According to the Montana Department of Health and Human Services, the number of drug samples testing positive for fentanyl was cut in half between 2024 and 2025.
A decrease that large likely means there is less fentanyl on Montana’s streets. But that didn’t equate to fewer overdoses.
Ambulance services responded to roughly 250 more suspected opioid overdoses in 2025. That’s a 35% increase compared to the previous year. Overdose deaths also ticked up slightly.
Tasha Camron runs drug harm-reduction programs for Butte-Silver Bow County and hears directly from people using drugs. She says there are new drugs like xylazine, an animal tranquilizer, showing up.
“We just see such a variation of additives, that it’s hard to pinpoint. That’s how chaotic it is.”
Camron’s staff regularly trains those using opioids to use the overdose reversal drug Narcan.
She says people may use it on someone they thought took fentanyl, but they don’t wake up.
“Because Narcan doesn’t work with the xylazine. So, there’s really not much in the moment to do other than call 911,” Camron says.
That might explain why 911 calls for overdoses ticked up as the presence of fentanyl went down.
Adams Sibley is with the University of North Carolina Chapel Hill’s opioid data lab. It tests illicit drugs from all over the country.
“I would say that we’ve moved from a crisis mostly driven by fentanyl, to a crisis driven by adulterated fentanyl, specifically with sedatives like xylazine and medetomidine,” he says.
Sibley says less exposure to opioids could decrease overdose risk. But says the drug supply is more complex than it’s ever been and remains dangerous.
