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Drug Overdose Statistics and Death Rates by County

By NJ Addiction Centers Editorial Team | Last reviewed: | 7 min read Clinically Reviewed

Drug Overdose Statistics and Death Rates by County

Key Takeaways

  • The CDC estimated approximately 107,941 drug overdose deaths in the US in the 12-month period ending June 2023, according to NCHS provisional data (2023).
  • Synthetic opioids (primarily fentanyl) were involved in approximately 75,000 of those deaths, making them the leading driver of the overdose crisis (CDC WONDER, 2023).
  • West Virginia had the highest state-level age-adjusted overdose death rate at 81.4 per 100,000 in 2022 (CDC WONDER, 2023).
  • New Jersey’s age-adjusted rate was 33.1 per 100,000 in 2022, slightly above the national average (CDC WONDER, 2023).
  • Overdose death rates among Black Americans increased 44% between 2019 and 2022, the sharpest increase among any racial group (CDC MMWR, 2023).
  • County-level data reveals that overdose hotspots often concentrate in areas with high poverty, limited treatment access, and proximity to drug distribution routes (CDC WONDER county data, 2023).

Statistics updated quarterly. Last reviewed March 28, 2026.

Drug overdose deaths remain the leading cause of injury-related death in the United States, surpassing motor vehicle crashes, firearms, and falls. The crisis has evolved through three distinct waves over the past 25 years, each driven by a different class of opioids, with stimulants and polysubstance use increasingly contributing to the death toll. This page compiles national, state, and county-level overdose data from the CDC, state health departments, and peer-reviewed research.

National Drug Overdose Death Statistics

The CDC’s National Center for Health Statistics (NCHS) tracks drug overdose deaths through the National Vital Statistics System. According to provisional and final data:

  • 2015: 52,404 drug overdose deaths (CDC WONDER, 2016).
  • 2017: 70,237 deaths, a 34% increase from 2015 (CDC WONDER, 2018).
  • 2019: 70,630 deaths, a brief plateau before the COVID-19 pandemic (CDC WONDER, 2020).
  • 2020: 93,655 deaths, a 32.4% surge coinciding with the pandemic (CDC WONDER, 2021).
  • 2021: 106,699 deaths, the first year to exceed 100,000 (CDC WONDER, 2022).
  • 2022: Approximately 107,941 deaths in the 12-month period ending June 2023, representing a slight plateau at historically high levels (NCHS provisional data, 2023).

The overall trend from 1999 through 2022 represents an approximately 500% increase in annual drug overdose deaths, from roughly 17,000 in 1999 to over 107,000 in 2022 (CDC WONDER, 2023).

Substances Driving the Crisis

The drug overdose crisis has occurred in three overlapping waves, as described by the CDC:

Wave 1 (1999-2010): Prescription opioids. Increased prescribing of opioid pain medications drove the initial surge. Deaths involving prescription opioids quadrupled from 1999 to 2010 (CDC, 2021).

Wave 2 (2010-2013): Heroin. As prescription opioid access tightened through regulation, many individuals transitioned to heroin, which was cheaper and more available. Heroin overdose deaths tripled between 2010 and 2015 (CDC, 2021).

Wave 3 (2013-present): Synthetic opioids. Illicitly manufactured fentanyl and its analogs have driven the most recent and most lethal wave. Synthetic opioid deaths increased from approximately 3,100 in 2013 to approximately 75,000 in 2022, a 24-fold increase in less than a decade (CDC WONDER, 2023).

Increasingly, stimulants are contributing to the death toll. Cocaine-involved overdose deaths reached approximately 27,569 in 2022, and methamphetamine-involved deaths reached approximately 34,022 (CDC WONDER, 2023). Many of these involve polysubstance combinations with opioids.

Overdose Deaths by State

States with Highest Overdose Rates

State-level data reveals substantial geographic variation. According to CDC WONDER age-adjusted drug overdose death rates for 2022 (per 100,000 population):

Top 10 highest rates:

  1. West Virginia: 81.4
  2. Tennessee: 56.6
  3. Louisiana: 55.9
  4. Kentucky: 55.6
  5. Ohio: 47.2
  6. Delaware: 44.8
  7. Maryland: 43.5
  8. Connecticut: 42.1
  9. Maine: 41.1
  10. Pennsylvania: 40.4

(Source: CDC WONDER, final mortality data, 2023.)

These states share several common features: significant exposure to prescription opioid overprescribing during the first wave, geographic proximity to fentanyl distribution corridors, and, in several cases, limited Medicaid expansion that delayed treatment access.

States with Lowest Rates

States with lowest age-adjusted overdose death rates (per 100,000):

  1. Nebraska: 11.2
  2. South Dakota: 12.8
  3. Iowa: 14.3
  4. North Dakota: 14.7
  5. Kansas: 16.1

(Source: CDC WONDER, 2023.)

Lower-rate states tend to be geographically distant from major drug distribution corridors, have smaller urban centers, and in some cases have different substance use profiles (e.g., higher rates of alcohol-related problems relative to opioid-related problems).

Where New Jersey Ranks

New Jersey’s age-adjusted overdose death rate was 33.1 per 100,000 in 2022, according to CDC WONDER data. This places the state slightly above the national average of 32.6 per 100,000 and ranks NJ in the middle tier of states, approximately 20th highest nationally.

NJ’s rate is higher than neighboring New York (21.5 per 100,000) but lower than nearby Pennsylvania (40.4), Delaware (44.8), and Maryland (43.5) (CDC WONDER, 2023). The state’s position reflects its proximity to the I-95 corridor, which is a primary fentanyl distribution route in the northeastern US (DEA intelligence briefings, 2023).

County-Level Overdose Data

Why County Data Matters

State-level averages mask significant internal variation. A state with a moderate overall rate may contain individual counties with overdose death rates two to four times the national average. County-level data is essential for targeting prevention and treatment resources effectively.

The CDC’s WONDER database provides county-level mortality data, though small-population counties may have suppressed data due to privacy protections when death counts are below 10 in a given year.

National examples of high-rate counties from CDC WONDER (2021-2022 data):

  • Cabell County, WV (Huntington): age-adjusted rate exceeding 130 per 100,000.
  • Kenton County, KY (Covington): rate exceeding 80 per 100,000.
  • Philadelphia County, PA: rate exceeding 70 per 100,000.

In New Jersey, county-level overdose data from the NJ OCSME (2022) shows:

  • Atlantic County: approximately 58.2 per 100,000.
  • Cape May County: approximately 53.8 per 100,000.
  • Camden County: approximately 48.1 per 100,000.
  • Hunterdon County: approximately 14.8 per 100,000 (among the lowest in NJ).

(Source: NJ OCSME county data, 2023; NJ CARES dashboard, 2023.)

Finding Data for Your Area

Several tools allow researchers, advocates, and community members to access county-level overdose data:

  • CDC WONDER (wonder.cdc.gov): The most comprehensive national source for county-level overdose mortality data. Users can query by county, year, substance type, and demographic characteristics.
  • NJ CARES Dashboard: NJ-specific tool providing county and municipal data on suspected drug deaths, naloxone administrations, and emergency department visits.
  • County Health Rankings (countyhealthrankings.org): Published by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, this resource compiles drug overdose death rates alongside other health indicators for every US county.

Demographic Patterns in Overdose Deaths

Age and Gender Patterns

Drug overdose deaths are not evenly distributed across age and gender groups. According to CDC WONDER data (2022):

  • Age: Adults aged 35-44 had the highest overdose death rate at approximately 57.4 per 100,000, followed by adults aged 25-34 at approximately 53.1 per 100,000 (CDC WONDER, 2023). The peak age of overdose death has shifted upward over the past decade, from the 25-34 age group in 2015 to the 35-44 age group in 2022.
  • Gender: Men accounted for approximately 68% of overdose deaths in 2022, with an age-adjusted rate of 45.8 per 100,000 compared to 21.1 per 100,000 for women (CDC WONDER, 2023). However, the rate of increase has been faster among women, with female overdose deaths increasing 260% from 2010 to 2022 compared to 210% for men.

Racial and Ethnic Disparities

One of the most significant trends in recent overdose data is the widening of racial disparities:

  • Black Americans experienced a 44% increase in overdose death rates between 2019 and 2022, the sharpest increase among any racial group. The age-adjusted rate among Black Americans reached approximately 44.2 per 100,000 in 2022, surpassing the rate among White Americans (36.8 per 100,000) for the first time since the current epidemic began (CDC MMWR, 2023).
  • American Indian/Alaska Native populations have the highest overdose death rate of any racial group at approximately 56.6 per 100,000 in 2022 (CDC WONDER, 2023).
  • Hispanic/Latino populations saw a 39% increase in overdose death rates between 2019 and 2022 (CDC WONDER, 2023).
  • White Americans, who had the highest rates during the prescription opioid and heroin waves, saw a 12% increase over the same period (CDC WONDER, 2023).

These shifts reflect changes in the drug supply (fentanyl contamination of the cocaine and counterfeit pill supply), disparities in treatment access, and the delayed impact of the opioid crisis on communities that were not the initial focus of prescription opioid marketing. A 2023 analysis published in JAMA Internal Medicine documented that Black individuals with opioid use disorder were significantly less likely to receive buprenorphine than White individuals, even after adjusting for insurance and geographic factors (Kilaru et al., 2023).

This page is part of the Addiction Statistics, Research, and Recovery Data guide on NJ Addiction Centers.

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