Drug overdose deaths have risen steadily over the past decade. The most robust data came from the U.S. Centers for Disease Control and Prevention (CDC) surveys in 2017 when it was reported that 70,237 drug overdose deaths occurred in that year alone.

Unfortunately, the most accurate reporting often comes a few years later. However, the CDC is using new methods of collecting overdose data that are improving the timeliness of reporting. As of April 2019, they found 67,123 reported cases of overdose deaths in the 12 months prior and predicted that the true number was around 69,294.

They also reported overdose deaths on a state-by-state basis between April 2018 and April 2019; however, the data are incomplete. The most comprehensive data on overdose rates by state come from a 2017 report. According to both reports, West Virginia had the highest rate of opioid overdose deaths considering its population size. Pennsylvania had the most overdose deaths in 2017 with 5,388. In 2019, California is estimated to have 5,899 as of April.

Which States Have the Highest Overdose Rates?

Overdose rates may change year to year with the opioid epidemic. However, the East Coast seems to be the epicenter for much of opioid use and overdose in the United States. The Northeast and Midwest are particularly affected. However, areas of the South, including West Virginia and Kentucky have also been significantly affected.

West Virginia

Although the state has the lowest population in the top four, it has the highest rate of overdose deaths, with 966 deaths estimated for the 12 months leading up to April 2019.


The state was hit hard by the opioid epidemic and saw a total of 5,111 overdose deaths in 2019. In 2017, they saw more than 4,000 deaths by overdoses involving opioids.


The state has the highest population in the top five and saw the most overdose deaths in 2017. In 2019, they are likely to have close to 5,000 overdose deaths.


Kentucky shares a border with the top two states for opioid overdose, and it has also been significantly affected. It sees a rate of 27.9 deaths per 100,000 people.

New Hampshire

The state has the smallest population in the top five, but it had 467 overdose deaths in 2017. It’s estimated that there were 440 in the year before April 2019.

To learn how other states have fared, you can also look up drug overdose statistics by state. The National Center for Health Statistics at the CDC offers a dashboard where site users can look up each state’s fatal drug overdose statistics between 1999 and 2019. The death rate and the number of deaths for each state are listed.

In 2019, the states with the largest number of deaths include:

  • California – 6,198
  • Florida – 5,268
  • Pennsylvania – 4,377
  • Ohio – 4,251
  • New York – 3,617
  • Texas – 3,136
  • New Jersey – 2,805
  • Illinois – 2,790
  • Michigan – 2,385
  • Maryland – 2,369
  • North Carolina – 2,266
  • Massachusetts – 2, 210
  • Tennessee – 2,089
  • Arizona – 1,907

The year 2019 is the latest year on record for drug overdose data in the U.S. as of this writing. Accidental drug overdose statistics make it easier to see which populations are being affected most by substance abuse and addiction. In some states, such as Arizona, Connecticut, and Florida, overdose deaths were high among people in the 24-35 age range, with deaths affecting more people at the higher end of that range. Other affected age groups include those older than age 35 up to 58 years old. Per information from the National Institute on Drug Abuse and Addiction (NIDA), more than 7,000 people in the U.S. died from drug-involved overdoses. These overdoses included illegal and legal substances, including prescription opioids.

Opioids Instrumental in Many Overdose Deaths

While the U.S. government says it does not track death rates for all drugs that people use, it does show us data for drugs such as opioids and other drugs that were used with an opioid, such as the deadly, potent fentanyl. These drugs include cocaine, methamphetamine and other psychostimulants, and antidepressants. 

Polydrug use is common among drug users, so some deaths recorded were caused after the use of multiple drugs. These substances can cause overdoses when used by themselves as well.

Trends also show that drug overdose deaths involving synthetic opioids and methamphetamine have shifted geographically in the U.S. Per the CDC, the largest increase in death rates involving synthetic opioids between 2018 and 2019 were in the Western U.S., at 67.9%. Also, the largest rise in death rates involving psychostimulant drugs like meth occurred in the Northeast at 43.8%.

Other noteworthy trends include:

  • Drug overdose death statistics involving psychostimulants are on the rise, and these deaths are happening with and without the use of synthetic opioids.
  • Nearly 50,000 people who died of an overdose in 2019 did so after using an opioid. Opioid-involved overdoses made up 70.6% of all drug overdose deaths, per the CDC.
  • The CDC also reports that no U.S. state experienced a significant decrease in drug overdose deaths between 2018 and 2019.

Risk Factors for Addiction

Overdose death rates can be influenced by many factors in communities and states, and at the national level.

Drug availability is one of the most significant factors in addiction and overdose rates.

High excessive drug prescribing can cause the excess to fall into the wrong hands.

White pills spilled over a blue 3D model of the United States

For instance, most illicit heroin users report starting with prescription opioids.

However, illicit drug availability accounts for much of the drug abuse and overdose in the United States.

According to the U.S. Drug Enforcement Administration’s 2018 National Drug Threat Assessment,

Mexican transnational criminal organizations have a significant presence in the United States, and they continue to traffic heroin, cocaine, and other illicit substances.

This has happened with benzodiazepine medications, which are among the most overprescribed drugs in the U.S. These potent sedatives and tranquilizers are often overprescribed to senior-aged adult patients, putting them at risk of falls and other injuries and long-term benzo dependence that can harm their health. Seniors are also at risk of overdose as they often take more than one prescribed medication.

Excessive prescribing can also expose younger people to drugs that they may find in the medicine cabinet at home or at school among their peers, who also should not have it.

More study is needed to understand the effects of overprescribing on addiction and how they affect drug overdose death statistics, but it is probable that some overdose victims who accidentally overdosed on drugs did so because of too much access to harmful substances.

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