The U.S. Counties Most Affected by the Opioid Crisis

"In recent years, drug abuse has fueled a surge in overdose deaths and created an emergent public health crisis in the United States. According to estimates from the Centers for Disease Control and Prevention , fatal drug overdoses surged by over 60% between 2018 and 2022 - from about 68,600 to nearly 111,000. These overdose deaths were linked to a wide range of both illicit and prescription drugs, including cocaine, methamphetamine, benzodiazepines, and antidepressants."

"Opioids are a class of drugs that can be derived from the opium poppy plant or created synthetically in a lab. In a medical context, prescription opioids can be an effective pain management tool. Opioids have a high potential for abuse, and even with medical supervision, they can be extremely dangerous. While thousands of fatal overdoses in the U.S. are linked to opioids like heroin and prescription painkillers each year, powerful synthetic opioids, such as fentanyl, account for the bulk of opioid overdose deaths."

"Encouragingly, since peaking in 2022, overdose deaths have been declining in the United States. In 2024, the most recent year of complete data, there were about 81,000 fatal overdoses nationwide, a 25% decline from the previous year. Data for the early months of 2025 suggest the improvement accelerated that year. Over the 12 month period ending in April of last year, there were an estimated 76,500 overdose deaths, down about 25% from the same period one year earlier."

Fatal drug overdoses rose sharply between 2018 and 2022, increasing by over 60% from about 68,600 to nearly 111,000 deaths, involving both illicit and prescription drugs. Opioids accounted for more than 75% of those deaths, with synthetic opioids such as fentanyl responsible for the largest share. Prescription opioids can manage pain medically but carry high abuse and overdose risk. Since peaking in 2022, annual overdose deaths have fallen, with about 81,000 fatalities in 2024 and an estimated 76,500 over the 12 months ending in April, representing roughly a 25% decline year over year. Significant local variation persists, and many communities remain severely affected.

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