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The opioid crisis: Every state's overdose death rate, ranked 2018
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The opioid crisis: Every state's overdose death rate, ranked 2018

  • Jun 8, 2026
  • Jun 8, 2026 Updated Jun 9, 2026
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Drug overdoses are skyrocketing across the U.S. That said, certain states have been hit substantially harder than others.

Intro

Drug overdoses are skyrocketing across the U.S., prompting multiple states and the Department of Health and Human Services to issue emergency declarations. Provisional data from the U.S. Centers for Disease Control estimate that drug overdoses are now responsible for at least 66,000 deaths annually (more than three times higher than in 1999) and are the leading cause of death among Americans under age 50. Drugs now kill more people in the U.S. each year than either car accidents or guns.

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51. Nebraska

  • Opioid overdose death rate (age-adjusted): 2.5 per 100,000
  • 10-year percent change: 32% increase
  • Most impacted age group: Unknown
  • Most impacted county: Douglas County

50. Montana

  • Opioid overdose death rate (age-adjusted): 4.2 per 100,000
  • 10-year percent change: 28% decrease
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

49. Texas

  • Opioid overdose death rate (age-adjusted): 5.1 per 100,000
  • 10-year percent change: 9% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Orange County

48. California

  • Opioid overdose death rate (age-adjusted): 5.2 per 100,000
  • 10-year percent change: 18% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Humboldt County

47. South Dakota

  • Opioid overdose death rate (age-adjusted): 5.2 per 100,000
  • 10-year percent change: 53% increase
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

46. Hawaii

  • Opioid overdose death rate (age-adjusted): 5.5 per 100,000
  • 10-year percent change: 10% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Honolulu County

45. Kansas

  • Opioid overdose death rate (age-adjusted): 5.7 per 100,000
  • 10-year percent change: 21% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Sedgwick County

44. Arkansas

  • Opioid overdose death rate (age-adjusted): 6.1 per 100,000
  • 10-year percent change: 11% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Unknown

43. Mississippi

  • Opioid overdose death rate (age-adjusted): 6.3 per 100,000
  • 10-year percent change: 152% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Unknown

42. Iowa

  • Opioid overdose death rate (age-adjusted): 6.6 per 100,000
  • 10-year percent change: 89% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Polk County

41. Minnesota

  • Opioid overdose death rate (age-adjusted): 7.5 per 100,000
  • 10-year percent change: 108% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Hennepin County

40. Idaho

  • Opioid overdose death rate (age-adjusted): 7.6 per 100,000
  • 10-year percent change: 49% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Ada County

39. North Dakota

  • Opioid overdose death rate (age-adjusted): 7.7 per 100,000
  • 10-year percent change: Unknown
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

38. Alabama

  • Opioid overdose death rate (age-adjusted): 7.7 per 100,000
  • 10-year percent change: 166% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Jefferson County

37. Oregon

  • Opioid overdose death rate (age-adjusted): 7.9 per 100,000
  • 10-year percent change: 25% decrease
  • Most impacted age group: 45-54 years
  • Most impacted county: Jackson County

36. Louisiana

  • Opioid overdose death rate (age-adjusted): 8.0 per 100,000
  • 10-year percent change: 70% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: St. Tammany Parish

35. Wyoming

  • Opioid overdose death rate (age-adjusted): 9.1 per 100,000
  • 10-year percent change: Unknown
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

34. Georgia

  • Opioid overdose death rate (age-adjusted): 9.1 per 100,000
  • 10-year percent change: 146% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Gwinnett County

33. Washington

  • Opioid overdose death rate (age-adjusted): 9.6 per 100,000
  • 10-year percent change: 8% decrease
  • Most impacted age group: 45-54 years
  • Most impacted county: Cowlitz County

32. Colorado

  • Opioid overdose death rate (age-adjusted): 9.9 per 100,000
  • 10-year percent change: 43% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Denver County

31. Oklahoma

  • Opioid overdose death rate (age-adjusted): 11.8 per 100,000
  • 10-year percent change: 4% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Tulsa County

30. Arizona

  • Opioid overdose death rate (age-adjusted): 11.9 per 100,000
  • 10-year percent change: 45% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Pima County

29. Indiana

  • Opioid overdose death rate (age-adjusted): 13.1 per 100,000
  • 10-year percent change: 337% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Marion County

28. Alaska

  • Opioid overdose death rate (age-adjusted): 13.5 per 100,000
  • 10-year percent change: 229% increase
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

27. South Carolina

  • Opioid overdose death rate (age-adjusted): 13.6 per 100,000
  • 10-year percent change: 152% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Greenville County

26. Virginia

  • Opioid overdose death rate (age-adjusted): 13.7 per 100,000
  • 10-year percent change: 149% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Tazewell County

25. Florida

  • Opioid overdose death rate (age-adjusted): 14.6 per 100,000
  • 10-year percent change: 95% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Sarasota County

24. Nevada

  • Opioid overdose death rate (age-adjusted): 14.8 per 100,000
  • 10-year percent change: No change
  • Most impacted age group: 45-54 years
  • Most impacted county: Clark County

23. New York

  • Opioid overdose death rate (age-adjusted): 15.4 per 100,000
  • 10-year percent change: 185% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Bronx County

22. North Carolina

  • Opioid overdose death rate (age-adjusted): 15.7 per 100,000
  • 10-year percent change: 99% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Wilkes County

21. Illinois

  • Opioid overdose death rate (age-adjusted): 15.8 per 100,000
  • 10-year percent change: 116% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Cook County

20. Wisconsin

  • Opioid overdose death rate (age-adjusted): 16 per 100,000
  • 10-year percent change: 150% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Kenosha County

19. Missouri

  • Opioid overdose death rate (age-adjusted): 16.3 per 100,000
  • 10-year percent change: 123% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: St. Louis city

18. New Jersey

  • Opioid overdose death rate (age-adjusted): 16.5 per 100,000
  • 10-year percent change: 284% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Cape May County

17. Utah

  • Opioid overdose death rate (age-adjusted): 17.0 per 100,000
  • 10-year percent change: 17% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Salt Lake County

16. Delaware

  • Opioid overdose death rate (age-adjusted): 17.4 per 100,000
  • 10-year percent change: 241% increase
  • Most impacted age group: Unknown
  • Most impacted county: New Castle County

15. New Mexico

  • Opioid overdose death rate (age-adjusted): 18.3 per 100,000
  • 10-year percent change: 41% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Bernalillo County

14. Vermont

  • Opioid overdose death rate (age-adjusted): 18.7 per 100,000
  • 10-year percent change: 91% increase
  • Most impacted age group: Unknown
  • Most impacted county: Unknown

13. Tennessee

  • Opioid overdose death rate (age-adjusted): 18.8 per 100,000
  • 10-year percent change: 138% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Knox County

12. Pennsylvania

  • Opioid overdose death rate (age-adjusted): 18.8 per 100,000
  • 10-year percent change: 422% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Cambria County

11. Michigan

  • Opioid overdose death rate (age-adjusted): 18.9 per 100,000
  • 10-year percent change: 195% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Wayne County

10. Kentucky

  • Opioid overdose death rate (age-adjusted): 24.1 per 100,000
  • 10-year percent change: 194% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Kenton County

9. Connecticut

  • Opioid overdose death rate (age-adjusted): 24.8 per 100,000
  • 10-year percent change: 265% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: New Haven County

8. Maine

  • Opioid overdose death rate (age-adjusted): 25.6 per 100,000
  • 10-year percent change: 237% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Unknown

7. Rhode Island

  • Opioid overdose death rate (age-adjusted): 26.8 per 100,000
  • 10-year percent change: 116% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Providence County

6. Maryland

  • Opioid overdose death rate (age-adjusted): 30.1 per 100,000
  • 10-year percent change: 198% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Baltimore city

5. Massachusetts

  • Opioid overdose death rate (age-adjusted): 30.2 per 100,000
  • 10-year percent change: 196% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Bristol County

4. District of Columbia

  • Opioid overdose death rate (age-adjusted): 30.6 per 100,000
  • 10-year percent change: 181% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: N/A

3. Ohio

  • Opioid overdose death rate (age-adjusted): 33.6 per 100,000
  • 10-year percent change: 460% increase
  • Most impacted age group: 45-54 years
  • Most impacted county: Trumbull County

2. New Hampshire

  • Opioid overdose death rate (age-adjusted): 36.3 per 100,000
  • 10-year percent change: 343% increase
  • Most impacted age group: 35-44 years
  • Most impacted county: Rockingham County

1. West Virginia

  • Opioid overdose death rate (age-adjusted): 45.2 per 100,000
  • 10-year percent change: 167% increase
  • Most impacted age group: 25-34 years
  • Most impacted county: Logan County
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