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

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
RankStateTotal Drug OverdosesPercent Involving Fentanyl
US7023740%
1Pennsylvania538837%
2Ohio511169%
3Florida508842%
4California486811%
5New York392157%
6Texas298912%
7Illinois277845%
8Michigan269451%
9New Jersey268551%
10North Carolina241453%
11Maryland224769%
12Massachusetts216876%
13Indiana185235%
14Tennessee177633%
15Kentucky156650%
16Georgia153727%
17Arizona153217%
18Virginia150755%
19Missouri136745%
20Wisconsin117740%
21Washington116912%
22Louisiana110814%
23Connecticut107264%
24Colorado101511%
25South Carolina100840%
26West Virginia97463%
27Alabama83524%
28Oklahoma77513%
29Minnesota73325%
30Nevada67610%
31Utah65014%
32Oregon53016%
33New Mexico49315%
34New Hampshire46780%
35Arkansas44615%
36Maine42466%
37Mississippi35423%
38Iowa34127%
39Delaware33853%
40Kansas33310%
41Rhode Island32063%
42District of Columbia31059%
43Idaho2369%
44Hawaii2033%
45Nebraska15216%
46Alaska14725%
47Vermont13457%
48Montana1195%
49South Dakota7319%
50Wyoming6925%
51North Dakota6818%
States ranked by Opioid Overdoses
RankStateOpioid OverdosesPercent Involving Fentanyl
US4760075%
1Ohio429382%
2Florida324566%
3New York322469%
4Pennsylvania254878%
5Illinois220257%
6California219924%
7Michigan203367%
8Maryland198578%
9New Jersey196970%
10North Carolina195366%
11Massachusetts191386%
12Texas145824%
13Tennessee126946%
14Virginia124167%
15Indiana117655%
16Kentucky116067%
17Georgia101441%
18Connecticut95572%
19Missouri95265%
20Arizona92829%
21Wisconsin92650%
22West Virginia83374%
23South Carolina74954%
24Washington74219%
25Colorado57819%
26Utah45620%
27New Hampshire42488%
28Alabama42247%
29Minnesota42244%
30Louisiana41538%
31Nevada41216%
32Oklahoma38826%
33Maine36077%
34Oregon34425%
35New Mexico33223%
36Rhode Island27773%
37Delaware25071%
38District of Columbia24475%
39Iowa20645%
40Arkansas18836%
41Mississippi18544%
42Kansas14422%
43Vermont11468%
44Idaho10321%
45Alaska10236%
46Nebraska5942%
47Hawaii5313%
48Montana3816%
49North Dakota3534%
50South Dakota3540%
51Wyoming4736%
States Ranked by Total Drug Overdose Rate
YearStateTotal Drug Overdose RatePercent Involving Fentanyl
US21.540%
1West Virginia53.663%
2District of Columbia44.759%
3Ohio43.869%
4Pennsylvania42.137%
5Maryland37.169%
6Kentucky35.250%
7Delaware35.153%
8New Hampshire34.880%
9Maine31.766%
10Massachusetts31.676%
11Rhode Island30.263%
12Connecticut29.964%
13New Jersey29.851%
14Indiana27.835%
15Michigan27.051%
16Tennessee26.433%
17Florida24.242%
18Louisiana23.714%
19New Mexico23.615%
20North Carolina23.553%
21Nevada22.510%
22Missouri22.445%
23Arizona21.817%
24Illinois21.745%
25Vermont21.557%
26Utah21.014%
27Wisconsin20.340%
28South Carolina20.140%
29Alaska19.925%
30New York19.857%
31Oklahoma19.713%
32Colorado18.111%
33Virginia17.855%
34Alabama17.124%
35Washington15.812%
36Arkansas14.815%
37Georgia14.727%
38Hawaii14.23%
39Idaho13.79%
40Minnesota13.125%
41Oregon12.816%
42California12.311%
43Wyoming11.925%
44Mississippi11.923%
45Kansas11.410%
46Montana11.35%
47Iowa10.827%
48Texas10.612%
49North Dakota9.018%
50South Dakota8.419%
51Nebraska7.916%
States Ranked by Opioid Overdose Rate
RankStateOpioid Overdose RatePercent Involving Fentanyl
US14.675%
1West Virginia45.974%
2Ohio36.882%
3District of Columbia35.275%
4Maryland32.878%
5New Hampshire31.688%
6Massachusetts27.986%
7Maine26.977%
8Connecticut26.672%
9Rhode Island26.173%
10Kentucky26.067%
11Delaware26.071%
12New Jersey21.970%
13Michigan20.467%
14Pennsylvania19.978%
15North Carolina19.066%
16Tennessee18.946%
17Vermont18.368%
18Indiana17.655%
19Illinois17.257%
20New York16.269%
21Wisconsin16.050%
22New Mexico15.923%
23Missouri15.665%
24Florida15.566%
25South Carolina14.954%
26Utah14.720%
27Virginia14.767%
28Alaska13.836%
29Nevada13.716%
30Arizona13.229%
31Colorado10.319%
32Washington10.019%
33Oklahoma9.926%
34Georgia9.741%
35Louisiana8.938%
36Alabama8.747%
37Oregon8.325%
38Wyoming8.136%
39Minnesota7.644%
40Iowa6.545%
41Arkansas6.336%
42Mississippi6.244%
43Idaho6.021%
44California5.624%
45Texas5.224%
46Kansas4.922%
47North Dakota4.634%
48South Dakota4.040%
49Hawaii3.713%
50Montana3.616%
51Nebraska3.142%

Jacob James Rich is a policy analyst at Reason Foundation.