.
The drop in criminal offenses reported reflects ongoing trends, but so does a continued rise in offenses for drug possession.
Total offenses dropped from 12,212 the year before to 11,470 offenses last year, according to the North Carolina Department of Public Instruction, which released the data Wednesday afternoon.
One hundred and seventy babies, kids and teens in North Carolina died after fentanyl exposure between 2015 and 2024, new state data shows.
Infants, children younger than 5 and teenagers aged 13 to 17 were the most likely to die after fentanyl exposure here during the past decade, according to updated data from the Office of the Chief Medical Examiner.
The data, focused on fentanyl-positive deaths between 2015 and 2024, was presented by the state Office of the Chief Medical Examiner to a committee of the state Child Fatality Task Force last week.
Fentanyl is extremely dangerous because its residue is easy to ingest, and drug paraphernalia like needles or spoon often contains enough fentanyl to kill a small child. In one toddler death cited by the medical examiner’s office, a 1-year-old was exposed to fentanyl left on a cotton ball next to the bed where the mother and child slept.
“Illicit fentanyl really is one of the substances that is predominantly toxic to the pediatric population,” Sandra Bishop-Freeman, chief toxicologist and forensic laboratory director at the state Office of the Chief Medical Examiner, told the Charlotte Observer.
Among teenagers, accidental ingestion often comes via other drugs — even borrowing what a teen thinks is a Tylenol from a classmate could lead to an overdose from a laced pill. In a case cited by the medical examiner’s office, a 16-year-old who died of fentanyl overdose took what they thought was Xanax at a party.
More 17-year-olds died than any other group among minors between 2015 and 2024, with 52 lives lost. Infants less than 6 months old had the second-highest death toll, with the total reaching 24.
Among racial groups, American Indian and Black residents experienced the highest number of pediatric fentanyl-positive deaths in the state, the data says.
And loss of life overall in North Carolina is much higher than a decade ago — growing from 243 deaths in 2015 to 1,954 in 2024.
Shown is a fatal dose of the synthetic opioid drug fentanyl. U.S. DRUG ENFORCEMENT ADMINISTRATION
Despite pediatric dangers, deaths decline in recent years
There is some good news: Despite the number of fentanyl-related deaths remaining elevated compared to decades past, the rate has begun to slow over the past several years.
Fentanyl deaths among all age groups fell 26% statewide in October 2025 compared to the previous year, with deaths in Mecklenburg County down to 142 from 192.
Overdose deaths have been declining the past two years, CDC data released Wednesday shows. North Carolina’s fentanyl overdose rate among all age groups fell by more than 30% between August 2024 and 2025.
Increased access to preventatives, such as the overdose-reversing nasal spray naloxone, could be helping slow overdose death trends.
The overdose-reversing nasal spray naloxone, also known by its brand name Narcan, has become easier to access in recent years, federal data shows.
A multifaceted prevention strategy has likely helped contributed to the slowdown in overdose deaths in North Carolina, according to Kella Hatcher, executive director of the NC Child Fatality Task Force. Her group has been studying pediatric overdoses for several years.
“You have to keep working on a combination of efforts to make progress, and that’s the case with many [preventable] causes of death,” Hatcher said.
A 2025 Prevention Block Grant funded several primary prevention programs, including youth education efforts that served close to 9,000 during the year. Another program distributed more than 11,000 lock boxes and 15,000 medication disposal kits, according to Tuesday’s presentation.
Opioid settlement dollars are also funding prevention work in many North Carolina counties. The state is receiving $1.4 billion as part of national settlements with opioid companies, money aimed at bringing resources to communities harmed by the opioid epidemic.
The medical examiner’s office will continue to share data with state and county agencies focused on helping curb the preventable childhood deaths, toxicologist Bishop-Freeman said.
“Despite the trends possibly plateauing, these pediatric deaths are still too many,” Bishop-Freeman said.
A Raleigh mom is raising awareness about drug overdose risks by gifting skateboards to children across the Triangle area. Her mission not only remembers her son but also educates families on the dangers of substance abuse.
Susan Plattner’s son, Caleb Mehlman, spent most of his free time at Marsh Creek Skatepark in Raleigh. She said skateboarding was second nature for her son.
“At the age of three, I had a scooter, and he figured out how to push the handle down and turn it into a skateboard, and that was it,” Plattner said. “He was skating passionately ever since then.”
