Published On: Sat, May 22nd, 2021

Deadliest states for drug overdoses

Protesters Want Drug Overdose Prevention Policies Enacted

Erik McGregor/LightRocket via Getty Images

What are America’s deadliest states for drug overdoses?

The Centers for Disease Control and Prevention publishes annual data on drug-overdose death rates in every state. 

Here is a ranking of every state by overdose-related deaths for 2019, the most recent year available.

50. Nebraska


Patrick T. Fallon/AFP/Getty Images

8.7 per 100,000 residents 

There were 161 drug overdose deaths in Nebraska in 2019, 23 more than the state saw in the previous year.

49. South Dakota



10.5 deaths per 100,000 residents

Former meth user Jeremy Bucholz speaks to South Dakota students about the addictive drug. In 2018, South Dakota had the fewest drug overdoses per capita in the United States.

48. Texas


Jim Watson/AFP/Getty Images

10.8 deaths per 100,000 residents

Then-President Donald Trump speaks during a visit to the U.S. Border Patrol’s McAllen Station. Agents displayed bricks of heroin and meth wrapped in black tape.

47. North Dakota

New Town At Epicenter Of Oil Boom As Well As Social Issues

Linda Davidson/The Washington Post/Getty Images

11.4 deaths per 100,000 residents

A police officer searches a car for drugs during a routine traffic stop in New Town, North Dakota.

46. Iowa

Barry Schmidt

Nati Harnik

11.5 deaths per 100,000 residents

This recovering meth addict said he had to move more than 150 miles from his home to receive treatment.

45. Georgia

Opioid Treatment Georgia

Kevin D. Liles/AP

13.1 deaths per 100,000 residents

Paul Connell, CEO of a Rossville methadone clinic, shows one liquid dose of methadone, which is used to treat opioid addiction.

44. Arkansas

DEA Pill Arrests

Danny Johnston / AP

13.5 deaths per 100,000 residents

A man is escorted from a medical clinic in Little Rock by Drug Enforcement Administration officers. The raid was part of a year-long DEA operation involving four states.

43. Mississippi


Rogelio V. Solis/AP

13.6 deaths per 100,000 residents

In 2009, 18 people were arrested in connection with what, at the time, was considered Mississippi’s largest meth distribution ring.

42. Oregon

Homeless Crisis On The Coast

Ted S. Warren/AP

14 deaths per 100,000 residents

Business owners near this Portland park have complained to authorities about public drug use.

40 (TIE). Montana

Death and Disappearance in Indian Country

David Goldman / AP

14.1 deaths per 100,000 residents

Drug abuse has devastated many families on the Blackfeet Indian Reservation in Browning, Montana.

40 (TIE). Wyoming


Wayne Nicholls/AP

14.1 deaths per 100,000 residents

Community leaders of the Wind River Indian Reservation hang posters warning against the dangers of drugs such as meth.

39. Minnesota


Kerem Yucel/AFP/Getty Images

14.2 deaths per 100,000 residents

An aid worker left a note with suggestions for maintaining a needle exchange program in a Minneapolis homeless camp.

38. Kansas

Kansas Police Scour Rural Areas For Meth Labs

Larry W. Smith / Getty Images

14.3 deaths per 100,000 residents

A deputy sheriff holds holds two bags of methamphetamine.

37. California

Drug releated deaths are up on the West Coast

Nick Otto/The Washington Post/Getty Images

15 deaths per 100,000 residents

A drug counselor hands out the overdose-antidote naloxone and fentanyl detection packets to people in an alley in San Francisco’s Tenderloin neighborhood.

36. Idaho

Opioids State Taxes Glance

Patrick Sison/AP

15.1 deaths per 100,000 residents

In 2018, an Idaho bill proposed a tax on opiates that would be used to fund addiction treatment centers. The bill was defeated.

35. Washington

U.S. Customs And Border Patrol Monitor Canadian Border

Getty Images

15.8 deaths per 100,000 residents

A dog trains to aid the Department of Homeland Security in detecting drugs along the U.S.-Canadian border.

34. Hawaii

Politics of Pain Hawaii

Cathy Bussewitz/AP

15.9 deaths per 100,000 residents

Vials of the overdose-reversing drug naloxone and clean syringes have been distributed in Honolulu to try to reduce deaths from overdoses.

33. Alabama

Gray Death

Mike Stewart/AP

16.3 deaths per 100,000 residents

A forensic chemist studies an opioid mixture nicknamed “gray death.” 

32. Oklahoma

Cherokees Hepatitis Treatment

Justin Juozapavicius / AP

16.7 deaths per 100,000 residents

This woman is one of many Cherokee people in Oklahoma to test positive for hepatitis C as a consequence of drug use.

31. Alaska

Opioids Alaska Lawsuit

Toby Talbot/AP

17.8 deaths per 100,000 residents

In 2017, the state of Alaska sued Purdue Pharma, the maker of the opioid OxyContin. Overdose deaths increased in Alaska in 2019 compared to the year before.

30. Colorado

Heroin Colorado

David Zalubowski / AP

18 deaths per 100,000 residents

Heroin overdose deaths doubled in Colorado between 2011 and 2015. In this photo, a doctor demonstrates how to inject a dose of life-saving naloxone.

29. New York

Protesters using a banner blocking access to the building in

Erik McGregor/LightRocket/Getty Images

18.2 deaths per 100,000 residents

Here, protesters rally outside of Governor Andrew Cuomo’s office in New York City in 2019. They accused him of neglecting drug overdose numbers in the state.

28. Virginia


Salwan Georges/The Washington Post/Getty Images

18.3 deaths per 100,000 residents

An Alexandria man holds a photo of his nephew, who died in 2019 after overdosing on fentanyl.

27. Utah

Opioid Deaths Utah

Rick Bowmer/AP

18.9 deaths per 100,000 residents

Recovering addicts and families who have lost loved ones to overdoses attend a 2017 press conference on the opioid crisis in Utah.

26. Nevada

Vegas Methamphetamine Bust

Julie Jacobson/AP

20.1 deaths per 100,000 residents

This photo shows 212 pounds of meth seized in Las Vegas.

25. Wisconsin

Congress Opioids

J. Scott Applewhite/AP

21.1 deaths per 100,000 residents

Then Speaker of the House Paul Ryan holds a photo of a Wisconsin family whose son overcame addiction to prescription drugs.

24. Illinois

Rockford, Illinois Police And EMT Battle Opioid Epidemic

Scott Olson / Getty Images

21.9 deaths per 100,000 residents

An Illinois firefighter treats an overdose victim as she is transported to a hospital.

23. North Carolina

Funeral Held For Marine Corps Cpl. Robert Richards At Arlington National Cemetery

Mark Wilson/Getty Images

22.3 deaths per 100,00 residents

U.S. Marine Cpl. Robert Richards was buried at Arlington National Cemetery after he reportedly died of an accidental overdose in Jacksonville, North Carolina. 

North Carolina’s overdose death rate held steady from 2018 to 2019, decreasing by just 0.1 deaths per 100,000 residents.

22. South Carolina

Opioid Crisis Police

Christina Myers/AP

22.7 deaths per 100,000 residents

In Lexington County, deputies stopped field testing drugs in 2017 as a precautionary measure due to the dangers of handling powerful synthetic opioids like fentanyl. Now, chemists analyze the substances in a lab to determine their contents.

21. Vermont

Vermont Battles With Deadly Heroin Epidemic

Spencer Platt/Getty Images

23.8 deaths per 100,000 residents

A 23-year-old injects suboxone, an opioid that is sometimes prescribed to help recovering addicts cope with the symptoms of heroin withdrawal.

20. Michigan

Opioid Unit Michigan

David Eggert / AP

24.4 deaths per 100,000 residents

Michigan officials speak to reporters after announcing a new state opioid unit in 2017.

19. Florida

Broward County Deals With Influx Of New Synthenic Drug, Flakka

Joe Raedle / Getty Images

25.5 deaths per 100,000 residents

A Broward County sheriff’s sergeant speaks to a woman to see if she is carrying the deadly synthetic drug flakka, categorized as bath salts.

18. Indiana

Children Of Opioids

Darron Cummings / AP

26.6 deaths per 100,000 residents

An Indiana mother plays with her son while discussing her struggle with addiction.

17. Arizona

The Meadows

Getty Images

26.8 deaths per 100,000 residents

This residential drug treatment center is located in Arizona.

16. Missouri

SmallBiz Small Talk Substance Abuse

Jeff Roberson / AP

26.9 deaths per 100,000 residents

This Missouri woodworking business hires former drug users and felons to help them reintegrate into society.

15. Louisiana

Supreme Court Upholds Use of Drug-Sniffing Dogs In Traffic Stops

Mario Villafuerte / Getty Images

28.3 deaths per 100,000 residents

The Supreme Court ruled that police, like this officer in Louisiana, could legally use drug-sniffing dogs at traffic stops.

14. Rhode Island

Opioid Epidemic Art

Bob Salsberg/AP

29.5 deaths per 100,000 residents

An 11-foot, 800-pound sculpture of a burnt spoon is displayed outside a Rhode Island drugmaker’s office to protest the opioid crisis.

13. Maine

Marijuana Opioid Alternative

Robert F. Bukaty/AP

29.9 deaths per 100,000 residents

After a marked decrease in Maine’s overdose deaths from 2017 to 2018, the state’s overdose death rate again increased by 2 fatalities per 100,000 residents from 2018 to 2019.

12. New Mexico

Officer Adopts Opioid Baby

Russell Contreras/AP

30.2 deaths per 100,000 residents

Albuquerque police officer Ryan Holets holds his adopted daughter, Hope. Holets persuaded a pregnant heroin user to let him adopt her unborn child.

11. Tennessee

Women Behind Bars

David Goldman / AP

31.2 deaths per 100,000 residents

A Tennessee woman sits in a holding cell after being arrested on suspicion of drug possession.

10. New Jersey

Camden Battles Crime And Poverty In Effort To Re-Vitalize Community

Andrew Burton/Getty Images

31.7 deaths per 100,000 residents

A recovering heroin addict in Camden points to a scar from injecting drugs.

9. New Hampshire


Don Emmert / AFP/Getty Images

32 deaths per 100,000 residents

A New Hampshire firefighter helps a 35-year-old man who overdosed on heroin in 2018.

8. Massachusetts

New England Towns Struggle With Heroin Epidemic

John Moore/Getty Images

32.1 deaths per 100,000 residents

A Gloucester police officer holds bags of heroin confiscated as evidence.

7. Kentucky

Ky Drug Treatment

Timothy D. Easley/AP

32.5 deaths per 100,000 residents

A judge discusses a drug rehabilitation probation program with prisoners in Kentucky.

6. Connecticut

New England Towns Struggle With Opioid And Heroin Epidemic

John Moore / Getty Images

34.7 deaths per 100,000 residents

A heroin user injects himself in New London in 2016.

5. Pennsylvania

Philadelphia Begins Clean Up Of Drug Infested Encampment In Kensington Area

Spencer Platt/Getty Images

35.6 deaths per 100,000 residents

A man holds and injection of heroin by a railway underpass in Philadelphia. Pennsylvania’s overdose death rate decreased slightly from 2018 to 2019.

4. Maryland

U.S. Surgeon General Vivek Murthy Addresses Opioid Epidemic At Baltimore Health Clinic

Alex Wong / Getty Images

38.2 deaths per 100,000 residents

This photo was taken after a 2016 news conference on the opioid crisis in Baltimore.

3. Ohio

Ohio Rust Belt Struggles With Opioid Addiction And Poverty

Spencer Platt/Getty Images

38.3 deaths per 100,000 residents

Medical workers and police treat a woman who has overdosed on heroin. Ohio’s overdose death rate fell by 12.4 fatalities per 100,000 residents from 2017 to 2019.

2. Delaware

Heroin Arrest


48 deaths per 100,000 residents

This photo, provided by Delaware State Police, shows 15,000 packets heroin found during a traffic stop in Delaware. 

In this state, the overdose death rate increased by 11 fatalities per 100,000 residents from 2017 to 2019.

1. West Virginia


Brendan Smialowski/AFP/Getty Images

52.8 deaths per 100,000 residents

Two West Virginia men wait outside while police search an abandoned house used by addicts. 

West Virginia’s overdose death rate fell, from 2017 to 2018, but increased again from 2018 to 2019. The state still remains the deadliest in the nation for drug overdoses per capita.

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