January 2025 Monthly Overdose Report

Download the entire PDF report: Maine Monthly Overdose Report for January 2025

Overview: Composite total of fatal and nonfatal overdoses

This report documents suspected and confirmed fatal and nonfatal drug overdoses in Maine during January 2025 as well asfor the period January 2024–January 2025 (Table 1). The total number of confirmed and suspected fatal overdoses during 2024 is 490, 19.1% lower than the total confirmed fatal overdoses for 2023, 606. The total number of nonfatal overdoses during 2024 is 8,046, 13.3% lower than the total reported nonfatal overdoses for 2023, 9,275. During January 2025, the proportion of fatal overdoses averaged 6.9% of total overdoses. Monthly proportions of 2024 fatalities fluctuated from a low of4.8% in August to a high of 7.2% in March. During 2024, fatal overdoses constituted 5.7% of all overdoses, lower than 2023 (6.1%).  

Data derived from multiple statewide sources were compiled and deduplicated to calculate fatal and nonfatal overdosetotals (Table 1). These include nonfatal overdose incidents reported by hospital emergency departments (ED), nonfatal emergency medical service (EMS) responses without transport to the ED, overdose reversals reported by law enforcement in the absence of EMS, and overdose reversals reported by community members or agencies receiving state-supplied naloxone through the Maine Naloxone Distribution Initiative. There are also an unknown number of private overdose reversals that were not reported and an unknown number of community-reported reversals that may have overlapped with emergency responseby EMS or law enforcement. The total number of fatal overdoses in this report includes those that have been confirmed, as well asthose that are suspected but not yet confirmed for June, August, October, November, December 2024, and January 2025 (see Figure 1).

The total number of suspected and confirmed fatal overdoses and reported nonfatal overdoses for January 2025, 525, isdisplayed in Table 1 near the bottom row.  Of those 525, there were 36 (6.9%) confirmed and suspected fatal overdoses, 232 (44.2%) nonfatal emergency department visits, 193 (36.8%) nonfatal EMS responses not transported to the emergencydepartment, 53 (10.1%) reported community overdose reversals, and 11 (2.1%) law enforcement reversals in incidents that did not include EMS.

Table 1: Composite reported overdose totals, all drugs, January 2024–January 2025

 Nonfatal  Fatal Composite
Emergency Dept.EMS not transportedto emergencyCommunity reversalswith naloxoneLaw enforcement nonfatal overdose responsewithout EMSTotal nonfatal overdosesTotal confirmed and suspected fatal overdosesTotal overdoses
January 20242692261392666043703
February 20243052421362871143754
March 20243792331192775859817
April 20242532051901466243705
May 20243112571652475739796
June 20243442322021279042832
July 20242932351662371738755
August 20242892151191063332665
September 2024318199114663734671
October 2024301198861760234636
November 2024260177581851339552
December 2024355190491260544650
2024 YTD total36772609154321780464908535
% of 2024 YTD total43.1%30.6%18.1%2.5%94.3%5.7%100%
January 2025232193531148936525
2025 YTD total232193531148936525
% of 2025 YTD total44.2%36.8%10.1%2.1%93.1%6.9%100%

Law Enforcement Response to Fatal and Nonfatal Overdose Incidents

Due to the method used to deduplicate nonfatal overdose incidents to derive a composite number of overdoses for the month, the total activity of both law enforcement officials and EMS agencies is underrepresented in Table 1 because of the overlap between them. The process used to deduplicate overdoses begins by removing fatal overdoses from the emergency department and EMS overdose incidents. Then the number of patients transported to emergency departments by Maine EMS are removed from the EMS overdose incidents. Finally, EMS involvement and fatal overdose incidents are removed from law enforcement responses.

Table 2 shows the public safety response to fatal and nonfatal overdose events in Januarry 2025 as well as January–December 2024. During 2024, law enforcement officers responded to a reported 1,151 overdose incidents (446 fatal; 705 nonfatal), and Maine EMS responded to a reported 9,510 incidents (391 fatal; 9,119 nonfatal). In January 2025, law enforcement officers responded to a reported 71 overdose incidents (34 fatal; 37 nonfatal), and Maine EMS responded to a reported 741 incidents (24 fatal; 717 nonfatal).

Table 2. Fatal and nonfatal overdose emergency response count from law enforcement and Maine Emergency Medical Services, including overlapping cases

Fatal overdose response Jan–Dec 2024Nonfatal overdose response Jan–Dec 2024Total overdose response Jan–Dec 2024Fatal overdose response Jan 2025Nonfatal overdose response Jan 2025Total Overdose Response Jan 2025
Maine EMS3919119951024717741
Law Enforcement4467051151343771
*Please note numbers will fluctuate from month-to-month as public safety agencies catch up their reporting . Due to methodological convention, alcohol-only cases are excluded from this table.  However, we recognize that alcohol is a large part of substance misuse epidemic. Cases with both drugs and alcohol are included. 

 


County Distribution of Suspected Nonfatal Overdoses

Table 3 shows the frequency distribution of nonfatal overdoses to which EMS responded at the county level. Overdose reversal totals reported by community partners and emergency departments are not reported by county; only EMS case data include county frequencies. The January 2025 monthly totals in the far right column can be compared to the percentage of the census population on the far left, or the percentage of nonfatal overdoses for the year in 2024. Caution must be exercised viewing single counties, especially for a single month, due to small numbers. These may fluctuate randomly, without reflecting any statistically significant trend.

The 2024 percentage totals for most counties fall within 0 to 1 percentage points of the 2020 census distribution. Compared to the 2020 census proportion, Androscoggin County is 2 percentage points higher and Cumberland County is 3 percentage points higher and York County is 4 percentage points lower.

Table 3. County of EMS incident among suspected and confirmed nonfatal overdoses

% 2020 estimated Census populationJan–Dec 2024  
Est. N = 9119
Jan 2025  
Est. N = 717
Androscoggin8%91310%8412%
Aroostook5%4885%253%
Cumberland22%230925%19828%
Franklin2%1652%122%
Hancock4%2413%162%
Kennebec9%90710%608%
Knox3%2623%193%
Lincoln3%1712%101%
Oxford4%3344%243%
Penobscot11%113712%9914%
Piscataquis1%1011%112%
Sagadahoc3%1522%132%
Somerset4%3994%284%
Waldo3%1972%152%
Washington2%2252%233%
York16%111812%8011%

January 2025

100%
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Jan – Dec 2024

100%
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Age and Gender Distribution of Suspected Nonfatal Overdoses with EMS Response

Table 4 displays the age composition of individuals suspected of experiencing nonfatal overdoses involving EMS response in January 2025 as well as 2023. Overdose reversal totals reported by community partners and emergency departments are not categorized and reported by age; only EMS case data include monthly age frequencies. Age group totals can be compared to the 2020 census proportion in the far left column. Caution must be exercised as the small number of cases in each month is vulnerable to random fluctuation that may not reflect a significant statistical trend. The age distribution for 2024 compared to the 2020 census proportion shows a disproportionately large impact of suspected nonfatal overdose victims with EMS involvement for those aged 25–54. This impact is illustrated by looking at the 25–54-year age groups, which constitutes 36% of the popultion in the 2020 census compared to 61% in the overdose population during 2024. In 2024 there were 14 percentage points fewer overdose victims among those under the age of 18 compared to the percentage of the census population in that age group. Similarly, there were 3 percentage points fewer overdose victims among those aged 55–64, and 11 percentage points fewer overdose victims among those 65 and older compared to the percentages of the census population for those age groups.  

Table 4. Reported age group among suspected nonfatal overdose victims involving EMS response

% 2020 estimated Census populationJan–Dec 2024
Est. N = 9162
Jan 2025
Est. N = 715
< 1818%3844%284%
18-247%8299%537%
25-3412%178219%12818%
35-4412%234326%20629%
45-5412%148416%11716%
55-6416%123013%10314%
> 6423%111012%8011%

Table 5 displays the reported gender of individuals experiencing nonfatal overdoses involving EMS response in January 2025 as well as 2024. Overdose reversal totals reported by community partners and emergency departments are not categorized by gender; only EMS case data include monthly gender categories. Gender group totals can be compared to the 2020 census proportion by age group in the far left column or the 2024 totals in the center column. When comparing the January 2025 with 2024, as well as the census population proportion, caution must be exercised as the small number of casesin each month is vulnerable to random fluctuation that may not reflect a significant statistical trend. Males represent 49% of the 2020 estimated census population, 58% of the nonfatal overdose victims with EMS involvement in January 2025, and 58% during 2024.

Table 5. Reported gender among suspected nonfatal overdose victims involving EMS response

% 2020 estimated Census populationJan–Dec 2024
Est. N = 8810
Jan 2025
Est. N = 689
Male49%512258%39858%
Female51%368742%29142%
TransgenderNot collected10.0%00%

County Distribution of Suspected and Confirmed Fatal Overdoses

Table 6 shows the frequency distribution of fatal overdoses at the county level.[1] The January 2025 monthly totals in the far right column can be compared either to the percentage of the census population in the far left column, or the percentage of county fatal overdoses for 2024. Caution must be exercised when viewing single counties with small numbers for a single month. These may fluctuate randomly, without reflecting any significant statistical trend. The 2024 percentages for most counties fall within 0 to 1 percentage points of the 2020 census distribution. Compared to the 2020 census proportion, Aroostook County is 3 percentage points higher, Penobscot County is 2 percentage points higher, York County is 5 percentage points lower and Cumberland County is 3 percentage points lower.

Table 6. County of death among suspected and confirmed fatal overdoses

% 2020 estimated Census populationJan–Dec 2024
Est. N = 490
Jan 2025
Est. N = 36
Androscoggin8%469%13%
Aroostook5%398%38%
Cumberland22%9119%822%
Franklin2%61%13%
Hancock4%133%13%
Kennebec9%4710%38%
Knox3%224%26%
Lincoln3%173%13%
Oxford4%204%26%
Penobscot11%6513%617%
Piscataquis1%51%26%
Sagadahoc3%71%00%
Somerset4%224%00%
Waldo3%184%13%
Washington2%163%00%
York16%5611%514%

[1]This table reports the county of death rather than the county of residence.

Fatal overdoses January 2025

100%
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Fatal Overdoses January – December 2024

100%
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Age and Sex Distribution of Fatal Overdose Victims

Table 7 displays the age and sex composition[1] of the fatal overdose population for January 2025 and 2024 compared to the 2020 estimated census population. When comparing the January 2025 data with 2024 as well as with the censuspopulation proportion, caution must be exercised as the small number of cases in each month is vulnerable to randomfluctuation that may not reflect a significant statistical trend.

The cumulative proportion of males is lower in January 2025 (61%) compared to 2024 (66%). The age distribution for2024 compared to the 2020 census proportion shows a disproportionately large impact of fatal overdoses in those aged 35–64, as was true in 2023. That group includes 40% of the 2020 estimated census population, compared to 75% in the fatal overdose population in 2023 and 74% during 2024. Compared to the census population, in 2024, there were 4 percentage points fewer fatal overdoses among those aged 18–24 and 14 percentage points fewer among those 65 and older compared to the census estimated population for those age groups. 

There were, however, differences between the age structures of the nonfatal overdoses (Table 4) and the fatal overdoses.  In 2024,  the highest proportion of both fatal and nonfatal overdoses was among those aged 35–44 (26% among nonfatal and 29% among fatal). The second highest age group for nonfatal overdoses was 25–34 (19%), but second highest among fatal overdoses was the 45–54 age group (25%). 

Table 7. Decedent reported age group and sex among suspected and confirmed fatal overdoses

% 2020 estimated Census populationJan–Dec 2024
Est. N = 490
Jan 2025
Est. N = 36
Male49%32166%2261%
< 1818%41%00%
18-247%133%13%
25-3412%6413%411%
35-4412%14429%1131%
45-5412%12325%411%
55-6416%9820%1233%
> 6423%449%411%

[1] Note that death certificate reports sex as male or female without other gender categories.


Race, ethnicity, and other demographic indicators of decedents

Table 8 displays the reported race and ethnicity of confirmed and suspected fatal overdoses in January 2025 and 2024 compared to the 2020 estimated census population. Note that race and ethnicity are not finalized until the full death certificate is entered into Vital Records, and a small number of decedents’ records currently lack information about these variables. Out of 34 decedents for whom race was reported in Janaury 2025, 97% of the victims were identified as White, 0% as Black/AfricanAmerican, and 0% as American Indian/Alaska Native. Out of 33 decedents for whom Hispanic ethnicity status was reported, 0% were identified as Hispanic.

A: Race% 2020 Estimated Census PopulationJan-Dec 2024
Race N = 488
Jan 2025
Race N = 34
White alone91%45293%3397%
Black/African American alone2%184%00%
American Indian/Alaska Native alone1%92%00%
Other race and 2+ races combined3%92%13%
B: Ethnicity% 2020 Estimated Census PopulationJan–Dec 2024  
Ethnicity N = 481
Jan 2025
Ethnicity N = 33
Hispanic/Latinx alone 2%102%00%

Military status and housing stability of fatal overdose victims

Out of the 34 cases for which military background was reported in January 2025, 3 (9%) were identified as having a military background. 

Of the 36 total suspected and confirmed fatal overdose cases year to date in 2025, undomiciled or transient housing status was reported for 4 (11%) victims. Among those 4, there was one undomiciled overdose in each Androscoggin County, Cumberland County, Kennebec County, and York County. 


Basic incident patterns in fatal overdoses

Table 9 reports basic incident patterns for fatal overdoses. January 2025 can be compared to 2024 as a whole. Caution must be exercised interpreting a single month of data as numbers may fluctuate randomly and not reflect a statistically significant trend. In addition, data totals may change slightly as suspected cases are confirmed or eliminated. 

Both EMS and police responded together to most fatal overdoses (61%) in 2025. Law enforcement was more likely torespond to a scene alone (31%) than EMS (6%). The overwhelming majority (78%) of confirmed fatal drug overdoses were ruled as, or suspected of being, accidental manner of death. 

Of the 36 confirmed or suspected fatal overdoses in 2025, 8 (22%) had a reported history of prior overdose.

Although most cases had bystanders or witnesses present at the scene by the time first responders arrived, the detailsabout who was present at the time of the overdose were frequently unclear. However, responding family and friends or otherbystanders administered naloxone for 2 (6%) of the 2025 fatal overdoses. Often, EMS and/or law enforcement administered naloxone in addition to bystanders or witnesses. During 2025, 19% of suspected and confirmed fatal overdose cases hadnaloxone administered at the scene by EMS, bystanders, and/or law enforcement.

Of the 24 suspected or confirmed drug death cases with EMS involvement during 2025, 13 (54%) victims were alreadydeceased when EMS arrived. In the remaining 11 (46%) cases, resuscitation was attempted either at the scene or presumablyin the ambulance during transport to the emergency room. One case had an unreported response once EMS arrived. Of those11 who were still alive when EMS arrived, 3 (27%) were transported, and 8 (73%) did not survive to be transported. Thus, outof 24 ultimately fatal cases with EMS response, only 3 (13%) remained alive long enough to be transported but died during transport or at the emergency room. This outcome is likely due to a combination of the high number of cases with fentanyl as a cause of death and individuals using alone. Fentanyl acts more quickly than other opioids, and there is less time forbystanders to find an overdose victim alive, administer naloxone, and call 911.

Table 9. Incident characteristics among suspected and confirmed fatal overdoses

 Jan–Dec 2024
Est. N = 490
Jan 2025
Est. N = 36
EMS response alone418%26%
Law enforcement alone9119%1131%
EMS and law enforcement35071%2261%
Private transport to Emergency Dept.00%00%
Naloxone administration reported at the scene12726%719%
Bystander only administered4810%00%
Law enforcement only administered92%13%
EMS only administered429%38%
EMS and law enforcement administered20%00%
EMS and bystander administered122%13%
Law enforcement and bystander administered41%13%
EMS, bystander, and law enforcement administered10%00%
Naloxone administered by unspecified person20%00%
History of prior overdose14830%822%

Key drug categories and combinations causing overdose deaths

Table 10 displays the frequencies of the most prominent drug categories causing death among confirmed drug deaths. As expected, within the confirmed drug death cases so far in 2024, nonpharmaceutical fentanyl was the most frequent cause of death, mentioned on the death certificate of 324 (72%) victims.

Fentanyl is nearly always found in combination with multiple other drugs. Heroin involvement, declining rapidly in recentyears, was reported as a cause of death in 11 (2%) of 2024 deaths and 12 (2%) of 2023 deaths. Xylazine and nonpharmaceutical tramadol were identified as co-intoxicants with fentanyl for the first time in 2021. Among 452 confirmed deaths in 2024, there were 65 cases (14%) with xylazine listed in addition to fentanyl as a cause of death, and 1 case (<1%) with tramadol listed along with fentanyl.

Stimulants continue to increase as a cause of death, usually in combination with other drugs, particularly fentanyl. Cocaine-involved fatalities constituted 199 (44%) of confirmed cases in 2024, higher than in 2023 (37%). Fentanyl is mentioned as a cause of death in combination with cocaine in 155 cases, 78% of 2024 cocaine cases. Methamphetamine was cited as a cause of death in 168 (37%) of the confirmed fatal overdoses in 2024, higher than in 2023 (33%); 127 (76%) of themethamphetamine deaths also involved fentanyl as a co-intoxicant cause of death. Cocaine and methamphetamine are named together on 48 (10%) death certificates in 2024, in most of those cases (37, 77%) as co-intoxicants of fentanyl.

Table 10. Key drug categories and combinations causing death among confirmed overdoses

Cause of death (alone or in combination with other drugs) Sample size for confirmed cases onlyJan–Dec 2024
Est. N = 452
Jan 2025
Est. N = 4
Fentanyl or fentanyl analogs32472%250%
Heroin112%00%
Cocaine19944%250%
Methamphetamine16837%375%
Pharmaceutical opioids**8018%00%
Fentanyl and heroin112%00%
Fentanyl and cocaine15534%125%
Fentanyl and methamphetamine12728%125%
Fentanyl and xylazine6514%00%
Fentanyl and tramadol10%00%