In 2017, when the president of the United States addressed the issue of drug addiction in the country — specifically the country’s dependence on opioids — many people started paying more attention to the topic of substance misuse.

While substance use is not a new problem in the country, addiction and overdose rates have increased in recent years. This growing reliance on drugs has, in turn, resulted in more drug overdose deaths. Between 2005 and 2016, the number of overdoses due to drug misuse increased by 21 percent.

No area has been immune to this increase. According to data from the Centers from the Disease Control and Prevention, every state has seen a rise in its overdose death rate from 2005 to 2016. This figure represents the number of overdose deaths among a geographical area’s population during a given year, per 100,000 residents.

Looking at more recent trends, all but 12 states have had an overdose death rate increase from 2014 to 2016 of more than 0.5. Some regions of the United States, though, have been hit harder than others by severe drug addiction and misuse.

Upper East Coast and the Rise of Fentanyl

The average overdose death rate increase for a state from 2014 to 2016 was 4.99. Any state with an increase of 5.0 or higher was above this average, and 23 states fit this description. Of those, 10 states had an increase of at least 9.8 and many of these states are geographically located near another state, or states, in the group.

Some of the states along the upper east coast experienced the biggest increases, including:

  • Massachusetts increased from 19 to 33, a difference of 14.
  • New Hampshire increased 12.8, from an overdose death rate of 26.2 to 39.
  • Maine increased 11.9, from 16.8 to 28.7.
  • Connecticut increased 9.8, from 17.6 to 27.4.

All four of these states border at least one other in the group. This could indicate that rampant drug misuse, addiction and overdose are common in specific geographical regions. In Massachusetts, there were 1,289 drug overdose deaths in 2014 and 2,227 in 2016. New Hampshire had 334 overdose deaths in 2014 and 500 in 2016. Maine went from 216 in 2014 to 353 two years later. Connecticut increased in the number of overdose deaths from 623 to 971 in that same time span.

Some of this is attributed to a popular new drug, fentanyl. According to a report by The Guardian, the upper, northeastern states have seen large increases in overdose deaths within the last couple of years due to fentanyl and the increased misuse of heroin. An opioid, fentanyl is often taken to relieve pain. However, fentanyl is classified as a Schedule II controlled substance in the United States due to its high risk of misuse, addiction potential and overdose frequency. Fentanyl is considered a synthetic opioid and is 50 times more powerful than heroin, which is why it’s often the cause of overdose deaths.

This region is not the only one affected by fentanyl addiction. Florida and Ohio also saw significant increases in fentanyl and heroin misuse and overdose between 2014 and 2016, attributing to their own rise in overdose death rate. Florida increased from a rate of 13.2 to 23.7 and Ohio jumped from 24.6 to 39.1, much higher than the state average.

The East Coast’s Rising Overdose Rates

Another region of the United States that has experienced a major increase in drug overdoses is the mid-Atlantic area. Ranging from North Carolina up to Pennsylvania.

  • West Virginia topped the overdose death rate rankings both in 2014 and 2016, and the state also has seen the largest increase. The overdose death rate rose 16.5, from 35.5 to 52.
  • Pennsylvania increased by 16, the second-largest rise of any state, from an overdose death rate of 21.9 to 37.9.
  • Maryland increased by 15.8, from 17.4 to 33.2, and was the third-largest rise in the time span.
  • Delaware increased by 9.9, from 20.9 to 30.8.

These four states border at least one other in the group, and West Virginia borders Kentucky, which saw an overdose rate increase of 8.8 from 2014 to 2016. West Virginia had 627 overdose deaths in 2014 and 884 in 2016. Pennsylvania had 2,732 in 2014 and 4,329 in 2016. Maryland jumped from 2,070 overdose deaths in 2014 to 2,044 in 2016. Delaware had 189 overdose deaths in 2014 and 326 in 2016.

Some of the increases is likely due to the large rural populations in some of these states. According to the same report from The Guardian, these rural areas are reliant on physically taxing industries such as coal mining and timbering. Those types of professions are more susceptible to reliance on pain-relief medications and prescription opioids such as OxyContin and Vicodin. These pain-relief medications can cause an opioid dependence to form and potentially lead to addiction to illegal substances such as heroin.


Where the Overdose Rate Has Improved

Three states that are either connected by borders or in close proximity to one another — Arkansas, Kansas and Nebraska — actually saw a drop in each’s overdose death rate from 2014 to 2016. Arkansas dropped from 18.2 to 14, the biggest improvement of any state during this time span; Kansas dropped 0.6, from 11.7 to 11.1; and Nebraska dropped 0.8, from 7.2 to 6.4.

The other states that improved their overdose death rates from 2014 to 2016 were:

  • Montana (12.4 to 11.7)
  • Oregon (12.8 to 11.9)
  • Wyoming (19.4 to 17.6)
  • New Mexico (17.3 to 25.2)

Montana and Wyoming border one another, and Oregon is located in close proximity to those two states. Alaska and Utah, other nearby states, were the only two with the same overdose death rate in 2014 and 2016. California, another state in the western half of the country, saw a minimal increase of 0.1 in the time span.

Even if the overdose death rates in these states didn’t increase, or increased a small amount, that does not mean they are excluded from the country’s widespread drug epidemic. Montana still had 119 drug overdoses in 2016, Oregon had 506 that year, while Wyoming had 99 and New Mexico had 500.


These states might not have been affected the same amount as some on the East Coast, but regardless there are people living in these areas who suffer from substance use disorders and need assistance. If you or someone you know is addicted to drugs — whether it’s prescription medication, heroin, fentanyl or another substance — call The Recovery Village and take the first step toward recovery.

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.