States With Highest Rate of Fentanyl Overdoses

Fentanyl is a highly potent synthetic opioid that has been fueling the opioid epidemic in the U.S. for the past decade.^{1, 2} There are two types of fentanyl: prescription fentanyl, which doctors may prescribe to people suffering from severe pain, and illicitly manufactured fentanyl (IMF), which is the type that is primarily responsible for overdose-related harm and death.¹

In 2021, there were nearly 71,000 deaths involving synthetic opioids, mainly fentanyl, in the United States.¹ Fentanyl deaths have increased every year since 2012, and the rate of overdose deaths involving fentanyl in 2021 was almost 22 times the rate in 2013.^{1, 3}

This page highlights important fentanyl stats, including fentanyl use by state and fentanyl overdose by state. It will also help you learn how to seek treatment for fentanyl addiction.

Why Is Fentanyl So Dangerous?

Fentanyl is highly potent and significantly stronger than other opioids.³ It is up to 50 times stronger than heroin and 100 stronger than morphine.¹ Just a small amount of fentanyl can lead to an overdose, depending on a person’s size, tolerance, and previous use.^{3, 4}

In addition to its potency, fentanyl is dangerous because it is often added to other street drugs, including cocaine, heroin, MDMA, and methamphetamine.^{1, 5} Sometimes, people know they are taking drugs that contain fentanyl. However, oftentimes, the danger comes from people being unaware that their drugs are mixed with fentanyl, which can significantly increase the risk of overdose.⁵

Without testing, it can be almost impossible to know if an illicitly obtained pill or powder contains fentanyl.⁴ The Drug Enforcement Administration (DEA) reports that a lethal dose of fentanyl is around two milligrams.⁴

Which States Have the Highest Number of Overdoses?

The top 10 states with the highest number of fentanyl overdose include:³

• California.
• Florida.
• New York.
• Ohio.
• Pennsylvania.
• North Carolina.
• Illinois.
• Tennessee.
• New Jersey.
• Texas.

The above list includes information provided by the Centers for Disease Control (CDC) regarding synthetic opioid overdose deaths, mainly involving fentanyl, by state of residence in 2022.³ This list is based on the total number of deaths, not the rate of deaths. In general, states with higher populations have more total fentanyl overdose deaths.³

Fentanyl Overdoses in California

In 2021, the CDC reported a total of 10, 901 overdose deaths in California.⁶ However, according to provisional stats about fentanyl from 2022, California had the highest total number of overdose deaths from fentanyl out of all states, with a total of 6,453 overdose deaths.³

Fentanyl Overdoses in Florida

In 2021, the CDC reported a total of 7,827 overdose deaths in Florida.⁶ According to provisional fentanyl overdose stats, Florida had the second-highest total number of overdose deaths from fentanyl, with 5,083 deaths in 2022.³

Fentanyl Overdoses in New York

In 2021, the CDC reported a total of 5,842 overdose deaths in New York.⁶ According to provisional data, New York had the third-highest total number of overdose deaths from fentanyl, with 4,950 deaths in 2022.³

Which States Have the Highest Rate of Overdoses?

The top 10 states that have the highest rate of fentanyl overdose include:³

• West Virginia.
• Washington, DC.
• Delaware.
• Maine.
• Tennessee.
• Kentucky.
• Vermont.
• Connecticut.
• Ohio.
• Maryland.

This information is regarding synthetic opioid overdose deaths, mostly fentanyl, by state of residence in 2022.³ These stats regarding fentanyl overdoses by state report the crude death rate per 100,000 people, meaning that these rates are adjusted for population size.³

Finding Treatment for Fentanyl Addiction

If you or a loved one are struggling with fentanyl misuse or addiction, treatment is available and can help you begin the path to recovery.⁸ The first step might be to consult your primary care physician, who can conduct an assessment, provide a diagnosis, and inform you of your treatment options. Fentanyl addiction is diagnosed as an opioid use disorder, or OUD.⁸

Fentanyl addiction treatment may include a variety of interventions, including specific detox medications that can help people safely stop using fentanyl or other drugs, medications to treat OUD, including buprenorphine, methadone, and naltrexone, and evidence-based therapies, such as cognitive-behavioral therapy or contingency management.^{5, 8}

When you’re ready to reach out, please call us at to speak to an admissions navigator about your treatment and rehab options. You can also use our directory tool to find fentanyl addiction treatment near you.