City in Every State With the Most Fatal Overdoses

In recent years, the opioid crisis has shed a startling light on how drug overdoses affect the United States. While drug overdoses can be either accidental or intentional, the mortality rate continues to rise. In 1999, less than 20,000 people died from overdoses, while in 2021, nearly 107,000 people lost their lives to drug overdoses according to the National Center for Health Statistics.

These numbers are expected to continue rising, too. The Centers for Disease Control and Prevention noted a 14% increase in mortality rate between 2020 and 2021. And, while the organization does not yet have firm numbers from 2023, it predicted 112,962 deaths across the country by June of that year.

Additionally, the CDC has provided a breakdown of drug overdoses by state. However, this information is only updated through 2021. It also only lists each state’s mortality rate, not city or metro names, which is what we aim to do here.

From Reno, Nevada to Casper, Wyoming, the list below indicates which city in each state has the highest overdose rate. According to this information which was obtained through the 2023 County Health Rankings, West Virginia has the highest overdose rate per 100,000 people. The area surrounding Beckley has an overdose rate of 87, compared to other areas like Bismarck, North Dakota where the overdose rate is only 9. For similar reading, you can check out the city in every state with the shortest life expectancy. (Also See This Is the Drunkest City in the US: Ranking America’s Top 50)

Alabama

• Metro area with most overdoses: Birmingham-Hoover
• Overdoses in city per 100,000 people 28
• Overdoses in state per 100,000 people: 17

Alaska

• Metro area with most overdoses: Anchorage
• Overdoses in city per 100,000 people 21
• Overdoses in state per 100,000 people: 18

Arizona

• Metro area with most overdoses: Prescott Valley-Prescott
• Overdoses in city per 100,000 people 33
• Overdoses in state per 100,000 people: 28

Arkansas

• Metro area with most overdoses: Hot Springs
• Overdoses in city per 100,000 people 29
• Overdoses in state per 100,000 people: 15

California

• Metro area with most overdoses: Bakersfield
• Overdoses in city per 100,000 people 32
• Overdoses in state per 100,000 people: 17

Colorado

• Metro area with most overdoses: Pueblo
• Overdoses in city per 100,000 people 35
• Overdoses in state per 100,000 people: 21

Connecticut

• Metro area with most overdoses: Norwich-New London
• Overdoses in city per 100,000 people 41
• Overdoses in state per 100,000 people: 34

Delaware

• Metro area with most overdoses: Dover
• Overdoses in city per 100,000 people 36
• Overdoses in state per 100,000 people: 44

Florida

• Metro area with most overdoses: Palm Bay-Melbourne-Titusville
• Overdoses in city per 100,000 people 51
• Overdoses in state per 100,000 people: 27

Georgia

• Metro area with most overdoses: Rome
• Overdoses in city per 100,000 people 20
• Overdoses in state per 100,000 people: 15

Hawaii

• Metro area with most overdoses: Urban Honolulu
• Overdoses in city per 100,000 people 18
• Overdoses in state per 100,000 people: 17

Idaho

• Metro area with most overdoses: Twin Falls
• Overdoses in city per 100,000 people 26
• Overdoses in state per 100,000 people: 15

Illinois

• Metro area with most overdoses: Rockford
• Overdoses in city per 100,000 people 44
• Overdoses in state per 100,000 people: 24

Indiana

• Metro area with most overdoses: Muncie
• Overdoses in city per 100,000 people 42
• Overdoses in state per 100,000 people: 28

Iowa

• Metro area with most overdoses: Des Moines-West Des Moines
• Overdoses in city per 100,000 people 17
• Overdoses in state per 100,000 people: 11

Kansas

• Metro area with most overdoses: Wichita
• Overdoses in city per 100,000 people 22
• Overdoses in state per 100,000 people: 14

Kentucky

• Metro area with most overdoses: Lexington-Fayette
• Overdoses in city per 100,000 people 42
• Overdoses in state per 100,000 people: 36

Louisiana

• Metro area with most overdoses: New Orleans-Metairie
• Overdoses in city per 100,000 people 46
• Overdoses in state per 100,000 people: 31

Maine

• Metro area with most overdoses: Bangor
• Overdoses in city per 100,000 people 40
• Overdoses in state per 100,000 people: 30

Maryland

• Metro area with most overdoses: Baltimore-Columbia-Towson
• Overdoses in city per 100,000 people 59
• Overdoses in state per 100,000 people: 41

Massachusetts

• Metro area with most overdoses: Pittsfield
• Overdoses in city per 100,000 people 45
• Overdoses in state per 100,000 people: 33

Michigan

• Metro area with most overdoses: Flint
• Overdoses in city per 100,000 people 48
• Overdoses in state per 100,000 people: 26

Minnesota

• Metro area with most overdoses: Rochester
• Overdoses in city per 100,000 people 14
• Overdoses in state per 100,000 people: 15

Mississippi

• Metro area with most overdoses: Gulfport-Biloxi
• Overdoses in city per 100,000 people 25
• Overdoses in state per 100,000 people: 14

Missouri

• Metro area with most overdoses: Springfield
• Overdoses in city per 100,000 people 24
• Overdoses in state per 100,000 people: 28

Montana

• Metro area with most overdoses: Billings
• Overdoses in city per 100,000 people 20
• Overdoses in state per 100,000 people: 13

Nebraska

• Metro area with most overdoses: Lincoln
• Overdoses in city per 100,000 people 11
• Overdoses in state per 100,000 people: 9

Nevada

• Metro area with most overdoses: Reno
• Overdoses in city per 100,000 people 28
• Overdoses in state per 100,000 people: 23

New Hampshire

• Metro area with most overdoses: Manchester-Nashua
• Overdoses in city per 100,000 people 35
• Overdoses in state per 100,000 people: 31

New Jersey

• Metro area with most overdoses: Vineland-Bridgeton
• Overdoses in city per 100,000 people 59
• Overdoses in state per 100,000 people: 32

New Mexico

• Metro area with most overdoses: Albuquerque
• Overdoses in city per 100,000 people 36
• Overdoses in state per 100,000 people: 30

New York

• Metro area with most overdoses: Kingston
• Overdoses in city per 100,000 people 34
• Overdoses in state per 100,000 people: 21

North Carolina

• Metro area with most overdoses: New Bern
• Overdoses in city per 100,000 people 44
• Overdoses in state per 100,000 people: 24

North Dakota

• Metro area with most overdoses: Bismarck
• Overdoses in city per 100,000 people 9
• Overdoses in state per 100,000 people: 12

Ohio

• Metro area with most overdoses: Springfield
• Overdoses in city per 100,000 people 48
• Overdoses in state per 100,000 people: 38

Oklahoma

• Metro area with most overdoses: Lawton
• Overdoses in city per 100,000 people 20
• Overdoses in state per 100,000 people: 18

Oregon

• Metro area with most overdoses: Grants Pass
• Overdoses in city per 100,000 people 24
• Overdoses in state per 100,000 people: 16

Pennsylvania

• Metro area with most overdoses: Johnstown
• Overdoses in city per 100,000 people 50
• Overdoses in state per 100,000 people: 36

South Carolina

• Metro area with most overdoses: Greenville-Anderson
• Overdoses in city per 100,000 people 29
• Overdoses in state per 100,000 people: 26

South Dakota

• Metro area with most overdoses: Sioux Falls
• Overdoses in city per 100,000 people 13
• Overdoses in state per 100,000 people: 8

Tennessee

• Metro area with most overdoses: Knoxville
• Overdoses in city per 100,000 people 51
• Overdoses in state per 100,000 people: 34

Texas

• Metro area with most overdoses: Corpus Christi
• Overdoses in city per 100,000 people 17
• Overdoses in state per 100,000 people: 12

Utah

• Metro area with most overdoses: Salt Lake City
• Overdoses in city per 100,000 people 22
• Overdoses in state per 100,000 people: 19

Vermont

• Metro area with most overdoses: Burlington-South Burlington
• Overdoses in city per 100,000 people 16
• Overdoses in state per 100,000 people: 25

Virginia

• Metro area with most overdoses: Roanoke
• Overdoses in city per 100,000 people 37
• Overdoses in state per 100,000 people: 20

Washington

• Metro area with most overdoses: Yakima
• Overdoses in city per 100,000 people 21
• Overdoses in state per 100,000 people: 18

West Virginia

• Metro area with most overdoses: Beckley
• Overdoses in city per 100,000 people 87
• Overdoses in state per 100,000 people: 57

Wisconsin

• Metro area with most overdoses: Milwaukee-Waukesha
• Overdoses in city per 100,000 people 34
• Overdoses in state per 100,000 people: 22

Wyoming

• Metro area with most overdoses: Casper
• Overdoses in city per 100,000 people 18
• Overdoses in state per 100,000 people: 14