The U.S. is grappling with a drug epidemic. More than 200,000 Americans have died from a fentanyl overdose since 2015. Fentanyl is a dangerous opioid that is up to 100 times stronger than morphine, according to the Centers for Disease Control and Prevention.
More Americans ages 18-45 were killed by fentanyl than any other cause in 2020 – including suiсide, car accidents, and COVID-19. No state has been left untouched by the fentanyl crisis, but in some states the crisis is worse, and fatalities have skyrocketed in recent years.
To determine the states with the highest rate of fentanyl fatalities, 24/7 Wall St. reviewed the report “Fentanyl: The State We’re In” from advocacy group Families Against Fentanyl. The report uses data from the CDC on the total number of fentanyl-caused deaths by state from 2015-2021. We used the number of fentanyl deaths and five-year population data from the Census Bureau to rank the states by fentanyl fatalities per capita.
Fentanyl has often been used as a pain management treatment for cancer patients, but illicitly manufactured fentanyl is often mixed in with other narcotics and causes a high share of the drug overdose and fatality cases in the U.S.
The number of fentanyl fatalities per capita over the last few years varies widely from state to state. A dozen states reported fewer than 20 fatalities per 100,000 residents from 2015 to 2021. Conversely, 12 other states reported more than 100 fentanyl-related fatalities per 100,000 during that same time – and one state recorded over 200 deaths per 100,000.
The prevalence of fentanyl-related deaths has grown significantly in recent years. From 2015 to 2021, the number of fentanyl deaths increased by 547% in the U.S. overall. Additionally, all but one state for which there is data saw fentanyl deaths more than double in that same time period. These are the 25 most dangerous drugs.
Click here for the states with the most fentanyl deaths
50. Hawaii
> Fentanyl deaths per capita, 2015-2021: 7.2 per 100,000
> Total fentanyl deaths, 2015-2021: 102 (4th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +154%
> Population: 1,422,094
[in-text-ad]
49. Montana
> Fentanyl deaths per capita, 2015-2021: 10.6 per 100,000
> Total fentanyl deaths, 2015-2021: 111 (5th lowest)
> Increase in fentanyl deaths from 2015 to 2021: N/A
> Population: 1,050,649
48. South Dakota
> Fentanyl deaths per capita, 2015-2021: 10.7 per 100,000
> Total fentanyl deaths, 2015-2021: 93 (3rd lowest)
> Increase in fentanyl deaths from 2015 to 2021: N/A
> Population: 870,638
47. Nebraska
> Fentanyl deaths per capita, 2015-2021: 11.0 per 100,000
> Total fentanyl deaths, 2015-2021: 210 (6th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +431%
> Population: 1,914,571
[in-text-ad-2]
46. Texas
> Fentanyl deaths per capita, 2015-2021: 11.5 per 100,000
> Total fentanyl deaths, 2015-2021: 3,260 (22nd highest)
> Increase in fentanyl deaths from 2015 to 2021: +670%
> Population: 28,260,856
45. North Dakota
> Fentanyl deaths per capita, 2015-2021: 12.0 per 100,000
> Total fentanyl deaths, 2015-2021: 91 (2nd lowest)
> Increase in fentanyl deaths from 2015 to 2021: N/A
> Population: 756,717
[in-text-ad]
44. Idaho
> Fentanyl deaths per capita, 2015-2021: 13.0 per 100,000
> Total fentanyl deaths, 2015-2021: 224 (8th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +450%
> Population: 1,717,750
43. Wyoming
> Fentanyl deaths per capita, 2015-2021: 15.3 per 100,000
> Total fentanyl deaths, 2015-2021: 89 (the lowest)
> Increase in fentanyl deaths from 2015 to 2021: N/A
> Population: 581,024
42. Oklahoma
> Fentanyl deaths per capita, 2015-2021: 17.1 per 100,000
> Total fentanyl deaths, 2015-2021: 674 (14th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +102%
> Population: 3,932,870
[in-text-ad-2]
41. Kansas
> Fentanyl deaths per capita, 2015-2021: 17.1 per 100,000
> Total fentanyl deaths, 2015-2021: 499 (9th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +561%
> Population: 2,910,652
40. Oregon
> Fentanyl deaths per capita, 2015-2021: 19.0 per 100,000
> Total fentanyl deaths, 2015-2021: 784 (15th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +932%
> Population: 4,129,803
[in-text-ad]
39. Iowa
> Fentanyl deaths per capita, 2015-2021: 19.9 per 100,000
> Total fentanyl deaths, 2015-2021: 626 (12th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +318%
> Population: 3,139,508
24/7 Wall St.
38. Utah
> Fentanyl deaths per capita, 2015-2021: 20.1 per 100,000
> Total fentanyl deaths, 2015-2021: 624 (11th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +174%
> Population: 3,096,848
37. Arkansas
> Fentanyl deaths per capita, 2015-2021: 21.6 per 100,000
> Total fentanyl deaths, 2015-2021: 649 (13th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +441%
> Population: 2,999,370
[in-text-ad-2]
36. California
> Fentanyl deaths per capita, 2015-2021: 25.9 per 100,000
> Total fentanyl deaths, 2015-2021: 10,188 (6th highest)
> Increase in fentanyl deaths from 2015 to 2021: +2,137%
> Population: 39,283,497
35. Washington
> Fentanyl deaths per capita, 2015-2021: 26.0 per 100,000
> Total fentanyl deaths, 2015-2021: 1,928 (25th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +1,169%
> Population: 7,404,107
[in-text-ad]
34. Nevada
> Fentanyl deaths per capita, 2015-2021: 27.0 per 100,000
> Total fentanyl deaths, 2015-2021: 804 (16th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +950%
> Population: 2,972,382
33. Mississippi
> Fentanyl deaths per capita, 2015-2021: 27.9 per 100,000
> Total fentanyl deaths, 2015-2021: 833 (17th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +980%
> Population: 2,984,418
32. Colorado
> Fentanyl deaths per capita, 2015-2021: 28.1 per 100,000
> Total fentanyl deaths, 2015-2021: 1,578 (22nd lowest)
> Increase in fentanyl deaths from 2015 to 2021: +1,008%
> Population: 5,610,349
[in-text-ad-2]
31. Georgia
> Fentanyl deaths per capita, 2015-2021: 30.0 per 100,000
> Total fentanyl deaths, 2015-2021: 3,121 (23rd highest)
> Increase in fentanyl deaths from 2015 to 2021: +292%
> Population: 10,403,847
30. Alaska
> Fentanyl deaths per capita, 2015-2021: 30.3 per 100,000
> Total fentanyl deaths, 2015-2021: 223 (7th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +593%
> Population: 737,068
[in-text-ad]
29. Alabama
> Fentanyl deaths per capita, 2015-2021: 30.7 per 100,000
> Total fentanyl deaths, 2015-2021: 1,495 (21st lowest)
> Increase in fentanyl deaths from 2015 to 2021: +694%
> Population: 4,876,250
24/7 Wall St.
28. Minnesota
> Fentanyl deaths per capita, 2015-2021: 31.8 per 100,000
> Total fentanyl deaths, 2015-2021: 1,769 (24th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +1,189%
> Population: 5,563,378
27. Louisiana
> Fentanyl deaths per capita, 2015-2021: 43.0 per 100,000
> Total fentanyl deaths, 2015-2021: 2,008 (25th highest)
> Increase in fentanyl deaths from 2015 to 2021: +2,363%
> Population: 4,664,362
[in-text-ad-2]
26. New Mexico
> Fentanyl deaths per capita, 2015-2021: 46.2 per 100,000
> Total fentanyl deaths, 2015-2021: 967 (18th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +890%
> Population: 2,092,454
25. Arizona
> Fentanyl deaths per capita, 2015-2021: 57.0 per 100,000
> Total fentanyl deaths, 2015-2021: 4,016 (18th highest)
> Increase in fentanyl deaths from 2015 to 2021: +2,172%
> Population: 7,050,299
[in-text-ad]
24. Wisconsin
> Fentanyl deaths per capita, 2015-2021: 62.3 per 100,000
> Total fentanyl deaths, 2015-2021: 3,605 (21st highest)
> Increase in fentanyl deaths from 2015 to 2021: +925%
> Population: 5,790,716
24/7 Wall St.
23. Virginia
> Fentanyl deaths per capita, 2015-2021: 65.9 per 100,000
> Total fentanyl deaths, 2015-2021: 5,570 (13th highest)
> Increase in fentanyl deaths from 2015 to 2021: +403%
> Population: 8,454,463
22. South Carolina
> Fentanyl deaths per capita, 2015-2021: 72.1 per 100,000
> Total fentanyl deaths, 2015-2021: 3,619 (20th highest)
> Increase in fentanyl deaths from 2015 to 2021: +713%
> Population: 5,020,806
[in-text-ad-2]
21. Illinois
> Fentanyl deaths per capita, 2015-2021: 72.1 per 100,000
> Total fentanyl deaths, 2015-2021: 9,206 (9th highest)
> Increase in fentanyl deaths from 2015 to 2021: +778%
> Population: 12,770,631
20. New York
> Fentanyl deaths per capita, 2015-2021: 73.9 per 100,000
> Total fentanyl deaths, 2015-2021: 14,464 (3rd highest)
> Increase in fentanyl deaths from 2015 to 2021: +486%
> Population: 19,572,319
[in-text-ad]
19. Indiana
> Fentanyl deaths per capita, 2015-2021: 76.7 per 100,000
> Total fentanyl deaths, 2015-2021: 5,113 (15th highest)
> Increase in fentanyl deaths from 2015 to 2021: +1,370%
> Population: 6,665,703
18. Florida
> Fentanyl deaths per capita, 2015-2021: 78.9 per 100,000
> Total fentanyl deaths, 2015-2021: 16,496 (2nd highest)
> Increase in fentanyl deaths from 2015 to 2021: +746%
> Population: 20,901,636
17. Missouri
> Fentanyl deaths per capita, 2015-2021: 80.0 per 100,000
> Total fentanyl deaths, 2015-2021: 4,883 (16th highest)
> Increase in fentanyl deaths from 2015 to 2021: +629%
> Population: 6,104,910
[in-text-ad-2]
16. North Carolina
> Fentanyl deaths per capita, 2015-2021: 80.5 per 100,000
> Total fentanyl deaths, 2015-2021: 8,264 (11th highest)
> Increase in fentanyl deaths from 2015 to 2021: +748%
> Population: 10,264,876
15. Michigan
> Fentanyl deaths per capita, 2015-2021: 85.9 per 100,000
> Total fentanyl deaths, 2015-2021: 8,565 (10th highest)
> Increase in fentanyl deaths from 2015 to 2021: +348%
> Population: 9,965,265
[in-text-ad]
14. Vermont
> Fentanyl deaths per capita, 2015-2021: 90.2 per 100,000
> Total fentanyl deaths, 2015-2021: 563 (10th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +406%
> Population: 624,313
24/7 Wall St.
13. Tennessee
> Fentanyl deaths per capita, 2015-2021: 97.2 per 100,000
> Total fentanyl deaths, 2015-2021: 6,521 (12th highest)
> Increase in fentanyl deaths from 2015 to 2021: +879%
> Population: 6,709,356
12. Pennsylvania
> Fentanyl deaths per capita, 2015-2021: 108.9 per 100,000
> Total fentanyl deaths, 2015-2021: 13,933 (4th highest)
> Increase in fentanyl deaths from 2015 to 2021: +760%
> Population: 12,791,530
[in-text-ad-2]
11. New Jersey
> Fentanyl deaths per capita, 2015-2021: 112.9 per 100,000
> Total fentanyl deaths, 2015-2021: 10,020 (8th highest)
> Increase in fentanyl deaths from 2015 to 2021: +837%
> Population: 8,878,503
10. Kentucky
> Fentanyl deaths per capita, 2015-2021: 119.3 per 100,000
> Total fentanyl deaths, 2015-2021: 5,307 (14th highest)
> Increase in fentanyl deaths from 2015 to 2021: +400%
> Population: 4,449,052
[in-text-ad]
9. Maine
> Fentanyl deaths per capita, 2015-2021: 124.1 per 100,000
> Total fentanyl deaths, 2015-2021: 1,657 (23rd lowest)
> Increase in fentanyl deaths from 2015 to 2021: +256%
> Population: 1,335,492
8. Rhode Island
> Fentanyl deaths per capita, 2015-2021: 131.3 per 100,000
> Total fentanyl deaths, 2015-2021: 1,388 (19th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +126%
> Population: 1,057,231
7. Connecticut
> Fentanyl deaths per capita, 2015-2021: 134.2 per 100,000
> Total fentanyl deaths, 2015-2021: 4,798 (17th highest)
> Increase in fentanyl deaths from 2015 to 2021: +456%
> Population: 3,575,074
[in-text-ad-2]
6. Delaware
> Fentanyl deaths per capita, 2015-2021: 154.5 per 100,000
> Total fentanyl deaths, 2015-2021: 1,479 (20th lowest)
> Increase in fentanyl deaths from 2015 to 2021: +889%
> Population: 957,248
5. Massachusetts
> Fentanyl deaths per capita, 2015-2021: 155.4 per 100,000
> Total fentanyl deaths, 2015-2021: 10,646 (5th highest)
> Increase in fentanyl deaths from 2015 to 2021: +108%
> Population: 6,850,553
[in-text-ad]
4. Ohio
> Fentanyl deaths per capita, 2015-2021: 162.4 per 100,000
> Total fentanyl deaths, 2015-2021: 18,929 (the highest)
> Increase in fentanyl deaths from 2015 to 2021: +248%
> Population: 11,655,397
3. New Hampshire
> Fentanyl deaths per capita, 2015-2021: 162.4 per 100,000
> Total fentanyl deaths, 2015-2021: 2,190 (24th highest)
> Increase in fentanyl deaths from 2015 to 2021: +05%
> Population: 1,348,124
2. Maryland
> Fentanyl deaths per capita, 2015-2021: 167.7 per 100,000
> Total fentanyl deaths, 2015-2021: 10,096 (7th highest)
> Increase in fentanyl deaths from 2015 to 2021: +578%
> Population: 6,018,848
[in-text-ad-2]
1. West Virginia
> Fentanyl deaths per capita, 2015-2021: 216.6 per 100,000
> Total fentanyl deaths, 2015-2021: 3,937 (19th highest)
> Increase in fentanyl deaths from 2015 to 2021: +430%
> Population: 1,817,305
Get Ready To Retire (Sponsored)
Start by taking a quick retirement quiz from SmartAsset that will match you with up to 3 financial advisors that serve your area and beyond in 5 minutes, or less.
Each advisor has been vetted by SmartAsset and is held to a fiduciary standard to act in your best interests.
Here’s how it works:
1. Answer SmartAsset advisor match quiz
2. Review your pre-screened matches at your leisure. Check out the advisors’ profiles.
3. Speak with advisors at no cost to you. Have an introductory call on the phone or introduction in person and choose whom to work with in the future
Get started right here.
Thank you for reading! Have some feedback for us?
Contact the 24/7 Wall St. editorial team.
Latest from 24/7
