April 2025 Monthly Overdose Report

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

Overview: Composite total of fatal and nonfatal overdoses

This report documents suspected and confirmed fatal and nonfatal drug overdoses in Maine during April 2025 as well asfor the period January 2024–April 2025 (Table 1). The total number of confirmed and suspected fatal overdoses during 2025 is 135, 30.1% lower than the total confirmed fatal overdoses for January–April 2024, 193. The total number of nonfatal overdoses during January–April 2025 is 2,289, 17.9% lower than the total reported nonfatal overdoses for January–April 2024, 2,789. Monthly proportions of 2025 fatalities from January to April averaged 5.6%. They ranged from a high of 6.1% in February to a low of 4.9% in March. During 2024, fatal overdoses constituted 5.8% of all overdoses, just slightly 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, and December 2024 as well as January, February, March, and April 2025 (see Figure 1).

The total number of suspected and confirmed fatal overdoses and reported nonfatal overdoses for April 2025, 649, isdisplayed in Table 1 near the bottom row. Of those 649, there were 36 (5.5%) confirmed and suspected fatal overdoses, 294 (45.3%) nonfatal emergency department visits, 211 (32.5%) nonfatal EMS responses not transported to the emergencydepartment, 90 (13.9%) reported community overdose reversals, and 18 (2.8%) law enforcement reversals in incidents that did not include EMS.

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

 Nonfatal   
Emergency Dept.EMS not transportedto emergencyCommunity reversalswith naloxoneLaw enforcement nonfatal overdose responsewithout EMSTotalnonfatal overdosesTotal confirmed andsuspectedfatal overdosesTotal overdoses
January 20242692251392665945704
February 20243052421362871143754
March 20243792321192775760817
April 20242532051901466245707
May 20243112571652475740797
June 20243442322021279042832
July 20242932351662371739756
August 20242882151191063233666
September 2024317199114663634671
October 2024301198861760234636
November 2024261173581851340553
December 2024352190491260341645
2024 YTD total36732606154321780394968538
% of 2024 YTD total43.1%30.6%18.1%2.6%94.3%5.8%100%
January 2025234193531549531526
February 2025256159741850733538
March 2025374200713167635711
April 2025294211901861336649
2025 YTD Total11567632888222891352424
% of 2025 YTD Total47.7%31.5%11.9%3.4%94.4%5.6%100%
Composite reported overdose totals, all drugs

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 January–April 2025 as well as January–December 2024. During 2024, law enforcement officers responded to a reported 1,158 overdose incidents (453 fatal; 705 nonfatal), and Maine EMS responded to a reported 9,498 incidents (390 fatal; 9,108 nonfatal). During 2025, law enforcement officers responded to a reported 285 incidents (118 fatal; 167 nonfatal), and Maine EMS responded to a reported 2961 incidents (92 fatal; 2869 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–Apr 2025Nonfatal overdose response Jan–Apr 2025Total Overdose Response Jan–Apr 2025
Maine EMS390910894989228692961
Law Enforcement4537051158118167285

 


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 April 2025 monthly totals in the far right column can be compared to the percentage of the census population on the far left, the percentage of nonfatal overdoses for the year in 2025, or 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 2025 percentage totals for most counties fall within 0 to 2 percentage points of the 2020 census distribution. Compared to the 2020 census proportion, Cumberland County is 5 percentage points higher, Penobscot County is 4 percentage points higher, and Androscoggin County is 3 percentage points higher. York County is 6 percentage points lower.

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

% 2020 estimated Census populationJan–Dec 2024  
Est. N = 9108
Jan–Apr 2025  
Est. N = 2869
Apr 2025  
Est. N = 765
Androscoggin8%91310%32811%7610%
Aroostook5%4885%1074%233%
Cumberland22%230925%76827%21428%
Franklin2%1652%522%162%
Hancock4%2413%662%172%
Kennebec9%90710%2619%598%
Knox3%2623%823%213%
Lincoln3%1712%532%122%
Oxford4%3344%1014%324%
Penobscot11%113812%41915%11815%
Piscataquis1%1011%321%111%
Sagadahoc3%1522%442%132%
Somerset4%3994%1254%375%
Waldo3%1972%572%91%
Washington2%2252%833%223%
York16%110612%29110%8511%

Nonfatal Overdoses (EMS) April 2025

Nonfatal Overdoses (EMS) Jan – Apr 2025


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 April 2025, 2025 year to date, and 2024. 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 both 2024 and 2025 year to date 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 constitute 36% of the population in the 2020 census compared to 63% in the nonfatal overdose population in 2025. In 2025, there are 13 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 = 9152
Jan–Apr 2025 
Est. N = 2865
Apr 2025 
Est. N = 758
< 1818%3834%1355%344%
18-247%8299%2258%507%
25-3412%178219%53519%13217%
35-4412%234426%81028%22329%
45-5412%148316%45316%13217%
55-6416%122513%36213%10414%
> 6423%110612%34512%8311%

Table 5 displays the reported gender of individuals experiencing nonfatal overdoses involving EMS response in April 2025, 2025 year to date, 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 January–December 2024 totals in the center column. When comparing the January–April 2025 with 2024, as well as the census population proportion, cautionmust be exercised as the small number of cases in each month is vulnerable to random fluctuation that may not reflect asignificant statistical trend. Males represent 49% of the 2020 estimated census population, 58% of the nonfatal overdose victims with EMS involvement in 2024, and 59% during January–April 2025.

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

% 2020 estimated Census populationJan–Dec 2024 
Est. N = 8800
Jan–Apr 2025 Est.
N = 2762
Apr 2025
Est. N = 735
Male49%511658%162259%45362%
Female51%368342%113841%28238%
TransgenderNot collected10.0%20.07%00%

County Distribution of Suspected and Confirmed Fatal Overdoses

Table 6 shows the frequency distribution of fatal overdoses at the county level. The April 2025 monthly totals in the far right column can be compared either to the percentage of the census population in the far left column, the percentage of county fatal overdoses for 2024, or the 2025 year-to-date percentages. 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 2025 percentages for most counties fall within 0 to 2 percentage points of the 2020 census distribution. Compared to the 2020 census proportion, Penobscot County is 5 percentage points higher. Hancock County, Oxford County, Sagadahoc County and York County are 3 percentage points lower.

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

% 2020 estimated Census populationJan–Dec 2024 
Est. N = 496
Jan–April 2025 
Est. N = 135
April 2025 
Est. N = 36
Androscoggin8%469%1410%514%
Aroostook5%398%86%26%
Cumberland22%9419%3224%925%
Franklin2%61%43%13%
Hancock4%153%21%00%
Kennebec9%479%129%719%
Knox3%224%32%00%
Lincoln3%184%21%13%
Oxford4%204%21%00%
Penobscot11%6513%2216%411%
Piscataquis1%51%21%00%
Sagadahoc3%71%00%00%
Somerset4%224%43%13%
Waldo3%184%43%13%
Washington2%163%64%00%
York16%5611%1813%514%

Fatal overdoses April 2025

Fatal Overdoses Jan – Apr 2025


Age and Sex Distribution of Fatal Overdose Victims

Table 7 displays the age and sex composition of the fatal overdose population for April 2025, 2025 year to date, and 2024, compared to the 2020 estimated census population. When comparing the April 2025 data with 2024 as well as with thecensus population 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 higher so far in 2025 (68%) compared to 2024 (66%). The age distribution for2025 compared to the 2020 census proportion shows a disproportionately large impact of fatal overdoses in those aged 35–64, as was true in 2024. That group includes 40% of the 2020 estimated census population, compared to 73% in the fatal overdose population in 2025 and 74% during 2024. Those ages 18–24 constitute 7% of the 2020 census population but 6% of  2025 fatal overdoses. Those 65 and older comprise 23% of the census population but only 7% of the fatal overdoses.

There were, however, differences between the age structures of the nonfatal overdoses (Table 4) and the fatal overdoses. In 2025, the highest proportion of both fatal and nonfatal overdoses was among those aged 35–44 (28% among nonfatal and 33% among fatal). The second highest age group was 25–34 (19% among nonfatal and 21% among fatal). The 55–64 age group had 13% among nonfatal and 21% among fatal. 

Note that death certificate reports sex as male or female without  gender categories.

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

% 2020 estimated Census populationJan–Dec 2024 
Est. N = 496
Jan–April 2025 
Est. N = 135
April 2025 
Est. N = 36
Male49%32566%9268%2261%
< 1818%51%00%00%
18-247%133%86%13%
25-3412%6613%1914%514%
35-4412%14429%4433%1131%
45-5412%12526%2619%1131%
55-6416%10020%2821%617%
> 6423%439%107%26%

Race, ethnicity, and other demographic indicators of decedents

Table 8 displays the reported race and ethnicity of confirmed and suspected fatal overdoses in April 2025, 2025 year to date, 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 thesevariables. Out of 135 decedents for whom race was reported in 2025, 97% of the victims were identified as White, 0% asBlack/African American, and 1% as American Indian/Alaska Native. Out of 135 decedents for whom Hispanic ethnicity status was reported, 1% were identified as Hispanic.

A: Race% 2020 Estimated Census PopulationJan-Dec 2024 
Race N = 494
Jan-Apr 2025 
Race N = 135
April 2025
Race N = 36
White alone94%45793%13197%3494%
Black/African American alone2%194%00%00%
American Indian/Alaska Native alone1%92%12%00%
Other race and 2+ races combined3%92%32%26%
B: Ethnicity% 2020 Estimated Census PopulationJan–Dec 2024  
Ethnicity N = 487
Jan–April 2025 
Ethnicity N = 135
April 2025
Ethnicity N = 34
Hispanic/Latinx alone 2%102%21%00% 

Military status and housing stability of fatal overdose victims

Out of the 133 cases for which military background was reported in 2025, 6 (5%) were identified as having a military background. Out of the 35 cases in April 2025 where military background was reported, 0 (0%) were identified as having a military background. 

Of the 135 total suspected and confirmed fatal overdose cases year to date in 2025, undomiciled or transient housing status was reported for 13 (10%) victims. Among those 13, the largest proportions of undomiciled persons were found in Cumberland County (4, 31%) and Androscoggin County (3, 23%). In April 2025, 1 fatal overdose victim (3%) was identified as undomiciled. 


Basic incident patterns in fatal overdoses

Table 9 reports basic incident patterns for fatal overdoses. April 2025 can be compared to 2024 or 2025 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 (56%) in 2025. Law enforcement was more likely torespond to a scene alone (30%) than EMS (10%). The overwhelming majority (87%) of confirmed fatal drug overdoses were ruled as, or suspected of being, accidental manner of death. 

Of the 135 confirmed or suspected fatal overdoses in 2025, 34 (25%) 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 14 (10%) of the 2025 fatal overdoses, lower than the proportion in 2024 (13%). Often,EMS and/or law enforcement administered naloxone in addition to bystanders or witnesses. During 2025, 28% of suspected and confirmed fatal overdose cases had naloxone administered at the scene by EMS, bystanders, and/or law enforcement. Thisrate is higher than 2024 (25%).

Of the 92 suspected or confirmed drug death cases with EMS involvement during 2025, 39 (42%) victims were alreadydeceased when EMS arrived. In the remaining 53 (58%) 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 those53 who were still alive when EMS arrived, 20 (38%) were transported, and 53 (62%) did not survive to be transported. Thus,out of 92 ultimately fatal cases with EMS response, only 20 (22%) 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 withfentanyl as a cause of death and individuals using alone. Fentanyl acts more quickly than other opioids, and there is less timefor bystanders 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 = 496
Jan–Apr 2025
Est. N = 135
 Apr 2025 
Est. N = 36
EMS response alone398%1310%411%
Law enforcement alone9720%4030%1439%
EMS and law enforcement35171%7656%1850%
Private transport to Emergency Dept.00%00%00%
Naloxone administration reported at the scene12625%3828%1028%
Bystander only administered4810%97%38%
Law enforcement only administered92%32%00%
EMS only administered418%1612%514%
EMS and law enforcement administered20%43%00%
EMS and bystander administered122%43%26%
Law enforcement and bystander administered41%11%00%
EMS, bystander, and law enforcement administered10%00%00%
Naloxone administered by unspecified person20%00%00%
History of prior overdose14730%3425%1028%

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 2025, nonpharmaceutical fentanyl was the most frequent cause of death, mentioned on the death certificate of 75 (64%) victims, lower than the percentage in 2024 (70%). Note, however, that the small number of confirmed cases so far in 2025 makes analysis based on drug categories very preliminary, because numbers can fluctuate as toxicology results are received and cases are completed. 

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 6 (5%) of 2025 deaths, 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 117 confirmed deaths in 2025, there were 14 cases (12%) with xylazine listed in addition to fentanyl as a cause of death, and 0 cases (0%) with tramadol listed along with fentanyl. Bromazolam, a nonpharmaceutical benzodiazepine, has been found in 6 (5%) cases so far in 2025, all in combination with fentanyl. It was found for the first time in 2022 as a co-intoxicant of fentanyl.  It has been named as a cause of death in 17 (4%) completed cases in 2024, 16 in combination with fentanyl.

Stimulants continue to increase as a cause of death, usually in combination with other drugs, particularly fentanyl. Cocaine-involved fatalities constituted 52 (44%) of confirmed cases so far in 2025, nearly the same as 2024 (43%) and an increase from 37% in 2023. Fentanyl is mentioned as a co-intoxicant cause in 36 (69%) of 2025 year-to-date cocaine cases. Methamphetamine was cited as a cause of death in 47 (40%) of the confirmed fatal overdoses so far in 2025, higher than in 2024 (38%); 32 (68%) of the methamphetamine deaths also involved fentanyl as a co-intoxicant cause of death. Cocaine and methamphetamine are named together on 13 (10%) death certificates in 2025, in most of those cases (11, 85%) 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 = 481
Jan–April 2025 
Est. N = 117
 April 2025 
Est. N = 24
Fentanyl or fentanyl analogs33570%7564%1979%
Heroin112%65%313%
Cocaine20943%5244%1771%
Methamphetamine18138%4740%1458%
Pharmaceutical opioids**8117%2320%313%
Fentanyl and heroin112%65%313%
Fentanyl and cocaine16033%3631%1354%
Fentanyl and methamphetamine13528%3227%1042%
Fentanyl and xylazine7015%1412%313%
Fentanyl and tramadol10%00%00%