Mental Health America outlines state-level rankings and policy recommendations across public health, health care, schools, and jails to address the overdose crisis

ALEXANDRIA, Va. — A new report from Mental Health America (MHA) highlights specific policy recommendations with the highest potential to prevent and reduce opioid deaths in the U.S., and identifies states where additional investments are most urgently needed. In advance of International Overdose Awareness Day on August 31, the report details opportunities for action across the continuum of services and supports for opioid use, including prevention, treatment, and recovery.

Encouragingly, overdose deaths in the U.S. decreased significantly in 2024, reaching the lowest annual total since 2019. Yet overdose remains a leading cause of preventable death. In 2024, there were an estimated 80,391 drug overdose deaths in the U.S., and more than 54,000 of those deaths (68%) involved an opioid. Although many states are making progress in preventing opioid overdose deaths, that progress is not uniform across the country. And while numerous research-supported solutions exist to prevent opioid use and treat opioid use disorder, states differ significantly in adopting and implementing these strategies.

“Sustained reductions in overdose deaths will require sustained investment in policies that we know can have the greatest impact,” said Schroeder Stribling, president and CEO of Mental Health America. “As states consider how to best use opioid settlement dollars, we encourage policymakers to embrace solutions that are supported by research to prevent overdoses and save lives.”

Based on an analysis of national-level data from the U.S. Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Justice, and other sources, this new report provides a comprehensive ranking of opioid overdose and response across the states. States were ranked across four systems that have the greatest potential for impact: public health,  health care, schools, and jails.

The report identified 14 states that have the highest need for strategic investment. Mississippi, Alaska, California, and Louisiana received low scores in three out of the four systems. Alabama, Arizona, Arkansas, Georgia, Idaho, Kansas, Nevada, South Carolina, Tennessee, and Texas received low scores in more than one of the four systems.

The report also summarizes actionable recommendations for preventing and reducing opioid overdose deaths across these four sectors:

  • Public health settings: Recommendations include educating communities on opioid risk, implementing widespread distribution of naloxone (a medication that reverses an opioid overdose), attending to the safety of the community by strategically evaluating need, allocating resources for opioid overdose prevention strategies, and more.
  • Health care settings: Recommendations include increasing training for health care providers, supporting widespread access to medications for opioid use disorder, identifying and investing in recovery supports for people with opioid use disorder, and more.
  • Schools: Recommendations include providing schools with guidance on substance use education, increasing access to naloxone in higher-risk spaces, equipping parents with resources to address opioid use and overdose prevention, and more.
  • Jails: Recommendations include increasing distribution of naloxone, enhancing connections to community-based treatment resources for people leaving incarceration, and more.

“The MHA report offers a critical roadmap in our collective fight against the overdose crisis. While the significant reduction in overdose deaths to their lowest since 2019 is encouraging progress, this report underscores the persistent, urgent need for targeted, evidence-based solutions,” said Joe Papa, president and CEO of Emergent BioSolutions, which provided support for the report. “This data helps illuminate the path forward with actionable insights across public health, healthcare, schools, and even correctional settings. We remain committed to collaborating with partners to ensure life-saving solutions, including over-the-counter naloxone, reach those who need them most, ultimately turning the tide on this devastating epidemic.”

To read the full report, visit: The state of opioid overdose and response in U.S. 2025.

This work was supported by Emergent BioSolutions. Mental Health America maintained full editorial control over the data analysis and authorship of the report.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. If you are interested in seeking support for drug or alcohol conditions, visit FindSupport.gov or call 800-662-HELP (4357).

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About Mental Health America

Mental Health America is the nation’s leading community-driven nonprofit dedicated to promotion of mental health, well-being, and prevention. Mental Health America’s work is driven by its commitment to promote mental health as a critical part of whole person health, including prevention services for all; early identification and intervention for those at risk; and integrated care, services and supports for those who need them. Learn more at mhanational.org.

Media contact: media@mhanational.org