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Drug overdoses are the leading cause of injury deaths in the United States1

Over 63,900 individuals died from drug overdoses in 2016, an increase of more than 11,500 deaths from 2015.2 More than six out of 10 drug deaths involve an opioid, primarily prescription pain relievers (morphine, oxycodone, hydrocodone) or heroin.3













There were five times as many opioid-related overdose deaths in 2016 than in 1999, and opioid prescriptions have quadrupled.4 The effects of drug abuse and overdoses can be devastating as well as costly to society, burdening individuals, their families, the health care system and the economy. A 2017 report from the Council of Economic Advisors estimates the total cost of the opioid epidemic in the United States was between $293.9 billion and $622.1 billion in 2015.6
The rate of drug deaths varies based on geography and subpopulation.6 During 2014–2016, drug deaths were
  • 6.1 times higher in West Virginia than in Nebraska (41.4 deaths per 100,000 population, compared with 6.8 deaths per 100,000)
  • 2.3 times higher among whites than Hispanics (18.9 deaths per 100,000, compared with 8.1 deaths per 100,000)
  • 1.4 times higher among whites than blacks (18.9 deaths per 100,000, compared with 13.5 deaths per 100,000)

Spotlight: North Dakota

Sharp Rise in Drug Death Rate Increases Urgency to Act

During 2014–2016 the drug death rate in North Dakota was 8.3 deaths per 100,000 population.6 While the rate of drug deaths is lower in North Dakota than in the nation overall, the drug death rate in this state is rising sharply. North Dakota has experienced a 45.6 percent increase in drug deaths since the 2017 edition of America’s Health Rankings Annual Report and the rate of drug deaths has more than doubled since the 2015 edition. 70 percent of drug overdose deaths in North Dakota were due to opioids in 2016, compared with 66 percent of overdose deaths in the nation.7












North Dakota has unique challenges.
  • It is one of the least populated states and is primarily rural. As a result, finding a suitable drug treatment center within a reasonable travel distance can be a challenge.8
  • North Dakota has a larger American Indian/Alaska Native population than most states,9 and the drug death rate is highest among this group. The drug death rate among American Indian/Alaska Natives in North Dakota was more than three-fold higher than whites (24.2 deaths per 100,000, compared with 7.6 per 100,000) during 2014–2016.6
Partnering with communities to identify and help address their needs is an important step toward addressing drug deaths in North Dakota.

Partnership in Action: Supporting Substance Abuse Treatment, Long-term Recovery and Wellness

Cankdeska Cikana Community College (CCCC) and the United Health Foundation announced a partnership in February 2018 to expand access to substance abuse (including opioid abuse) treatment and support long-term recovery and wellness in the Spirit Lake Dakota community, North Dakota. CCCC conducted a comprehensive assessment that found members of the community identified access to substance abuse treatment facilities as the greatest community health care need, and the Spirit Lake Tribal Council has declared a state of emergency related to substance abuse.
The new partnership will support the construction and launch of a new facility. This will include the conversion of a former group home into a residential substance abuse treatment center for adults in the Spirit Lake Dakota community. The partnership will provide in-kind expertise and counsel to develop a culturally competent staffing model and cultivate a workforce pipeline for effectively delivering addiction treatment and prevention services in a rural setting.
The Cankdeska Cikana Community College is implementing the grant in coordination with the existing Spirit Lake Recovery & Wellness Program and the college’s own students and faculty. Students and faculty from the College’s construction trades department will support renovation activities, and Spirit Lake Recovery & Wellness employees will staff the new residential treatment center.
[1] U.S. Department of Justice Drug Enforcement Administration. 2016 National Drug Threat Assessment Summary. [2] Centers for Disease Control and Prevention. Provisional Drug Overdose Death Counts. [3] Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-related Risks and Outcomes, 2017. [4] Centers for Disease Control and Prevention. Prescription Opioid Overdose Data. [5] Council of Economic Advisors. The Underestimated Cost of the Opioid Crisis. [6] Centers for Disease Control and Prevention. National Vital Statistics System 2014-2016 [7] Kaiser Family Foundation. Opioid Overdose Deaths and Opioid Overdose Deaths as a Percentage of All Drug Overdose Deaths. [8] The Treatment Center. Addiction Facts by State: North Dakota. [9] U.S. Census Bureau. Quick Factors: North Dakota.

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