15 States With The Highest Drug Overdose Death Rates In The US

In this article, we will take a look at the 15 states with the highest drug overdose death rates in the US. If you want to skip our discussion on the drug crisis, you can go directly to the 5 States With The Highest Drug Overdose Death Rates In The US.

In the 12-month period ending in July 2023, over 106,000 Americans lost their lives due to drug overdoses, marking a slight decrease compared to the previous year. The reported figure reflects a 1% reduction from the 107,747 overdose-related deaths recorded in the 12-month period ending July 2022. The decline raises questions about potential underreporting or signals a positive shift due to governmental policies and intervention efforts. The United States recorded a continuous annual rise in drug overdose deaths until 2021, after which a decline has been observed. The drug overdose death toll crossed 100,000 in 2021 during the peak of the Covid-19 pandemic. The increase in the death rates was influenced by disruptions in medical care, higher mental distress, and the widespread availability of certain drugs. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), around 91 million Americans resided in areas facing a shortage of mental health professionals in 2021. With the rates of depression and anxiety rising and the lack of mental health support, individuals turned to substances as a means of reducing their distress.

Across states, Washington witnessed the most significant percentage increase in overdose-related deaths, rising by 38.5% between July 2022 and July 2023. In contrast, North Carolina experienced the most substantial decline, with a 23.4% decrease in drug overdose deaths. Meanwhile, Illinois and New York were among the states with the highest drug overdose death rates in the US in 2023. The highest number of deaths reported in 2023 was due to opioids, with opioids responsible for 76% of total overdose-related deaths in the country. This number was slightly lower than the 80% opioid-related deaths predicted for the 12 months ending in July 2023. You can also check out the 20 Cities with the Highest Opioid Deaths in the U.S. here. On the other hand, the reported number of drug overdose deaths involving psychostimulants such as methamphetamine and synthetic opioids (including fentanyl but excluding methadone) saw a significant increase in 2023 compared to 2022. Meanwhile, heroin overdoses witnessed a decline, dropping from 7,066 in July 2022 to 4,542 in 2023 across the country.

Pharmaceutical Industry’s Role in the Opioid Epidemic

Drug overdose remains a significant contributor to both fatal and non-fatal accidents and injuries, with opioids and stimulants being responsible for the highest number of casualties. Several pharmaceutical companies have come under fire for promoting the use of opioids, leading to addiction. In 2019, Purdue Pharma settled a lawsuit filed by the state of Oklahoma for $270 million, alleging the company’s responsibility for thousands of deaths in the state. Purdue Pharma, having paid millions in settlements over the past two decades, has now declared bankruptcy.

Four other pharmaceutical companies collectively paid a sum of $26 billion in 2022 to settle lawsuits holding them responsible for the worsening opioid epidemic in the US. These companies include Johnson & Johnson (NYSE:JNJ), Cencora Inc (NYSE:COR) (formerly known as AmerisourceBergen), Cardinal Health (NYSE:CAH), and McKesson (NYSE:MCK). Johnson & Johnson, a health-tech giant with a global presence, faced controversies not only related to opioids but also concerning harmful ingredients in baby products. In 2022, the company paid $5 billion in a nationwide settlement, which was utilized for healthcare and drug treatment programs. Despite announcing the suspension of opioid production in 2020, it was only after the lawsuit settlement in 2022 that Johnson & Johnson (NYSE:JNJ) stopped selling prescription opioid medicine in the United States. This collective effort by states and federal bodies held major pharmaceutical companies accountable for the devastating opioid epidemic. The billions received in settlements have provided support to rehabilitation programs and treatment facilities for substance abuse and addiction. This collaborative action is believed to be a contributing factor to the noticeable decline in the number of opioid-related deaths in the country in the past year.

Here’s what ClearBridge Investments said about Johnson & Johnson (NYSE:JNJ) in its Q3 2023 investor letter:

“The health care space provided some opportunities in the quarter, as we increased our exposure to medical device company Becton, Dickinson as well as large cap pharmaceutical company Johnson & Johnson (NYSE:JNJ). Johnson & Johnson recently spun out its consumer health care business, becoming a more focused yet broadly diversified pharmaceutical and medtech company.”

Photo by Matteo Badini on Unsplash

Our Methodology

To shortlist the 15 states with the highest drug overdose death rates in the US, we referred to the 2023 annual report published by the Centers for Disease Control and Prevention (CDC). We have analyzed the data provided for drug overdose deaths by jurisdiction for the 12 months ending in July 2023. The drug overdose death rates represent the percentage of total drug overdose-related deaths accounted by each state. The states have been ranked in ascending order of the death rates and the count of drug overdose deaths as of July 2023.

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States With The Highest Drug Overdose Death Rates In The US

15. Maryland

Drug Overdose Death Rate = 2.37%

Count of Drug Overdose Deaths: 2,532

Maryland has consistently ranked among the top 15 states with the highest drug overdose death rates. In 2021, the state accounted for a total of 2,737 deaths due to drug overdose in the country. By July 2022, Maryland recorded approximately 2,487 overdose-related deaths, representing a 1.8% increase in the following 12 months.

14. Massachusetts

Drug Overdose Death Rate = 2.38%

Count of Drug Overdose Deaths: 2,541

While Massachusetts has one of the highest drug overdose death rates in the country, it has seen a decline in total deaths due to drug overdose in the past year. There has been a 3.3% decline in the death rate since last year. However, Massachusetts still accounts for 2.38% of total drug overdose deaths in the country.

13. New Jersey    

Drug Overdose Death Rate = 2.39%

Count of Drug Overdose Deaths: 2,548

New Jersey accounts for 2.39% of overall drug overdose deaths in the country. The state has seen a decline of 13.7% in deaths related to drug overdose between July 2022 and 2023. The reported number of deaths attributed to overdose in New Jersey in 2023 was lower than what was initially predicted.

12. Arizona

Drug Overdose Death Rate = 2.62%

Count of Drug Overdose Deaths: 2,794

Arizona saw a slight increment in the total number of deaths caused by drug overdose over the past year. In July 2022, Arizona recorded a total of 2,777 deaths, which increased by 0.6% this year to 2794 deaths. Arizona currently makes up 2.62% of total deaths due to drug overdose in the US.

11. Michigan

Drug Overdose Death Rate = 2.72%

Count of Drug Overdose Deaths: 2,904

Michigan has seen a decline of 2.8% in deaths caused by drug overdose between July 2022 and July 2023. The total number of overdose-related deaths in Michigan in 2023 was 2,904, accounting for 2.72% of the overdose-related deaths across the nation. Michigan is at the eleventh position on our list of 15 states with the highest drug overdose death rates in the US.

10. North Carolina

Drug Overdose Death Rate = 2.90%

Count of Drug Overdose Deaths: 3,090

North Carolina saw one of the greatest declines in drug overdose-related deaths in the country. Between July 2022 and 2023, North Carolina’s numbers decreased by 23.4%, signifying meaningful change caused by healthcare policies and interventions. North Carolina currently makes up 2.9% of total deaths due to drug overdose in the country.

9. New York

Drug Overdose Death Rate = 3.12%

Count of Drug Overdose Deaths: 3,224

New York is among the top 10 US states with the highest drug overdose death rates. It currently makes up for 3.12% of total drug overdose-related deaths in the country. There has been an increase of 1.7% in the number of overdose-related deaths in New York in the past year.

8. Washington

Drug Overdose Death Rate = 3.14%

Count of Drug Overdose Deaths: 3,348

Washington saw the biggest YoY increase in the number of drug overdose deaths in the 12 months ending in July 2023. There was a sharp 38.5% increase in the number of people who died due to overdose-related issues. The state accounts for 3.14% of the total deaths due to overdose in the country.

7. Illinois

Drug Overdose Death Rate = 3.52%

Count of Drug Overdose Deaths: 3,753

Illinois observed a decline of 2% in the total number of deaths caused by drug overdose within the state. The state makes up 3.52% of the total deaths due to drug overdose in the US.

6. Tennessee

Drug Overdose Death Rate = 3.56%

Count of Drug Overdose Deaths: 3,799

Tennessee is one of the top 10 states with the highest drug overdose death rates in the US. In 2021, the state recorded a total of 3,813 overdose-related deaths. This number decreased slightly in 2022 and then increased by 0.4% in 2023. The state currently accounts for 3.56% of total deaths in the US due to drug overdose.

Companies like Johnson & Johnson (NYSE:JNJ), Cencora Inc (NYSE:COR), Cardinal Health (NYSE:CAH), and McKesson (NYSE:MCK) have been accused in the past of contributing to the drug crises in the US.