United States · 12 months ending May 2026
Updated October 22, 2026 · v1.1Deaths are down 11.5% from a year earlier and 41% below the August 2023 peak of 112,418. That is still about 182 people every day.
Trend
A decade of overdose deaths
This chart tracks estimated overdose deaths across rolling 12-month periods. Recent figures are provisional and may change as death investigations are completed.
What’s in the supply
Substances involved
Share of the 66,478 deaths where each substance was listed on the death certificate. Most deaths involve more than one substance, so the shares add up to more than 100%.
Death certificates record what a toxicology lab found, not what the person thought they were taking. That gap is where drug checking helps: test strips screen for specific adulterants, reagents narrow down identification, and only a lab can confirm.
By state
Deaths and rates by state
Predicted provisional counts, 12 months ending May 2026, compared with the same period a year earlier. Rates are crude deaths per 100,000 residents (Census Vintage 2025). New York includes New York City.
| # | State | Deaths | Rate per 100kRate | Change |
|---|---|---|---|---|
| 1 | New Mexico | 1,128 | 53.1 | ▲ 31.9% |
| 2 | District of Columbia | 318 | 45.8 | ▼ 12.2% |
| 3 | Nevada | 1,323 | 40.3 | ▼ 12.3% |
| 4 | Alaska | 292 | 39.6 | ▼ 11.0% |
| 5 | West Virginia | 663 | 37.5 | ▼ 8.7% |
| 6 | Arizona | 2,822 | 37.0 | ▼ 1.5% |
| 7 | Washington | 2,528 | 31.6 | ▼ 20.7% |
| 8 | Colorado | 1,847 | 30.7 | ▲ 10.3% |
| 9 | Tennessee | 1,967 | 26.9 | ▼ 15.8% |
| 10 | Louisiana | 1,160 | 25.1 | ▼ 13.0% |
| 11 | Maine | 354 | 25.0 | ▼ 13.4% |
| 12 | Delaware | 255 | 24.1 | ▼ 27.4% |
| 13 | Vermont | 155 | 24.0 | ▼ 14.8% |
| 14 | Kentucky | 1,034 | 22.4 | ▼ 26.7% |
| 15 | California | 8,554 | 21.7 | ▼ 9.5% |
| 16 | South Carolina | 1,198 | 21.5 | ▼ 14.6% |
| 17 | Connecticut | 787 | 21.3 | ▼ 14.1% |
| 18 | Maryland | 1,295 | 20.7 | ▼ 15.9% |
| 19 | Hawaii | 295 | 20.6 | ▼ 14.0% |
| 20 | Pennsylvania | 2,620 | 20.1 | ▼ 17.8% |
| 21 | Oregon | 848 | 19.8 | ▼ 38.9% |
| 22 | Ohio | 2,319 | 19.5 | ▼ 16.0% |
| 23 | Missouri | 1,205 | 19.2 | ▼ 8.4% |
| 24 | North Carolina | 2,139 | 19.1 | ▼ 19.5% |
| 25 | Oklahoma | 781 | 18.9 | ▼ 21.0% |
| 26 | Massachusetts | 1,308 | 18.3 | ▼ 6.8% |
| 27 | New York | 3,652 | 18.3 | ▼ 8.4% |
| 28 | Utah | 646 | 18.3 | ▼ 6.5% |
| 29 | Indiana | 1,226 | 17.6 | ▼ 22.5% |
| 30 | New Hampshire | 245 | 17.3 | ▼ 2.0% |
| 31 | Florida | 4,001 | 17.1 | ▼ 7.3% |
| 32 | Michigan | 1,720 | 17.0 | ▼ 3.3% |
| 33 | Minnesota | 981 | 16.8 | ▼ 2.7% |
| 34 | Rhode Island | 186 | 16.7 | ▼ 33.8% |
| 35 | Wisconsin | 997 | 16.7 | ▲ 1.9% |
| 36 | Kansas | 462 | 15.5 | ▼ 18.1% |
| 37 | New Jersey | 1,475 | 15.4 | ▼ 17.0% |
| 38 | Alabama | 783 | 15.1 | ▼ 23.3% |
| 39 | Illinois | 1,915 | 15.1 | ▼ 14.3% |
| 40 | Wyoming | 88 | 14.9 | ▲ 3.5% |
| 41 | Montana | 165 | 14.4 | ▼ 6.8% |
| 42 | Mississippi | 416 | 14.1 | ▼ 10.0% |
| 43 | Texas | 4,444 | 14.0 | ▼ 4.2% |
| 44 | North Dakota | 110 | 13.8 | ▼ 6.8% |
| 45 | Virginia | 1,212 | 13.6 | ▼ 9.5% |
| 46 | Georgia | 1,526 | 13.5 | ▼ 20.6% |
| 47 | Idaho | 265 | 13.1 | ▼ 12.3% |
| 48 | Arkansas | 374 | 12.0 | ▲ 1.4% |
| 49 | Iowa | 362 | 11.2 | ▼ 13.4% |
| 50 | South Dakota | 82 | 8.8 | ▼ 5.7% |
| 51 | Nebraska | 167 | 8.3 | ▲ 11.3% |
By county
25 highest county rates
Reported provisional counts, 12 months ending March 2026 (data as of October 4, 2026). Only counties with 20 or more deaths are ranked, because rates from smaller counts are unstable. CDC suppresses counts of 1–9.
| # | County | Deaths | Rate per 100kRate | Change vs a year earlierChange |
|---|---|---|---|---|
| 1 | Rio Arriba, NM | 69 | 173.2 | ▲ 32.7% |
| 2 | Taos, NM | 34 | 98.4 | ▲ 9.7% |
| 3 | Lake, CA | 62 | 91.5 | ▼ 3.1% |
| 4 | San Miguel, NM | 23 | 87.6 | ▲ 27.8% |
| 5 | Baltimore (city), MD | 470 | 82.5 | ▼ 22.4% |
| 6 | Cabell, WV | 66 | 72.4 | ▼ 18.5% |
| 7 | Fayette, WV | 27 | 70.7 | ▲ 50.0% |
| 8 | Anderson, TN | 57 | 69.5 | ▲ 29.5% |
| 9 | Logan, WV | 21 | 69.1 | ▼ 27.6% |
| 10 | Mason, WA | 49 | 68.9 | ▲ 53.1% |
| 11 | Boyd, KY | 32 | 67.0 | ▼ 13.5% |
| 12 | Petersburg (city), VA | 22 | 65.2 | ▲ 69.2% |
| 13 | Santa Fe, NM | 101 | 64.4 | ▲ 21.7% |
| 14 | Scioto, OH | 45 | 63.1 | ▲ 12.5% |
| 15 | St. Louis (city), MO | 174 | 62.6 | ▼ 7.4% |
| 16 | Bernalillo, NM | 401 | 60.1 | ▲ 35.9% |
| 17 | Anchorage, AK | 170 | 59.2 | ▼ 4.0% |
| 18 | Floyd, KY | 20 | 58.1 | ▲ 53.8% |
| 19 | Robeson, NC | 67 | 55.9 | ▲ 11.7% |
| 20 | Raleigh, WV | 40 | 55.7 | ▼ 14.9% |
| 21 | El Paso, CO | 420 | 55.5 | ▲ 15.4% |
| 22 | Wayne, WV | 20 | 53.6 | ▲ 33.3% |
| 23 | Orleans, LA | 194 | 53.6 | ▲ 1.0% |
| 24 | Anderson, TX | 32 | 53.5 | ▲ 60.0% |
| 25 | Okanogan, WA | 24 | 53.1 | ▼ 27.3% |
International
How other countries compare
Countries define and count overdose deaths differently. Read the flags before comparing rows.
| Place | What’s counted | Year | Deaths | Rate | Flags |
|---|---|---|---|---|---|
| United States CDC NCHS VSRR, October 2026 | Drug overdose deaths, all intents (ICD-10 X40–44, X60–64, X85, Y10–14) | 2025 · year of death | 70,735 | 20.7 per 100k Crude, all ages | ProvisionalCrude rateIncludes suicides |
| Canada PHAC Health Infobase, September 22, 2026 | Apparent opioid toxicity deaths (opioids only; 96% accidental) | 2025 · year of death | 5,704 | 13.7 per 100k Crude, all ages | Opioids onlyPreliminaryCrude rate |
| Scotland NRS, September 23, 2026 | Drug use deaths (controlled drugs or drug-use disorder) | 2025 · registration year | 1,133 | 21.4 per 100k Age-standardised | Registration yearControlled drugs onlyAge-standardised |
| England & Wales ONS, October 17, 2025 | Deaths related to drug poisoning (incl. medicines; drug misuse subset: 3,736) | 2024 · registration year | 5,565 | 9.4 per 100k Age-standardised (ESP 2013) | Registration yearIncludes non-controlled medicines2025 data due November 2026 |
| Northern Ireland NISRA, May 13, 2026 | Drug-related deaths (drug misuse subset: 219) | 2024 · registration year | 251 | 13.5 per 100k Age-standardised (ESP 2013) | Registration yearAge-standardised |
| Australia Penington Institute, June 2026 | Unintentional drug-induced deaths (all intents: 2,596) | 2024 | 2,091 | 7.6 per 100k Per 100k residents | Excludes suicidesPreliminary |
| European Union (27) EUDA European Drug Report, June 9, 2026 | Drug-induced deaths (direct overdose deaths) | 2024 · year of death | 7,589 | 25 per million Crude, ages 15–64 only | Minimum estimateAges 15–64 basisGaps filled by estimate |
| Ireland HRB NDRDI, December 2025 | Drug poisoning deaths (excl. alcohol-only) | 2022 · year of death | 343 | 6.7 per 100k Age-standardised (ESP 2013) | Oldest data in tableAge-standardised |
Global estimate, 2023 (UNODC World Drug Report 2026). A modelled figure that counts deaths directly and indirectly linked to drug use, including hepatitis C and HIV. Only about 172,500 are direct deaths, so it is not comparable with the rows above.
Act on it
Naloxone Finder
Naloxone reverses opioid overdoses. Enter your ZIP code and see every way to get it near you: free sites, pharmacies, delivery and mail programs. Free to use, no sign-up, and we never ask for an address.
Find naloxoneSources: CDC NCHS · VSRR provisional drug overdose deaths (states, US) · CDC NCHS · VSRR provisional county-level overdose deaths · US Census Bureau · Vintage 2025 county population estimates · PHAC · Opioid- and stimulant-related harms in Canada · ONS · Drug poisoning deaths, England & Wales · NRS · Drug-related deaths in Scotland, 2025 · NISRA · Drug-related deaths in Northern Ireland · Penington Institute · Australia's Annual Overdose Report 2026 · EUDA · European Drug Report 2026 · HRB · Drug poisoning deaths in Ireland, 2022 · UNODC · World Drug Report 2026.
Version 1.1 · updated October 22, 2026 · New CDC release: US states now through May 2026 and counties through March 2026. Clearer dates and wording, and a blue gradient on the fentanyl card.
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