Examining CDC's State-by-State Data on Drug and Opioid Overdose Deaths

The Centers for Disease Control and Prevention recently released 2017 state-level mortality data. Over the last year, drug overdose trends grew more severe and will likely be a major topic of political and policy-making discourse. There were 70,237 total drug overdose deaths and 47,600 opioid overdose deaths in 2017. Total drug overdose and opioid overdose death rates increased 9 percent and 11 percent respectively over the 2016 totals. They have increased 257 percent and 400 percent respectively since 1999, according to CDC data.

Fentanyl remains the leading cause of overdose deaths and is disproportionately responsible for the increase in drug overdose rates from 2016. Fentanyl is a synthetic opioid that is up to 100 times stronger than morphine and is often produced and mailed in from China. Fentanyl was found in 40 percent of drug overdose deaths in 2017, up from 30 percent in 2016. Fentanyl or heroin was found in 51 percent of the total drug overdose deaths and 75 percent of opioid overdose deaths in 2017, up from 45 percent and 68 percent respectively in 2016.

In 2017, natural and semisynthetic opioid (prescriptions like oxycodone and hydrocodone) death rates that did not involve heroin or fentanyl decreased 9 percent from 2016. The cocaine-related death rate increased 33 percent from 2016 to 2017, but this is likely due to fentanyl adulteration, which was found in 52 percent of cocaine-related overdose victims, up from 40 percent compared to 2016. The cocaine overdose death rate with no fentanyl reported increased 7 percent from 2016.

These phenomena can be mostly attributed to the increased use of black-market opioids. Pennsylvania had the most drug overdose deaths in 2017, at 5,388 (37 percent fentanyl, 78 percent fentanyl for opioid overdose deaths), Ohio had the most opioid overdose deaths at 4,293 (82 percent fentanyl, 69 percent fentanyl for all drug deaths), and West Virginia had both the highest rates of total drug overdose deaths and opioid overdose deaths at 53.6 and 45.9 people per 100,000 respectively.

Below are the complete rankings of states and Washington, D.C., by total drug overdose deaths, opioid overdose deaths, total drug overdose death rates, and opioid overdose death rates according to CDC data.

(Figures are not mutually exclusive.)

States Ranked by Total Drug Overdoses

Rank	State	Total Drug Overdoses	Percent Involving Fentanyl
	US	70237	40%
1	Pennsylvania	5388	37%
2	Ohio	5111	69%
3	Florida	5088	42%
4	California	4868	11%
5	New York	3921	57%
6	Texas	2989	12%
7	Illinois	2778	45%
8	Michigan	2694	51%
9	New Jersey	2685	51%
10	North Carolina	2414	53%
11	Maryland	2247	69%
12	Massachusetts	2168	76%
13	Indiana	1852	35%
14	Tennessee	1776	33%
15	Kentucky	1566	50%
16	Georgia	1537	27%
17	Arizona	1532	17%
18	Virginia	1507	55%
19	Missouri	1367	45%
20	Wisconsin	1177	40%
21	Washington	1169	12%
22	Louisiana	1108	14%
23	Connecticut	1072	64%
24	Colorado	1015	11%
25	South Carolina	1008	40%
26	West Virginia	974	63%
27	Alabama	835	24%
28	Oklahoma	775	13%
29	Minnesota	733	25%
30	Nevada	676	10%
31	Utah	650	14%
32	Oregon	530	16%
33	New Mexico	493	15%
34	New Hampshire	467	80%
35	Arkansas	446	15%
36	Maine	424	66%
37	Mississippi	354	23%
38	Iowa	341	27%
39	Delaware	338	53%
40	Kansas	333	10%
41	Rhode Island	320	63%
42	District of Columbia	310	59%
43	Idaho	236	9%
44	Hawaii	203	3%
45	Nebraska	152	16%
46	Alaska	147	25%
47	Vermont	134	57%
48	Montana	119	5%
49	South Dakota	73	19%
50	Wyoming	69	25%
51	North Dakota	68	18%

States ranked by Opioid Overdoses

Rank	State	Opioid Overdoses	Percent Involving Fentanyl
	US	47600	75%
1	Ohio	4293	82%
2	Florida	3245	66%
3	New York	3224	69%
4	Pennsylvania	2548	78%
5	Illinois	2202	57%
6	California	2199	24%
7	Michigan	2033	67%
8	Maryland	1985	78%
9	New Jersey	1969	70%
10	North Carolina	1953	66%
11	Massachusetts	1913	86%
12	Texas	1458	24%
13	Tennessee	1269	46%
14	Virginia	1241	67%
15	Indiana	1176	55%
16	Kentucky	1160	67%
17	Georgia	1014	41%
18	Connecticut	955	72%
19	Missouri	952	65%
20	Arizona	928	29%
21	Wisconsin	926	50%
22	West Virginia	833	74%
23	South Carolina	749	54%
24	Washington	742	19%
25	Colorado	578	19%
26	Utah	456	20%
27	New Hampshire	424	88%
28	Alabama	422	47%
29	Minnesota	422	44%
30	Louisiana	415	38%
31	Nevada	412	16%
32	Oklahoma	388	26%
33	Maine	360	77%
34	Oregon	344	25%
35	New Mexico	332	23%
36	Rhode Island	277	73%
37	Delaware	250	71%
38	District of Columbia	244	75%
39	Iowa	206	45%
40	Arkansas	188	36%
41	Mississippi	185	44%
42	Kansas	144	22%
43	Vermont	114	68%
44	Idaho	103	21%
45	Alaska	102	36%
46	Nebraska	59	42%
47	Hawaii	53	13%
48	Montana	38	16%
49	North Dakota	35	34%
50	South Dakota	35	40%
51	Wyoming	47	36%

States Ranked by Total Drug Overdose Rate

Year	State	Total Drug Overdose Rate	Percent Involving Fentanyl
	US	21.5	40%
1	West Virginia	53.6	63%
2	District of Columbia	44.7	59%
3	Ohio	43.8	69%
4	Pennsylvania	42.1	37%
5	Maryland	37.1	69%
6	Kentucky	35.2	50%
7	Delaware	35.1	53%
8	New Hampshire	34.8	80%
9	Maine	31.7	66%
10	Massachusetts	31.6	76%
11	Rhode Island	30.2	63%
12	Connecticut	29.9	64%
13	New Jersey	29.8	51%
14	Indiana	27.8	35%
15	Michigan	27.0	51%
16	Tennessee	26.4	33%
17	Florida	24.2	42%
18	Louisiana	23.7	14%
19	New Mexico	23.6	15%
20	North Carolina	23.5	53%
21	Nevada	22.5	10%
22	Missouri	22.4	45%
23	Arizona	21.8	17%
24	Illinois	21.7	45%
25	Vermont	21.5	57%
26	Utah	21.0	14%
27	Wisconsin	20.3	40%
28	South Carolina	20.1	40%
29	Alaska	19.9	25%
30	New York	19.8	57%
31	Oklahoma	19.7	13%
32	Colorado	18.1	11%
33	Virginia	17.8	55%
34	Alabama	17.1	24%
35	Washington	15.8	12%
36	Arkansas	14.8	15%
37	Georgia	14.7	27%
38	Hawaii	14.2	3%
39	Idaho	13.7	9%
40	Minnesota	13.1	25%
41	Oregon	12.8	16%
42	California	12.3	11%
43	Wyoming	11.9	25%
44	Mississippi	11.9	23%
45	Kansas	11.4	10%
46	Montana	11.3	5%
47	Iowa	10.8	27%
48	Texas	10.6	12%
49	North Dakota	9.0	18%
50	South Dakota	8.4	19%
51	Nebraska	7.9	16%

States Ranked by Opioid Overdose Rate

Rank	State	Opioid Overdose Rate	Percent Involving Fentanyl
	US	14.6	75%
1	West Virginia	45.9	74%
2	Ohio	36.8	82%
3	District of Columbia	35.2	75%
4	Maryland	32.8	78%
5	New Hampshire	31.6	88%
6	Massachusetts	27.9	86%
7	Maine	26.9	77%
8	Connecticut	26.6	72%
9	Rhode Island	26.1	73%
10	Kentucky	26.0	67%
11	Delaware	26.0	71%
12	New Jersey	21.9	70%
13	Michigan	20.4	67%
14	Pennsylvania	19.9	78%
15	North Carolina	19.0	66%
16	Tennessee	18.9	46%
17	Vermont	18.3	68%
18	Indiana	17.6	55%
19	Illinois	17.2	57%
20	New York	16.2	69%
21	Wisconsin	16.0	50%
22	New Mexico	15.9	23%
23	Missouri	15.6	65%
24	Florida	15.5	66%
25	South Carolina	14.9	54%
26	Utah	14.7	20%
27	Virginia	14.7	67%
28	Alaska	13.8	36%
29	Nevada	13.7	16%
30	Arizona	13.2	29%
31	Colorado	10.3	19%
32	Washington	10.0	19%
33	Oklahoma	9.9	26%
34	Georgia	9.7	41%
35	Louisiana	8.9	38%
36	Alabama	8.7	47%
37	Oregon	8.3	25%
38	Wyoming	8.1	36%
39	Minnesota	7.6	44%
40	Iowa	6.5	45%
41	Arkansas	6.3	36%
42	Mississippi	6.2	44%
43	Idaho	6.0	21%
44	California	5.6	24%
45	Texas	5.2	24%
46	Kansas	4.9	22%
47	North Dakota	4.6	34%
48	South Dakota	4.0	40%
49	Hawaii	3.7	13%
50	Montana	3.6	16%
51	Nebraska	3.1	42%

Commentary

Examining CDC’s State-by-State Data on Drug and Opioid Overdose Deaths

The Centers for Disease Control and Prevention reports there were 70,237 total drug overdose deaths and 47,600 opioid overdose deaths in 2017.

States Ranked by Total Drug Overdoses

States ranked by Opioid Overdoses

States Ranked by Total Drug Overdose Rate

States Ranked by Opioid Overdose Rate