America is struggling to address the drug crisis that is claiming lives from coast to coast. No state has been spared from the toll that drugs have taken on American families and the dangers of drug overdoses, including opioid overdoses, cannot be understated.

Drug overdoses claim thousands of lives every year. According to data from the Centers for Disease Control and Prevention (CDC), the following ten states saw the highest overdose death rates during 2017.

Please note that the overdose death rate for each state is the number of deaths per 100,000 people in the state population in 2017. The overdose death rate is different from the total number of overdose deaths, which is reported as a whole number. The CDC adjusts this data for differences in population size and age distribution.

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

10. Rhode Island

Overdose Death Rate: 31.0 (+0.6% y/y)

In 2017, there were 320 drug overdose deaths in Rhode Island. The National Drug Intelligence Center’s Rhode Island Drug Threat Assessment lists marijuana as the state’s most commonly used substance, followed by OxyContin and “club drugs” like MDMA (ecstasy).

Opioid misuse rates continue to rise in this state due to the low cost of illegal opioids like heroin. Although heroin-related overdose deaths decreased in the state between 2014 and 2016, the overdose deaths caused by synthetic opioids nearly doubled during that time.

9. Massachusetts

Overdose Death Rate: 31.8 (-3.6% y/y)

The CDC recorded 2,168 fatal drug overdose deaths for Massachusetts in 2017.

Opioid overdoses are quite prevalent in Massachusetts: 85 percent of drug overdoses were due to heroin and fentanyl between 2013 and 2014, while 22 percent of overdoses resulted from a prescription opioid. Cocaine follows closely behind opioids as the most commonly used substance in Massachusetts.

8. Maine

Overdose Death Rate: 34.4 (+19% y/y)

In 2017, there was a total of 424 drug overdose deaths in the state of Maine, which was an increase from 353 deaths in 2016.

Much like the rest of the country, Maine has struggled with the opioid epidemic. Commonly used substances in Maine are heroin and synthetic opioids. The state has also seen an increase in overdose deaths from heroin, morphine and fentanyl.

7. Maryland

Overdose Death Rate: 36.3(+9.3% y/y)

Unfortunately, the drug overdose death rate in Maryland has been consistently higher than the national average every year since 1999. In 2017, Maryland saw 2,247 drug overdose deaths, an increase from 2,044 deaths in 2016.

Some of the most commonly misused substances in Maryland are opioids (including heroin) and stimulants like cocaine. In 2016, approximately 650 of the total number of drug overdose deaths in Maryland involved a synthetic opioid, with most deaths involving fentanyl.

6. Delaware

Overdose Death Rate: 37.0 (+20% y/y)

Delaware had 338 drug overdose deaths in 2017, which was an increase from 282 deaths in 2016. Some of the most commonly used substances in Delaware are opioids, followed closely by marijuana and heroin.

Fentanyl use is a concerning issue in Delaware. A reported 186 percent increase in fentanyl-related deaths was recorded in Delaware from 2015 to 2016.

5. New Hampshire

Overdose Death Rate: 37.0 (-5% y/y)

In 2017, New Hampshire saw 467 overdose deaths, which was a decrease from 481 in 2016. New Hampshire’s drug overdose death rate was identical to Delaware’s in 2017.

New Hampshire’s overdose rate is surprisingly higher than its neighbor Massachusetts’, which is mainly where New Hampshire’s opioid supply comes from. Some experts hypothesize that the overdose figures result from the lack of treatment available in the state.

4. Kentucky

Overdose Death Rate: 37.2 (+11% y/y)

In Kentucky, 1,419 residents died from drug overdoses in 2016. In 2017, the overdose death rate rose to 1,566.

According to the 2016 Overdose Fatality Report by the state’s justice and public safety cabinet, Jefferson County had the most overdose deaths during 2016. Louisville was among the most affected cities in the county for substance abuse and overdose deaths.

The report also noted that fentanyl (either taken alone or combined with heroin) was involved in 47 percent of Kentucky’s overdose deaths. Heroin overdose deaths increased as well, with 34 percent of overdose deaths being heroin-related in 2016, which was up from 28 percent in 2015.

3. Pennsylvania

Overdose Death Rate: 44.3 (+16% y/y)

Pennsylvania saw a rise in drug overdose deaths from to 4,627 in 2016 to 5,388 in 2017.

Opioid abuse is a major concern in Pennsylvania. Opioids (illicit or prescribed) were responsible for 85 percent of Pennsylvania’s overdose deaths in 2016, according to the Drug Enforcement Administration’s (DEA) analysis of overdose deaths in the state. There were 2,235 opioid-related overdose deaths­­­ in Pennsylvania in 2016 alone.

2. Ohio 

Overdose Death Rate: 46.3 (+18% y/y)

For at least two consecutive years (2016-2017), Ohio has ranked second-worst in the nation for drug overdose deaths, according to the CDC. Fatal drug overdoses in Ohio increased from 4,329 in 2016 to 5,111 in 2017. According to the National Institute on Drug Abuse (NIDA), Ohio’s rate of overdose deaths has tripled since 2010 and is more than double the national rate.

Some of the most common illicit substances used in Ohio include heroin, cocaine and marijuana. Prescription opioid misuse is also on the rise across the state. Many experts believe that fentanyl cut with heroin is the drug combination that spiked overdose deaths in Ohio and across the nation.

1. West Virginia 

Overdose Death Rate: 57.8 (+11% y/y)

Beyond its mountains, West Virginia is known for its abundant natural resources. Now, sadly, it is also known for its ranking as the state most affected by the opioid epidemic.  

West Virginia has had the highest number of drug overdose deaths in the nation for at least two consecutive years (2016-2017). Overdose deaths increased in West Virginia from 884 in 2016 to 974 in 2017.

According to NIDA, West Virginia also had the highest rate of opioid-related overdose deaths in the country in 2016. Across the state, deaths from synthetic opioids have quadrupled since 2010, according to NIDA.

The Recovery Village and other rehabilitation facilities aim to lower drug overdose rates across the country through comprehensive addiction treatment. If you or a loved one need help for a drug abuse issue, call The Recovery Village today to speak with representatives who can help. The call is free and confidential, and there is no obligation to enroll in treatment. Call now, recovery is possible.


Commonwealth of Kentucky. “2016 Overdose Fatality Report.” Kentucky Office of Drug Control Policy, 2016. Accessed March 2019.

DeMio, Terry. “Ohio’s overdose deaths soar again, […]st in the nation.”, 2017. Accessed March 2019.

DEA Philadelphia Division, the University of Pittsburgh. “Analysis of Overdose Deaths in Pennsylvania, 2016.” The United States Drug Enforcement Agency, 2017. Accessed March 2019.

Horn, Brittany. “Delaware fentanyl-related overdoses triple in 2016.” Delaware Online, 2017. Accessed March 2019.

Massachusetts Department of Health. “An Assessment of Opioid-Related Death[…]etts (2013-2014).” Published September 2016. Accessed March 2019.

National Drug Intelligence Center. “Rhode Island Drug Threat Assessment.” July 2003. Accessed March 2019.

National Institute on Drug Abuse. “Rhode Island Opioid Summary.” Revised February 2018. Accessed March 2019.

National Institute on Drug Abuse. “Maryland Opioid Summary.” Revised February 2018. Accessed March 2019.

National Institute on Drug Abuse. “Ohio Opioid Summary.” Revised February 2018. Accessed March 2019.

National Institute on Drug Abuse. “Pennsylvania Opioid Summary.” Revised February 2018. Accessed March 2019.

National Institute on Drug Abuse. “West Virginia Opioid Summary.” Revised February 2018. Accessed March 2019.

The Centers for Disease Control and Prevention. “Drug Overdose Mortality by State.” Last updated on January 10, 2019. Accessed March 25, 2019.

Seelye, Katharine. “How a ‘Perfect Storm’ in New Hamp[…]an Opioid Crisis.” The New York Times, 2018. Accessed March 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.