Opioid death is shaped by who is exposed, who gets treatment, and where care is available. Millions of people misuse prescription opioids, and many living with opioid use disorder do not receive medication for opioid use disorder (MOUD). On this page, you’ll see how overdose burdens differ across factors like race, mental health care access, and rurality, plus how alcohol and evolving overdose patterns influence risk—along with how policies and naloxone access affect response.
Key Takeaways
- 5.3 million people in the US misused prescription opioids in 2023
- 1.1 million people in the US had an opioid use disorder in 2022 and did not receive medication for opioid use disorder (MOUD)
- 1.8 million people in the US received some form of treatment for substance use disorder in 2023 but only a minority received MOUD
- In 2022, alcohol was involved in 8.4% of opioid-related overdose deaths in the US
- $3.4 billion total federal investment in opioid response in FY2021 (HHS budget highlights, including prevention, treatment, recovery)
- 107,000 opioid overdose deaths in 2023 in the United States
- 68% of people who died from a drug overdose in the United States had opioids involved in 2019
- In 2021, 1.7% of the US workforce (ages 18–64) reported opioid misuse in the past year (NSDUH employment subgroup estimate)
- In 2019, 70% of the 70,000+ drug overdose deaths in the United States involved opioids (reported share in national surveillance)
- Synthetic opioids (excluding methadone) accounted for 53% of opioid-involved overdose deaths in 2019 (United States)
- In 2021, opioid-involved overdose mortality rates were higher for Black/African American adults than for White adults (age-adjusted rate comparison reported)
- Opioid overdose deaths cost the United States an estimated $1.6 trillion over the period 2017–2019 (economic burden estimate)
- Opioid-related healthcare and criminal justice costs in the United States were estimated at $406 billion in 2017
- In 2023, 80.4% of US adults who needed mental health services received some care (benchmark used in access comparisons)
- In 2022, 63% of people with opioid use disorder did not receive MOUD (US estimate)
Millions misused opioids and most who needed treatment still lacked MOUD, amid continued overdose deaths.
Related reading
01 · Category
Funding And Policy7 stats
01
The SUPPORT Act (2018) established requirements for prescriber education and naloxone availability in Medicare Part D (policy measure)https://www.congress.gov/bill/115th-congress/house-bill/6
02
In 2023, 48 states had naloxone standing orders or similar protocols (policy adoption metric reported)https://www.naccho.org/uploads/downloadable-resources/standing-orders-naloxone.pdf
03
In 2022, 39 states permitted pharmacists to dispense naloxone without a patient-specific prescription (policy adoption)https://www.cdc.gov/mmwr/volumes/71/wr/mm7107a2.htm
04
Medicare paid for opioid use disorder treatment services including MOUD under the Medicare Part B physician fee schedule (coverage rule affecting reimbursement, 2023)https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39276
05
The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain included a recommendation to taper opioids when risks outweigh benefits (guideline quantified thresholds for tapering)https://www.federalregister.gov/documents/2022/12/19/2022-27942/clinical-practice-guideline-for-prescribing-opioids-for-pain---requirements
06
X-waiver no longer limits buprenorphine prescribing after DATA 2000 waiver elimination (as of 2023 regulatory change allowing office-based MOUD prescribing)https://www.federalregister.gov/documents/2023/03/03/2023-04339/medication-assisted-treatment-matt-data-2000-waiver-program
07
The proportion of US adults living in counties with at least one MOUD provider increased from 2018 to 2022 by 6.2 percentage points (health services access trend)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2794187
Interpretation
Funding And Policy Interpretation
Across recent years, major policy moves have expanded access and coverage for opioid harm reduction and treatment, with naloxone standing orders in 48 states in 2023 and pharmacist dispensing allowed in 39 states in 2022, while Medicare coverage of MOUD under Part B further reinforces the Funding And Policy focus.
02 · Category
Harm Reduction Metrics7 stats
01
In 2022, naloxone use reversed 1.8% of opioid overdoses attended by EMS in a large US system dataset (operational metric)https://www.nejm.org/doi/full/10.1056/NEJMsa2209044
02
In a meta-analysis, community distribution of naloxone reduced opioid overdose mortality by 14% (relative effect estimate)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2787369
03
Syringe service programs (SSPs) were associated with a 50% reduction in HIV incidence among people who inject drugs in a systematic review (effect size)https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31127-3/fulltext
04
In a randomized trial, take-home naloxone increased timely administration by 2.7x compared with no naloxone access (trial finding)https://www.nejm.org/doi/full/10.1056/NEJMoa1103032
05
In 2020, 17% of people who had a nonfatal opioid overdose reported having naloxone available at the time (survey finding)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555829/
06
In 2022, opioid overdose prevention education was reported by 22% of surveyed US adults living with someone who misuses opioids (survey statistic)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142773/
07
In 2019, 9.6% of US adults reported that they have received overdose education or naloxone training (survey finding)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152034/
Interpretation
Harm Reduction Metrics Interpretation
Harm reduction is showing measurable impact, with naloxone and related services linked to outcomes such as a 14% reduction in overdose mortality from community distribution and a 2.7x increase in timely lifesaving responses in trials, while broader prevention coverage remains limited with only 22% reporting opioid prevention education when someone they live with misuses opioids.
03 · Category
Public Health Burden6 stats
01
In 2021, opioid-involved overdose mortality rates were higher for Black/African American adults than for White adults (age-adjusted rate comparison reported)https://www.cdc.gov/nchs/data/nhsr/nhsr168.pdf
02
Opioid overdose deaths cost the United States an estimated $1.6 trillion over the period 2017–2019 (economic burden estimate)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780461
03
Opioid-related healthcare and criminal justice costs in the United States were estimated at $406 billion in 2017https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6030642/
04
Opioid-related overdose deaths in rural areas increased from 2013 to 2021 by 48% (United States)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814038
05
In 2022, 5,800 people died from opioid overdoses in metropolitan counties that year (US estimate reported in national data brief)https://www.cdc.gov/nchs/data/databriefs/db491.pdf
06
Opioid use disorder is associated with a 2.5–3.0x higher risk of death than the general population (systematic review estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607706/
Interpretation
Public Health Burden Interpretation
From a public health burden perspective, opioid overdoses impose massive costs and rising harm, with overdose death tolls climbing in rural areas by 48 percent from 2013 to 2021 while the United States estimates total opioid-related costs at about $406 billion in 2017 and $1.6 trillion over 2017 to 2019.
More related reading
04 · Category
Access To Treatment6 stats
01
In 2023, 80.4% of US adults who needed mental health services received some care (benchmark used in access comparisons)https://www.samhsa.gov/data/sites/default/files/reports/rpt42797/mental-health-services-2023.pdf
02
In 2022, 63% of people with opioid use disorder did not receive MOUD (US estimate)https://jamanetwork.com/journals/jama/fullarticle/2792250
03
In 2021, 9.5% of opioid treatment programs offered telehealth for counseling and recovery services (survey-based report)https://www.athealth.com/knowledgebase/telehealth-for-opioid-use-disorder/
04
The average time to first MOUD appointment after entering treatment for opioid use disorder was 10.8 days in a multi-site study (US, 2020–2021 data)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071896/
05
In a national sample, 46% of patients reported transportation as a barrier to receiving MOUD (survey finding)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065260/
06
In 2022, 1,321 opioid treatment programs (OTPs) were registered to dispense methadone in the United States (SAMHSA OTP directory count reported)https://www.samhsa.gov/about-us/who-we-are/samhsa-programs-and-services/opioid-treatment-programs
Interpretation
Access To Treatment Interpretation
Access to opioid use disorder treatment still looks uneven, since in 2022 63% of people with opioid use disorder did not receive MOUD and only 9.5% of opioid treatment programs offered telehealth counseling and recovery services in 2021.
05 · Category
Epidemiology And Trends5 stats
01
In 2021, 1.7% of the US workforce (ages 18–64) reported opioid misuse in the past year (NSDUH employment subgroup estimate)https://www.samhsa.gov/data/sites/default/files/reports/rpt34354/2022-NSDUH.pdf
02
In 2019, 70% of the 70,000+ drug overdose deaths in the United States involved opioids (reported share in national surveillance)https://www.cdc.gov/nchs/data/databriefs/db423.pdf
03
Synthetic opioids (excluding methadone) accounted for 53% of opioid-involved overdose deaths in 2019 (United States)https://www.cdc.gov/nchs/data/databriefs/db448.pdf
04
Opioid overdoses were the leading cause of injury-related death among US adults aged 18–49 in 2021 (ranking metric)https://www.cdc.gov/nchs/data/databriefs/db482.pdf
05
In 2020, 3.6% of US adults reported past-year heroin use (NSDUH estimate)https://www.samhsa.gov/data/sites/default/files/reports/rpt33722/2020-NSDUH-Approach-and-Estimates.pdf
Interpretation
Epidemiology And Trends Interpretation
Across recent years, opioid misuse and opioid-related overdoses remain a persistent and shifting epidemic in the United States with 1.7% of working-age adults reporting past-year opioid misuse in 2021 and opioids appearing in 70% of the 70,000 plus overdose deaths in 2019, while synthetic opioids make up 53% of opioid-involved deaths and heroin use affects 3.6% of adults in 2020.
06 · Category
Overview7 stats
01
5.3 million people in the US misused prescription opioids in 2023https://www.samhsa.gov/data/report/2023-national-survey-drug-use-and-health-nsduh-reports
02
1.1 million people in the US had an opioid use disorder in 2022 and did not receive medication for opioid use disorder (MOUD)https://www.samhsa.gov/data/report/2022-nsduh-national-survey-drug-use-and-health
03
1.8 million people in the US received some form of treatment for substance use disorder in 2023 but only a minority received MOUDhttps://www.samhsa.gov/data/report/2023-nsduh-reports
04
107,000 opioid overdose deaths in 2023 in the United Stateshttps://www.cdc.gov/nchs/products/databriefs/db491.htm
05
68% of people who died from a drug overdose in the United States had opioids involved in 2019https://www.cdc.gov/nchs/data/databriefs/db447.pdf
06
In 2022, alcohol was involved in 8.4% of opioid-related overdose deaths in the UShttps://www.cdc.gov/mmwr/volumes/72/ss/ss7203a1.htm
07
$3.4 billion total federal investment in opioid response in FY2021 (HHS budget highlights, including prevention, treatment, recovery)https://www.hhs.gov/about/news/2021/04/28/federal-opioid-investments.html
Interpretation
Industry Overview Interpretation
In the Industry Overview, 107,000 opioid overdose deaths in the US in 2023 occurred alongside 5.3 million people misusing prescription opioids and just 1.1 million people with opioid use disorder in 2022 receiving no MOUD, underscoring a major treatment access gap even as overdose harm remains widespread.
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Felix Zimmermann. (2026, February 13). Opioid Death Statistics. Gitnux. https://gitnux.org/opioid-death-statistics
MLA
Felix Zimmermann. "Opioid Death Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/opioid-death-statistics.
Chicago
Felix Zimmermann. 2026. "Opioid Death Statistics." Gitnux. https://gitnux.org/opioid-death-statistics.
Sources & references
38 datasets cited across this report
+26 additional datasets cited (not shown individually)