More than 93,000 people died of drug overdoses in the U.S. in 2020, a nearly 30% surge from 2019 and the most ever recorded in a single year, according to recently released data by the Centers for Disease Control and Prevention. In 2019, for the first time, accidental drug overdoses killed more Americans than fatal car crashes, which has historically been the leading cause of death among people between 1 and 54 years of age.
Addiction experts say the increase in overdose deaths was largely driven by the increased presence of the powerful synthetic opioid fentanyl in the U.S. Other contributors include problems related to the coronavirus pandemic, such increased isolation and job losses.
To determine the states with the highest drug overdose fatality rates, 24/7 Tempo reviewed the recently released CDC preliminary estimates of drug overdose deaths. The states are ranked based on the number of drug-related deaths per 100,000 residents.
The number of opioid overdose-related fatalities in the country was on the rise in almost every state each year between 2015 and 2017. Then, overdose deaths decreased in 32 states in 2018, dropping by 4.0% nationwide.
The rate of opioid deaths the following year did not change significantly in the vast majority of states. Just four states in 2019 reported a decline in deaths of more than 10% compared to 2018. Nationwide the number of fatal drug overdoses increased by 4.8% in 2019.
The CDC’s preliminary data shows the U.S. opioid crisis has worsened in 2020 beyond even the 2018 peak. Last year, all but two states — South Dakota and New Hampshire — reported an increase in the number of drug overdose-related deaths. And the decrease in New Hampshire was only 0.5%.
In 2020, 13 states went from a decrease in drug overdose deaths the previous year to an increase. The increase in 10 of those 13 states in the number of drug overdose deaths was significant, one even going from a decrease of 18.1% in 2019 to an increase of 57.6% in 2020.
The District of Columbia is not included in the following list. Had it been included, however, it would have been nearly at the top. D.C. had the second most drug overdose deaths per capita in 2020. It also had the second most fatal drug overdoses per capita on average every year between 2015 and 2019.
The drug epidemic has worsened nationally in the past two decades. Locally, however, some places have seen a decline in overdose deaths while others a significant increase. There are counties in almost every state where the problem is worse than both states and national averages. These are the counties with the worst drug problem in every state.
Click here to see states with the most drug overdose deaths in 2020
To determine the states with the highest drug overdose fatality rates, 24/7 Tempo reviewed the recently released Centers for Disease Control and Prevention preliminary estimates of drug overdose deaths from December 2019 to December 2020. The states are ranked based on the number of drug-related deaths per 100,000 residents.
Data on overdose deaths in all U.S. states for every year between 2015 and 2020 also came from the CDC. Drug overdose deaths in New York state do not include drug overdose deaths for New York City.
Population data comes from the U.S. Census Bureau’s 2019 American Community Survey.
50. South Dakota
> 2020 overdose fatality: 8 deaths for every 100,000 people (total: 74)
> 2019 overdose fatality: 10 deaths for every 100,000 people (total: 88)
> 2015 overdose fatality: 7 deaths for every 100,000 people (total: 62)
> Average deaths a year, 2015-2019: 8 per 10,000 people — 2nd fewest (total average overdose deaths: 70 a year)
> Pct. change in overdose deaths, 2019-2020: -15.9% — the largest decrease
> Pct. change in overdose deaths, 2015-2020: 19.4% — 3th smallest increase
> Population: 884,659
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49. Nebraska
> 2020 overdose fatality: 11 deaths for every 100,000 people (total: 209)
> 2019 overdose fatality: 8 deaths for every 100,000 people (total: 146)
> 2015 overdose fatality: 6 deaths for every 100,000 people (total: 123)
> Average deaths a year, 2015-2019: 7 per 10,000 people — the fewest (total average overdose deaths: 136 a year)
> Pct. change in overdose deaths, 2019-2020: 43.2% — 8th largest increase
> Pct. change in overdose deaths, 2015-2020: 69.9% — 23rd largest increase
> Population: 1,934,408
48. Iowa
> 2020 overdose fatality: 13 deaths for every 100,000 people (total: 419)
> 2019 overdose fatality: 11 deaths for every 100,000 people (total: 350)
> 2015 overdose fatality: 10 deaths for every 100,000 people (total: 300)
> Average deaths a year, 2015-2019: 10 per 10,000 people — 5th fewest (total average overdose deaths: 316 a year)
> Pct. change in overdose deaths, 2019-2020: 19.7% — 13th smallest increase
> Pct. change in overdose deaths, 2015-2020: 39.7% — 13th smallest increase
> Population: 3,155,070
47. Texas
> 2020 overdose fatality: 14 deaths for every 100,000 people (total: 4,153)
> 2019 overdose fatality: 11 deaths for every 100,000 people (total: 3,123)
> 2015 overdose fatality: 9 deaths for every 100,000 people (total: 2,579)
> Average deaths a year, 2015-2019: 10 per 10,000 people — 3rd fewest (total average overdose deaths: 2,887 a year)
> Pct. change in overdose deaths, 2019-2020: 33.0% — 25th largest increase
> Pct. change in overdose deaths, 2015-2020: 61.0% — 24th smallest increase
> Population: 28,995,881
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46. Montana
> 2020 overdose fatality: 15 deaths for every 100,000 people (total: 157)
> 2019 overdose fatality: 13 deaths for every 100,000 people (total: 139)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 131)
> Average deaths a year, 2015-2019: 12 per 10,000 people — 8th fewest (total average overdose deaths: 124 a year)
> Pct. change in overdose deaths, 2019-2020: 12.9% — 9th smallest increase
> Pct. change in overdose deaths, 2015-2020: 19.8% — 4th smallest increase
> Population: 1,068,778
45. Idaho
> 2020 overdose fatality: 16 deaths for every 100,000 people (total: 280)
> 2019 overdose fatality: 15 deaths for every 100,000 people (total: 264)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 214)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 13th fewest (total average overdose deaths: 237 a year)
> Pct. change in overdose deaths, 2019-2020: 6.1% — 3th smallest increase
> Pct. change in overdose deaths, 2015-2020: 30.8% — 7th smallest increase
> Population: 1,787,065
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44. Kansas
> 2020 overdose fatality: 16 deaths for every 100,000 people (total: 468)
> 2019 overdose fatality: 13 deaths for every 100,000 people (total: 380)
> 2015 overdose fatality: 11 deaths for every 100,000 people (total: 323)
> Average deaths a year, 2015-2019: 12 per 10,000 people — 7th fewest (total average overdose deaths: 336 a year)
> Pct. change in overdose deaths, 2019-2020: 23.2% — 17th smallest increase
> Pct. change in overdose deaths, 2015-2020: 44.9% — 15th smallest increase
> Population: 2,913,314
43. North Dakota
> 2020 overdose fatality: 16 deaths for every 100,000 people (total: 123)
> 2019 overdose fatality: 12 deaths for every 100,000 people (total: 90)
> 2015 overdose fatality: 9 deaths for every 100,000 people (total: 66)
> Average deaths a year, 2015-2019: 10 per 10,000 people — 4th fewest (total average overdose deaths: 76 a year)
> Pct. change in overdose deaths, 2019-2020: 36.7% — 17th largest increase
> Pct. change in overdose deaths, 2015-2020: 86.4% — 14th largest increase
> Population: 762,062
42. Arkansas
> 2020 overdose fatality: 17 deaths for every 100,000 people (total: 515)
> 2019 overdose fatality: 12 deaths for every 100,000 people (total: 362)
> 2015 overdose fatality: 13 deaths for every 100,000 people (total: 381)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 12th fewest (total average overdose deaths: 397 a year)
> Pct. change in overdose deaths, 2019-2020: 42.3% — 9th largest increase
> Pct. change in overdose deaths, 2015-2020: 35.2% — 9th smallest increase
> Population: 3,017,804
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41. Mississippi
> 2020 overdose fatality: 17 deaths for every 100,000 people (total: 510)
> 2019 overdose fatality: 12 deaths for every 100,000 people (total: 365)
> 2015 overdose fatality: 11 deaths for every 100,000 people (total: 333)
> Average deaths a year, 2015-2019: 11 per 10,000 people — 6th fewest (total average overdose deaths: 330 a year)
> Pct. change in overdose deaths, 2019-2020: 39.7% — 12th largest increase
> Pct. change in overdose deaths, 2015-2020: 53.2% — 16th smallest increase
> Population: 2,976,149
40. Georgia
> 2020 overdose fatality: 17 deaths for every 100,000 people (total: 1,848)
> 2019 overdose fatality: 13 deaths for every 100,000 people (total: 1,378)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 1,308)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 11th fewest (total average overdose deaths: 1,389 a year)
> Pct. change in overdose deaths, 2019-2020: 34.1% — 21st largest increase
> Pct. change in overdose deaths, 2015-2020: 41.3% — 14th smallest increase
> Population: 10,617,423
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39. Wyoming
> 2020 overdose fatality: 17 deaths for every 100,000 people (total: 101)
> 2019 overdose fatality: 12 deaths for every 100,000 people (total: 72)
> 2015 overdose fatality: 16 deaths for every 100,000 people (total: 92)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 14th fewest (total average overdose deaths: 77 a year)
> Pct. change in overdose deaths, 2019-2020: 40.3% — 11th largest increase
> Pct. change in overdose deaths, 2015-2020: 9.8% — 2nd smallest increase
> Population: 578,759
38. Oklahoma
> 2020 overdose fatality: 19 deaths for every 100,000 people (total: 746)
> 2019 overdose fatality: 16 deaths for every 100,000 people (total: 618)
> 2015 overdose fatality: 18 deaths for every 100,000 people (total: 722)
> Average deaths a year, 2015-2019: 18 per 10,000 people — 23rd fewest (total average overdose deaths: 723 a year)
> Pct. change in overdose deaths, 2019-2020: 20.7% — 15th smallest increase
> Pct. change in overdose deaths, 2015-2020: 3.3% — the smallest increase
> Population: 3,956,971
37. Minnesota
> 2020 overdose fatality: 19 deaths for every 100,000 people (total: 1,066)
> 2019 overdose fatality: 14 deaths for every 100,000 people (total: 788)
> 2015 overdose fatality: 10 deaths for every 100,000 people (total: 592)
> Average deaths a year, 2015-2019: 12 per 10,000 people — 9th fewest (total average overdose deaths: 682 a year)
> Pct. change in overdose deaths, 2019-2020: 35.3% — 19th largest increase
> Pct. change in overdose deaths, 2015-2020: 80.1% — 19th largest increase
> Population: 5,639,632
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36. Oregon
> 2020 overdose fatality: 19 deaths for every 100,000 people (total: 798)
> 2019 overdose fatality: 14 deaths for every 100,000 people (total: 610)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 497)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 10th fewest (total average overdose deaths: 539 a year)
> Pct. change in overdose deaths, 2019-2020: 30.8% — 24th smallest increase
> Pct. change in overdose deaths, 2015-2020: 60.6% — 23rd smallest increase
> Population: 4,217,737
35. Hawaii
> 2020 overdose fatality: 19 deaths for every 100,000 people (total: 274)
> 2019 overdose fatality: 17 deaths for every 100,000 people (total: 245)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 171)
> Average deaths a year, 2015-2019: 15 per 10,000 people — 16th fewest (total average overdose deaths: 206 a year)
> Pct. change in overdose deaths, 2019-2020: 11.8% — 7th smallest increase
> Pct. change in overdose deaths, 2015-2020: 60.2% — 22nd smallest increase
> Population: 1,415,872
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34. Utah
> 2020 overdose fatality: 19 deaths for every 100,000 people (total: 622)
> 2019 overdose fatality: 18 deaths for every 100,000 people (total: 575)
> 2015 overdose fatality: 20 deaths for every 100,000 people (total: 649)
> Average deaths a year, 2015-2019: 20 per 10,000 people — 25th most (total average overdose deaths: 630 a year)
> Pct. change in overdose deaths, 2019-2020: 8.2% — 5th smallest increase
> Pct. change in overdose deaths, 2015-2020: -4.2% — the smallest decrease
> Population: 3,205,958
33. Alaska
> 2020 overdose fatality: 20 deaths for every 100,000 people (total: 146)
> 2019 overdose fatality: 18 deaths for every 100,000 people (total: 133)
> 2015 overdose fatality: 17 deaths for every 100,000 people (total: 121)
> Average deaths a year, 2015-2019: 17 per 10,000 people — 20th fewest (total average overdose deaths: 126 a year)
> Pct. change in overdose deaths, 2019-2020: 9.8% — 6th smallest increase
> Pct. change in overdose deaths, 2015-2020: 20.7% — 5th smallest increase
> Population: 731,545
32. Alabama
> 2020 overdose fatality: 20 deaths for every 100,000 people (total: 989)
> 2019 overdose fatality: 15 deaths for every 100,000 people (total: 739)
> 2015 overdose fatality: 15 deaths for every 100,000 people (total: 720)
> Average deaths a year, 2015-2019: 15 per 10,000 people — 18th fewest (total average overdose deaths: 749 a year)
> Pct. change in overdose deaths, 2019-2020: 33.8% — 22nd largest increase
> Pct. change in overdose deaths, 2015-2020: 37.4% — 10th smallest increase
> Population: 4,903,185
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31. Washington
> 2020 overdose fatality: 23 deaths for every 100,000 people (total: 1,724)
> 2019 overdose fatality: 16 deaths for every 100,000 people (total: 1,251)
> 2015 overdose fatality: 15 deaths for every 100,000 people (total: 1,109)
> Average deaths a year, 2015-2019: 15 per 10,000 people — 17th fewest (total average overdose deaths: 1,162 a year)
> Pct. change in overdose deaths, 2019-2020: 37.8% — 13th largest increase
> Pct. change in overdose deaths, 2015-2020: 55.5% — 17th smallest increase
> Population: 7,614,893
30. California
> 2020 overdose fatality: 23 deaths for every 100,000 people (total: 9,142)
> 2019 overdose fatality: 16 deaths for every 100,000 people (total: 6,363)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 4,762)
> Average deaths a year, 2015-2019: 13 per 10,000 people — 15th fewest (total average overdose deaths: 5,280 a year)
> Pct. change in overdose deaths, 2019-2020: 43.7% — 7th largest increase
> Pct. change in overdose deaths, 2015-2020: 92.0% — 11th largest increase
> Population: 39,512,223
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29. New York (Data for NYC is not included)
> 2020 overdose fatality: 26 deaths for every 100,000 people (total: 4,979)
> 2019 overdose fatality: 19 deaths for every 100,000 people (total: 3,634)
> 2015 overdose fatality: 14 deaths for every 100,000 people (total: 2,761)
> Average deaths a year, 2015-2019: 18 per 10,000 people — 22nd fewest (total average overdose deaths: 3,544 a year)
> Pct. change in overdose deaths, 2019-2020: 37.0% — 15th largest increase
> Pct. change in overdose deaths, 2015-2020: 80.3% — 18th largest increase
> Population: 19,453,561
28. Virginia
> 2020 overdose fatality: 26 deaths for every 100,000 people (total: 2,186)
> 2019 overdose fatality: 18 deaths for every 100,000 people (total: 1,538)
> 2015 overdose fatality: 12 deaths for every 100,000 people (total: 1,002)
> Average deaths a year, 2015-2019: 16 per 10,000 people — 19th fewest (total average overdose deaths: 1,357 a year)
> Pct. change in overdose deaths, 2019-2020: 42.1% — 10th largest increase
> Pct. change in overdose deaths, 2015-2020: 118.2% — 5th largest increase
> Population: 8,535,519
27. Colorado
> 2020 overdose fatality: 26 deaths for every 100,000 people (total: 1,512)
> 2019 overdose fatality: 19 deaths for every 100,000 people (total: 1,100)
> 2015 overdose fatality: 16 deaths for every 100,000 people (total: 913)
> Average deaths a year, 2015-2019: 17 per 10,000 people — 21st fewest (total average overdose deaths: 1,004 a year)
> Pct. change in overdose deaths, 2019-2020: 37.5% — 14th largest increase
> Pct. change in overdose deaths, 2015-2020: 65.6% — 25th largest increase
> Population: 5,758,736
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26. Wisconsin
> 2020 overdose fatality: 26 deaths for every 100,000 people (total: 1,530)
> 2019 overdose fatality: 21 deaths for every 100,000 people (total: 1,200)
> 2015 overdose fatality: 15 deaths for every 100,000 people (total: 873)
> Average deaths a year, 2015-2019: 19 per 10,000 people — 24th fewest (total average overdose deaths: 1,083 a year)
> Pct. change in overdose deaths, 2019-2020: 27.5% — 21st smallest increase
> Pct. change in overdose deaths, 2015-2020: 75.3% — 21st largest increase
> Population: 5,822,434
25. Michigan
> 2020 overdose fatality: 27 deaths for every 100,000 people (total: 2,743)
> 2019 overdose fatality: 24 deaths for every 100,000 people (total: 2,358)
> 2015 overdose fatality: 20 deaths for every 100,000 people (total: 1,973)
> Average deaths a year, 2015-2019: 24 per 10,000 people — 15th most (total average overdose deaths: 2,383 a year)
> Pct. change in overdose deaths, 2019-2020: 16.3% — 10th smallest increase
> Pct. change in overdose deaths, 2015-2020: 39.0% — 12th smallest increase
> Population: 9,986,857
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24. Illinois
> 2020 overdose fatality: 28 deaths for every 100,000 people (total: 3,528)
> 2019 overdose fatality: 22 deaths for every 100,000 people (total: 2,775)
> 2015 overdose fatality: 15 deaths for every 100,000 people (total: 1,864)
> Average deaths a year, 2015-2019: 20 per 10,000 people — 23rd most (total average overdose deaths: 2,513 a year)
> Pct. change in overdose deaths, 2019-2020: 27.1% — 20th smallest increase
> Pct. change in overdose deaths, 2015-2020: 89.3% — 12th largest increase
> Population: 12,671,821
23. North Carolina
> 2020 overdose fatality: 29 deaths for every 100,000 people (total: 3,011)
> 2019 overdose fatality: 21 deaths for every 100,000 people (total: 2,236)
> 2015 overdose fatality: 15 deaths for every 100,000 people (total: 1,537)
> Average deaths a year, 2015-2019: 20 per 10,000 people — 24th most (total average overdose deaths: 2,064 a year)
> Pct. change in overdose deaths, 2019-2020: 34.7% — 20th largest increase
> Pct. change in overdose deaths, 2015-2020: 95.9% — 10th largest increase
> Population: 10,488,084
22. New Hampshire
> 2020 overdose fatality: 29 deaths for every 100,000 people (total: 393)
> 2019 overdose fatality: 29 deaths for every 100,000 people (total: 395)
> 2015 overdose fatality: 31 deaths for every 100,000 people (total: 415)
> Average deaths a year, 2015-2019: 32 per 10,000 people — 6th most (total average overdose deaths: 438 a year)
> Pct. change in overdose deaths, 2019-2020: -0.5% — the smallest decrease
> Pct. change in overdose deaths, 2015-2020: -5.3% — the largest decrease
> Population: 1,359,711
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21. Nevada
> 2020 overdose fatality: 30 deaths for every 100,000 people (total: 914)
> 2019 overdose fatality: 23 deaths for every 100,000 people (total: 710)
> 2015 overdose fatality: 22 deaths for every 100,000 people (total: 665)
> Average deaths a year, 2015-2019: 23 per 10,000 people — 18th most (total average overdose deaths: 716 a year)
> Pct. change in overdose deaths, 2019-2020: 28.7% — 22nd smallest increase
> Pct. change in overdose deaths, 2015-2020: 37.4% — 11th smallest increase
> Population: 3,080,156
20. Vermont
> 2020 overdose fatality: 30 deaths for every 100,000 people (total: 186)
> 2019 overdose fatality: 19 deaths for every 100,000 people (total: 118)
> 2015 overdose fatality: 16 deaths for every 100,000 people (total: 99)
> Average deaths a year, 2015-2019: 20 per 10,000 people — 22nd most (total average overdose deaths: 125 a year)
> Pct. change in overdose deaths, 2019-2020: 57.6% — the largest increase
> Pct. change in overdose deaths, 2015-2020: 87.9% — 13th largest increase
> Population: 623,989
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19. Missouri
> 2020 overdose fatality: 31 deaths for every 100,000 people (total: 1,921)
> 2019 overdose fatality: 26 deaths for every 100,000 people (total: 1,603)
> 2015 overdose fatality: 18 deaths for every 100,000 people (total: 1,087)
> Average deaths a year, 2015-2019: 23 per 10,000 people — 19th most (total average overdose deaths: 1,422 a year)
> Pct. change in overdose deaths, 2019-2020: 19.8% — 14th smallest increase
> Pct. change in overdose deaths, 2015-2020: 76.7% — 20th largest increase
> Population: 6,137,428
24/7 Wall St.
18. New Jersey
> 2020 overdose fatality: 32 deaths for every 100,000 people (total: 2,815)
> 2019 overdose fatality: 31 deaths for every 100,000 people (total: 2,774)
> 2015 overdose fatality: 16 deaths for every 100,000 people (total: 1,423)
> Average deaths a year, 2015-2019: 26 per 10,000 people — 11th most (total average overdose deaths: 2,329 a year)
> Pct. change in overdose deaths, 2019-2020: 1.5% — the smallest increase
> Pct. change in overdose deaths, 2015-2020: 97.8% — 9th largest increase
> Population: 8,882,190
17. Massachusetts
> 2020 overdose fatality: 33 deaths for every 100,000 people (total: 2,293)
> 2019 overdose fatality: 32 deaths for every 100,000 people (total: 2,215)
> 2015 overdose fatality: 25 deaths for every 100,000 people (total: 1,723)
> Average deaths a year, 2015-2019: 31 per 10,000 people — 9th most (total average overdose deaths: 2,102 a year)
> Pct. change in overdose deaths, 2019-2020: 3.5% — 2nd smallest increase
> Pct. change in overdose deaths, 2015-2020: 33.1% — 8th smallest increase
> Population: 6,892,503
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16. South Carolina
> 2020 overdose fatality: 34 deaths for every 100,000 people (total: 1,728)
> 2019 overdose fatality: 22 deaths for every 100,000 people (total: 1,131)
> 2015 overdose fatality: 14 deaths for every 100,000 people (total: 736)
> Average deaths a year, 2015-2019: 19 per 10,000 people — 25th fewest (total average overdose deaths: 969 a year)
> Pct. change in overdose deaths, 2019-2020: 52.8% — 4th largest increase
> Pct. change in overdose deaths, 2015-2020: 134.8% — the largest increase
> Population: 5,148,714
15. Indiana
> 2020 overdose fatality: 34 deaths for every 100,000 people (total: 2,268)
> 2019 overdose fatality: 25 deaths for every 100,000 people (total: 1,704)
> 2015 overdose fatality: 18 deaths for every 100,000 people (total: 1,232)
> Average deaths a year, 2015-2019: 23 per 10,000 people — 17th most (total average overdose deaths: 1,578 a year)
> Pct. change in overdose deaths, 2019-2020: 33.1% — 24th largest increase
> Pct. change in overdose deaths, 2015-2020: 84.1% — 15th largest increase
> Population: 6,732,219
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14. Florida
> 2020 overdose fatality: 35 deaths for every 100,000 people (total: 7,555)
> 2019 overdose fatality: 26 deaths for every 100,000 people (total: 5,524)
> 2015 overdose fatality: 16 deaths for every 100,000 people (total: 3,352)
> Average deaths a year, 2015-2019: 23 per 10,000 people — 20th most (total average overdose deaths: 4,850 a year)
> Pct. change in overdose deaths, 2019-2020: 36.8% — 16th largest increase
> Pct. change in overdose deaths, 2015-2020: 125.4% — 3rd largest increase
> Population: 21,477,737
13. Arizona
> 2020 overdose fatality: 36 deaths for every 100,000 people (total: 2,644)
> 2019 overdose fatality: 27 deaths for every 100,000 people (total: 1,981)
> 2015 overdose fatality: 17 deaths for every 100,000 people (total: 1,267)
> Average deaths a year, 2015-2019: 22 per 10,000 people — 21st most (total average overdose deaths: 1,585 a year)
> Pct. change in overdose deaths, 2019-2020: 33.5% — 23rd largest increase
> Pct. change in overdose deaths, 2015-2020: 108.7% — 8th largest increase
> Population: 7,278,717
12. Maine
> 2020 overdose fatality: 36 deaths for every 100,000 people (total: 490)
> 2019 overdose fatality: 27 deaths for every 100,000 people (total: 362)
> 2015 overdose fatality: 20 deaths for every 100,000 people (total: 267)
> Average deaths a year, 2015-2019: 26 per 10,000 people — 13th most (total average overdose deaths: 347 a year)
> Pct. change in overdose deaths, 2019-2020: 35.4% — 18th largest increase
> Pct. change in overdose deaths, 2015-2020: 83.5% — 16th largest increase
> Population: 1,344,212
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11. Rhode Island
> 2020 overdose fatality: 37 deaths for every 100,000 people (total: 396)
> 2019 overdose fatality: 30 deaths for every 100,000 people (total: 317)
> 2015 overdose fatality: 30 deaths for every 100,000 people (total: 319)
> Average deaths a year, 2015-2019: 31 per 10,000 people — 8th most (total average overdose deaths: 329 a year)
> Pct. change in overdose deaths, 2019-2020: 24.9% — 18th smallest increase
> Pct. change in overdose deaths, 2015-2020: 24.1% — 6th smallest increase
> Population: 1,059,361
10. New Mexico
> 2020 overdose fatality: 38 deaths for every 100,000 people (total: 788)
> 2019 overdose fatality: 29 deaths for every 100,000 people (total: 609)
> 2015 overdose fatality: 24 deaths for every 100,000 people (total: 496)
> Average deaths a year, 2015-2019: 25 per 10,000 people — 14th most (total average overdose deaths: 524 a year)
> Pct. change in overdose deaths, 2019-2020: 29.4% — 23rd smallest increase
> Pct. change in overdose deaths, 2015-2020: 58.9% — 21st smallest increase
> Population: 2,096,829
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9. Connecticut
> 2020 overdose fatality: 39 deaths for every 100,000 people (total: 1,385)
> 2019 overdose fatality: 35 deaths for every 100,000 people (total: 1,231)
> 2015 overdose fatality: 22 deaths for every 100,000 people (total: 799)
> Average deaths a year, 2015-2019: 29 per 10,000 people — 10th most (total average overdose deaths: 1,031 a year)
> Pct. change in overdose deaths, 2019-2020: 12.5% — 8th smallest increase
> Pct. change in overdose deaths, 2015-2020: 73.3% — 22nd largest increase
> Population: 3,565,287
8. Pennsylvania
> 2020 overdose fatality: 40 deaths for every 100,000 people (total: 5,172)
> 2019 overdose fatality: 35 deaths for every 100,000 people (total: 4,444)
> 2015 overdose fatality: 25 deaths for every 100,000 people (total: 3,263)
> Average deaths a year, 2015-2019: 35 per 10,000 people — 3rd most (total average overdose deaths: 4,441 a year)
> Pct. change in overdose deaths, 2019-2020: 16.4% — 11th smallest increase
> Pct. change in overdose deaths, 2015-2020: 58.5% — 20th smallest increase
> Population: 12,801,989
7. Louisiana
> 2020 overdose fatality: 41 deaths for every 100,000 people (total: 1,925)
> 2019 overdose fatality: 28 deaths for every 100,000 people (total: 1,304)
> 2015 overdose fatality: 19 deaths for every 100,000 people (total: 875)
> Average deaths a year, 2015-2019: 23 per 10,000 people — 16th most (total average overdose deaths: 1,090 a year)
> Pct. change in overdose deaths, 2019-2020: 47.6% — 5th largest increase
> Pct. change in overdose deaths, 2015-2020: 120.0% — 4th largest increase
> Population: 4,648,794
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6. Ohio
> 2020 overdose fatality: 45 deaths for every 100,000 people (total: 5,215)
> 2019 overdose fatality: 37 deaths for every 100,000 people (total: 4,279)
> 2015 overdose fatality: 29 deaths for every 100,000 people (total: 3,336)
> Average deaths a year, 2015-2019: 36 per 10,000 people — 2nd most (total average overdose deaths: 4,217 a year)
> Pct. change in overdose deaths, 2019-2020: 21.9% — 16th smallest increase
> Pct. change in overdose deaths, 2015-2020: 56.3% — 18th smallest increase
> Population: 11,689,100
5. Tennessee
> 2020 overdose fatality: 45 deaths for every 100,000 people (total: 3,091)
> 2019 overdose fatality: 31 deaths for every 100,000 people (total: 2,138)
> 2015 overdose fatality: 21 deaths for every 100,000 people (total: 1,455)
> Average deaths a year, 2015-2019: 26 per 10,000 people — 12th most (total average overdose deaths: 1,771 a year)
> Pct. change in overdose deaths, 2019-2020: 44.6% — 6th largest increase
> Pct. change in overdose deaths, 2015-2020: 112.4% — 6th largest increase
> Population: 6,829,174
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4. Maryland
> 2020 overdose fatality: 46 deaths for every 100,000 people (total: 2,761)
> 2019 overdose fatality: 39 deaths for every 100,000 people (total: 2,360)
> 2015 overdose fatality: 22 deaths for every 100,000 people (total: 1,320)
> Average deaths a year, 2015-2019: 35 per 10,000 people — 4th most (total average overdose deaths: 2,086 a year)
> Pct. change in overdose deaths, 2019-2020: 17.0% — 12th smallest increase
> Pct. change in overdose deaths, 2015-2020: 109.2% — 7th largest increase
> Population: 6,045,680
3. Delaware
> 2020 overdose fatality: 46 deaths for every 100,000 people (total: 449)
> 2019 overdose fatality: 43 deaths for every 100,000 people (total: 423)
> 2015 overdose fatality: 20 deaths for every 100,000 people (total: 195)
> Average deaths a year, 2015-2019: 34 per 10,000 people — 5th most (total average overdose deaths: 329 a year)
> Pct. change in overdose deaths, 2019-2020: 6.1% — 4th smallest increase
> Pct. change in overdose deaths, 2015-2020: 130.3% — 2nd largest increase
> Population: 973,764
2. Kentucky
> 2020 overdose fatality: 47 deaths for every 100,000 people (total: 2,104)
> 2019 overdose fatality: 31 deaths for every 100,000 people (total: 1,369)
> 2015 overdose fatality: 28 deaths for every 100,000 people (total: 1,248)
> Average deaths a year, 2015-2019: 31 per 10,000 people — 7th most (total average overdose deaths: 1,391 a year)
> Pct. change in overdose deaths, 2019-2020: 53.7% — 3rd largest increase
> Pct. change in overdose deaths, 2015-2020: 68.6% — 24th largest increase
> Population: 4,467,673
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1. West Virginia
> 2020 overdose fatality: 74 deaths for every 100,000 people (total: 1,326)
> 2019 overdose fatality: 48 deaths for every 100,000 people (total: 852)
> 2015 overdose fatality: 41 deaths for every 100,000 people (total: 729)
> Average deaths a year, 2015-2019: 48 per 10,000 people — the most (total average overdose deaths: 868 a year)
> Pct. change in overdose deaths, 2019-2020: 55.6% — 2nd largest increase
> Pct. change in overdose deaths, 2015-2020: 81.9% — 17th largest increase
> Population: 1,792,147
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