Opioid overdose data and rankings

Provisional number of overdoses from all opioids per 100,000 people

In 2024, over 54,000 people died of an opioid overdose, a significant decrease from overdose rates in 2023. According to the CDC, 30,000 fewer people died from an opioid overdose in 2024 compared to 2023.¹

States in the western half of the U.S. experienced smaller decreases in opioid overdose deaths than those in the eastern half of the country. West Virginia, Arkansas, and Wisconsin had the greatest decreases in opioid overdose deaths (greater than 45%). These reductions in opioid deaths demonstrate the impact of increased investment and the continued need for surveillance data for tailored community response.

1. The Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). U.S. Overdose Deaths Decrease Almost 27% in 2024. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2025/20250514.htm

State naloxone dispensing rate per 100 individuals in the state population

Naloxone is a safe, non-addictive opioid overdose reversal agent that has been shown to reduce fatal drug overdoses. According to the “U.S. Surgeon General’s Advisory on Naloxone and Opioid Overdose,” when communities make naloxone and overdose education available to residents, their rate of overdose deaths decreases.²

Currently, there are very few data sources on naloxone distribution outside of individual programs, due to a lack of infrastructure for standardized data collection across programs and providers distributing naloxone. One indicator that can be used to better understand how naloxone is getting into communities is the rate of naloxone prescriptions dispensed through retail pharmacies.

Nationally, the naloxone dispensing rate has increased every year since 2019, but there are wide disparities across states. In 2023, Texas, South Dakota, New Hampshire, Minnesota, Iowa, and Georgia had the lowest naloxone dispensing rates, at only 0.3 per 100 people in the population.

2. U.S. Department of Health and Human Services, Office of the Surgeon General. (2022). U.S. Surgeon General’s Advisory on Naloxone and Opioid Overdose. https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-naloxone/index.html#ftn2

Number of pharmacies per 1,000 people in the state population

In 2023, the Food and Drug Administration (FDA) approved Narcan, a naloxone product, for purchase over the counter (OTC) nationwide. Narcan is now available at most retail pharmacies, including CVS and Walgreens. However, if communities do not have access to a pharmacy, they will have less access to both prescription and OTC naloxone.

Most of the states with the lowest number of retail pharmacies per 1,000 people were located in the Western U.S. This is just reflective of state-level disparities, but these pharmacy deserts are even more pronounced at the county and ZIP code levels.

States with limited pharmacy access should invest in a no-wrong-door approach to naloxone distribution within communities, so that lifesaving supports are available to everyone within minutes of where someone may overdose. This includes increased distribution to law enforcement, crisis teams and community service providers, peer support specialists, as well as in schools and other public spaces where people may overdose.

Percentage of adults who report they do not have a personal doctor or health care provider

Most of the states with the least access to health care providers are in the Southwest U.S. In Nevada, Wyoming, New Mexico and Texas, more than 1 in 4 people report that they do not have a person or group of providers that they think of as their personal health care provider.

Access to health care is critical to ending the opioid overdose crisis. Health care providers can provide patients with substance use education, detect opioid or other substance use challenges early through screening, and connect patients with treatment and support for substance use if they screen at-risk. When people have access to a consistent personal doctor or health care provider, they can establish a more open and trusting patient-provider relationship. That relationship can enhance opportunities for patients to disclose opioid use.

At minimum, states where access to health care providers is limited should invest additional resources into public health departments to train community health workers and mobile teams to fill those gaps in care. In the short term, community health workers can conduct outreach to communities with limited access to health care and provide individuals at risk of overdose with harm reduction resources and supports.

Percentage of youth reporting they have seen or heard alcohol or drug prevention messages from a source outside of school

Nationally, only 63% of youth report that they have seen or heard alcohol or drug prevention messages from a source outside of school. In Wyoming and South Carolina, the lowest-ranked states, only about half of youth have received prevention messaging in their communities.

One of the key roles of public health is to broadly educate the community about how to stay healthy. Youth are less likely to use substances in communities that are permeated with actionable information, norms against substance use, and anti-stigma messaging. States should dedicate additional funding through state and local grants to equip public health departments with the resources they need to create or sustain prevention-focused community programs in the absence of federal funding.