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The Louisiana Department of Health is reporting something that sounds good on paper: opioid-related deaths plunged 59% from 2022 through preliminary 2025 data. At the same time, a federal survey puts Louisiana at or near the bottom of all states for past-year opioid misuse. That sharp contrast is the real story — a hopeful drop in deaths, mixed with stubborn misuse and a huge treatment shortfall that state leaders must face honestly.
LDH’s take: fewer deaths, fewer ER trips
State health officials say the numbers are real enough to celebrate. The Louisiana Department of Health reports opioid-related deaths fell 59%, emergency department visits tied to opioids dropped 52%, and opioid prescriptions per 100 residents fell about 10%. Secretary Bruce D. Greenstein called it “proven progress in behavioral health.” Those are big gains if they hold up once the 2025 figures are finalized and the data get cleaned up.
The federal mirror: high misuse, big treatment gap
But the federal National Survey on Drug Use and Health — the SAMHSA state estimates — paints a different picture about how many people are actually using opioids. SAMHSA’s model shows roughly 4.6% of Louisianans age 12 and up misused opioids in the past year, which translates to about 174,000 people. The estimates find about 95,000 people with opioid use disorder and put roughly 727,000 Louisianans in the “need treatment” bucket, while an estimated 574,000 of those did not receive care. So yes: fewer deaths, but lots of people still struggling and many not getting help.
How both numbers can be true — and why that matters
Here’s the part reporters sometimes skip: LDH’s figures come from surveillance data — deaths, ER visits, prescriptions — while SAMHSA’s numbers are model-based estimates from a household survey. They measure different things. Worse, the survey’s opioid misuse measure does not capture illegal fentanyl exposure well. That matters because fentanyl is a major driver of overdoses nationwide. So you can see falling overdose deaths at the same time a survey shows high community misuse. But that’s no excuse to get complacent. Falling deaths are a win. High misuse and a large treatment gap are a call to action.
What should happen next
State leaders — and yes, that means the people in charge at LDH and local officials — should keep what’s working and fix what’s not. Demand transparency: show the methods behind the 59% figure and confirm when 2025 numbers are final. Expand real treatment in the places people live, not just in press releases. Crack down on fentanyl trafficking and support programs that pair law enforcement with recovery services and faith- and community-based care. Celebrate the drop in deaths, but stop pretending the work is done while hundreds of thousands remain untreated. That’s the honest, commonsense approach Louisiana voters deserve.
