CDC's provisional death certificate data now cover all of 2025. 70,646 people died of drug overdoses in the United States in the 12 months ending December 2025, down from 80,860 in 2024 and 106,881 in 2023. We turned the state figures into five charts.
Where deaths rose
Deaths fell in 43 of 51 places (the 50 states and DC). They rose in eight, all in the West and Midwest: New Mexico, Arizona, Colorado, North Dakota, Minnesota, Montana, South Dakota and Nebraska. Deaths rose most in New Mexico, by 22.6%, and in Arizona, by 17.7%. Rhode Island had the largest fall, 34.2%. See the change for every state.
Highest and lowest rates
Per 100,000 people, the District of Columbia had the highest overdose death rate, 51.0, followed by New Mexico (45.2) and Alaska (44.9). Nebraska had the lowest, 7.2; the US rate was 20.7. By count, California led with 9,049 deaths. Death rates by state · Deaths by state.
Fentanyl and meth
Synthetic opioids, the category that includes fentanyl, were involved in 38,462 deaths, 54.4% of the total, and these deaths fell 21.0%, faster than overdose deaths overall. Psychostimulants such as methamphetamine were involved in 26,260 (37.2%). Alaska had the highest stimulant death rate and the second-highest fentanyl rate. Fentanyl death rates · Meth death rates.
The ten highest rates
| State | Deaths 2025 | Per 100,000 | Change vs 2024 |
|---|---|---|---|
| District of Columbia | 354 | 51.0 | -13.2% |
| New Mexico | 961 | 45.2 | +22.6% |
| Alaska | 331 | 44.9 | -2.4% |
| Arizona | 2,978 | 39.1 | +17.7% |
| West Virginia | 682 | 38.6 | -16.7% |
| Nevada | 1,230 | 37.5 | -16.5% |
| Washington | 2,968 | 37.1 | -6.8% |
| Delaware | 327 | 30.9 | -6.8% |
| Colorado | 1,819 | 30.3 | +10.9% |
| Tennessee | 2,132 | 29.1 | -16.6% |
About the data
The counts are CDC's provisional figures (NCHS Vital Statistics Rapid Release) for the 12 months ending in December, by the state where the death occurred. Final figures are by state of residence and exclude foreign residents, so they differ slightly: for 2024 the provisional total was 80,860 and the final one 79,384. New York adds CDC's separate New York City figure. Rates are our own calculation using BEA population estimates and are not age-adjusted. Louisiana and Nevada have no drug-specific counts in this dataset. For state crime rates in 2025, see our crime post.