Growth in drug overdose death rates by state, 2014-2024
CDC drug overdose deaths and death rates for all 50 states in 2014 and 2024, on three bases: age-adjusted final rates, crude final rates, and crude rates from 2024 provisional counts. Includes each state's yearly age-adjusted rate for 2014-2024, Washington's and the U.S. yearly rates, and Washington deaths involving synthetic opioids (mainly fentanyl), 2019-2024.
Coverage: 2014 and 2024 for the state comparison; yearly 2014-2024 for age-adjusted rates; 2019-2024 for Washington drug-specific counts.
Assembled to test the Washington Policy Center claim, in its March 2026 report "Homelessness in Washington State", that Washington had the highest growth in per-capita drug overdose deaths of any state from 2014 to 2024 (188%), rising from 29th to 4th. Every state is included so the ranking can be checked, and the three rate bases show whether the ranking depends on method.
Geography
United States, All 50 states, Washington
Unit of observation
State (2014 vs 2024 comparison); state-year (yearly rates); year (Washington drug-specific counts).
Update cadence
One-time release. CDC publishes final 2025 data in late 2026.
Curator
FactHub Research Team
Curated data tables
These related tables form this versioned dataset release. Each
table has its own downloadable file and field definitions.
Overdose deaths and rates by state, 2014 and 2024
All 50 states. 2014 from CDC xbxb-epbu; 2024 final from the CDC state map file; 2024 provisional from CDC VSRR; 2024 population from Census Vintage 2024. Ranks: 1 = highest, ties share the higher rank.
Structured results of every saved analysis, as JSON keyed by analysis id.
Saved analyses
Change in age-adjusted overdose death rate by state, 2014-2024
Question: Which states had the largest growth in overdose death rates from 2014 to 2024?
Result: Washington had the largest increase on all three bases: +182.7% age-adjusted, +185.1% crude (final) and +188.5% crude (provisional 2024). Alaska and Oregon were 2nd and 3rd on every basis. The U.S. rose 57.1% (age-adjusted).
Operation: For each state, percent change in the age-adjusted rate from 2014 to 2024, with the same change on crude final and crude provisional bases; ranked by the age-adjusted change. stateRanked prefixes the rank so charts list states in order.
Scope: All 50 states (District of Columbia excluded, as in the claim).
Alternative comparison:Increase in overdose death rate in deaths per 100,000, 2014-2024.
Measured as deaths added per 100,000 instead of percent change, Washington ranks 2nd behind Alaska on final data (+24.3 vs +28.3, age-adjusted). Its 1st place holds only for percentage growth.
Washington's rate, rank and growth on three bases
Question: Does Washington's ranking depend on how the rate is measured?
Result: Washington ranked 32nd (age-adjusted) or 29th (crude) in 2014, and 3rd on final 2024 data or 4th on provisional 2024 counts. Its growth ranked 1st on every basis: 182.7%, 185.1% and 188.5%.
Operation: Select Washington's 2014 and 2024 rates, ranks and growth for age-adjusted final, crude final, and crude provisional 2024 rates.
Question: Which states had the highest overdose death rates in 2024?
Result: On final data, West Virginia, Alaska and Washington had the three highest rates in 2024 (age-adjusted 48.9, 45.1 and 37.6). On provisional counts by place of death, Nevada moves to 2nd and Washington to 4th.
Operation: Top five states by 2024 age-adjusted final, crude final and crude provisional rate.
Final and provisional counts differ in coverage (residence vs place of death).
Washington's growth rank for different start and end years
Question: Is Washington 1st in growth for other time windows?
Result: Washington ranks 1st for 2014-2024 and 2014-2023 (where it ties Oregon to the first decimal), but 3rd behind Alaska and Oregon for 2015-2024, 2019-2024 and 2020-2024. From 2014 to 2019, before fentanyl spread west, Washington's growth ranked 35th.
Operation: For each window, percent change in age-adjusted rate for all 50 states; Washington's change and rank, and the top three.
Question: Was fast growth concentrated in western states?
Result: The median western state rose 79.4%, against 52.1% elsewhere. The three fastest risers (Washington, Alaska, Oregon) are all western.
Operation: Median 2014-2024 percent change in age-adjusted rate for the 13 Census West states and the other 37, and how many of each are in the top five.
Region is a rough stand-in for when fentanyl reached each drug market; it is not a measure of fentanyl supply.
Washington and U.S. age-adjusted overdose death rates, 2014-2024
Question: When did Washington's rise happen, compared with the nation's?
Result: Washington stayed between 13.3 and 15.8 per 100,000 from 2014 to 2019, below the U.S. rate, then rose to 22.0 in 2020, 42.4 in 2023 and 37.6 in 2024. The U.S. rate peaked at 32.6 in 2022 and fell to 23.1 in 2024.
Operation: Select yearly age-adjusted rates for Washington and the U.S.
Washington deaths involving synthetic opioids, 2019-2024
Question: How much of Washington's rise involved fentanyl-type drugs?
Result: Deaths involving synthetic opioids (mainly fentanyl) doubled from 328 in 2019 to 661 in 2020, before State v. Blake, and reached 2,687 in 2023. Their share of all overdose deaths rose from 26% to 77%.
Operation: Select provisional December 12-month counts for all overdoses and for synthetic opioids other than methadone; compute the share.
Drug involvement depends on toxicology testing, which improved over the period.
Increase in overdose death rate in deaths per 100,000, 2014-2024
Question: Does Washington also lead when growth is measured as deaths added per 100,000 people rather than as a percentage?
Result: Measured as deaths added per 100,000, Alaska rose most (+28.3 age-adjusted), and Washington was 2nd (+24.3) on final data. On provisional counts Nevada also passes Washington, which is 3rd. Washington leads only on percentage growth, because it started from a lower rate.
Operation: For each state and each of the three rate bases, subtract the 2014 rate from the 2024 rate; report Washington's increase, its rank and the top three.
Absolute increases favor states that started high; percentage increases favor states that started low. Neither is the single correct measure of growth.
188.5 percent change in per-capita rate, 2014-2024
+0.5 percent change in per-capita rate, 2014-2024
FactHub's value is on the report's basis (crude rates, 2024 provisional counts). On final data the growth is 185.1% (crude) or 182.7% (age-adjusted), still 1st.
Statements on record
Exact quotes, unaltered, with what surrounded them, the primary
source, and an archived copy of it.
“Washington is #1 in the nation for growth of per-capita overdose deaths, 188% above its 2014 level, with growth 196% above the national average.”
Eric Zimmerman, Author of the Washington Policy Center report; mayor of Normandy Park, Washington
Washington Policy Center report "Homelessness in Washington State", executive summary, page 3 ·
·
Assertion
Context: The sentence opens a paragraph on outliers in drug use and overdoses. The summary's first page lists the same finding as "the 1st highest growth of per-capita overdose deaths (2014-2024)". The full report states the figure uses crude rates from CDC WONDER for 2014 and NVSS provisional data for 2024. The report is dated March 2026; the day shown here stands for that month. Washington Policy Center posted it on April 17, 2026.
“In 2014, we were 29th in the country, according to the CDC, for drug overdose deaths per capita.”
Eric Zimmerman, Author of the Washington Policy Center report; mayor of Normandy Park, Washington
Interview on The John Curley Show, KIRO Newsradio, reported on MyNorthwest ·
·
Assertion
Context: Zimmerman was explaining his argument that drug use, not rent, best explains Washington homelessness. He went on to say Washington was fourth in 2024 among 50 states and had the most growth of any state.
“Similarly, if fentanyl potency mostly drives DPD rates, because fentanyl is available nationally it is difficult to explain Washington's nationally outlier rates of fentanyl overdoses seen in ERs”
Eric Zimmerman, Author of the Washington Policy Center report
Washington Policy Center report "Homelessness in Washington State", page 10 ·
·
Assertion
Context: DPD is the report's abbreviation for drug poisoning deaths. The report argues that fentanyl's potency alone does not explain Washington's outlier status and that drug proliferation, which it links to policy, also matters. The sentence continues by citing overdose deaths among Black Washingtonians and methamphetamine use.
“Policy shocks occur during this period in the form of Martin v. Boise (2018), Johnson v. Grant's Pass (2022), and State v. Blake (2021).”
Eric Zimmerman, Author of the Washington Policy Center report
Washington Policy Center report "Homelessness in Washington State", page 38 ·
·
Assertion
Context: The passage describes a 2018-2020 surge in fentanyl and other drugs, then lists court rulings the report calls policy shocks that strained public systems. The report presents its causal account as a theory ("we theorize") and elsewhere scores states on how they treat drug possession.
Retrieved November 3, 2026. Public domain (U.S. government work). Permitted
Reliability:
Government.
NCHS builds these figures from every death certificate filed in the U.S. through the National Vital Statistics System, the same data CDC WONDER serves. Deaths are counted by state of residence.
Retrieved October 18, 2026. Public domain (U.S. government work). Permitted
Reliability:
Government.
Official NCHS state statistics from final National Vital Statistics System mortality files, age-adjusted to the 2000 U.S. standard population.
Retrieved October 18, 2026. Public domain (U.S. government work). Permitted
Reliability:
Government.
Provisional death-certificate counts by state where the death happened, updated monthly; predicted values adjust for reporting delays.
Retrieved November 3, 2026. All rights reserved (quoted for review). Linked, not hosted.
Reliability:
Advocacy group.
Has a stake in this finding. Washington Policy Center is a free-market think tank. The report argues that drug use and drug policy, more than rent, drive Washington homelessness, so the overdose ranking supports its thesis.
Retrieved November 3, 2026. All rights reserved (quoted for review). Linked, not hosted.
Reliability:
Advocacy group.
Has a stake in this finding. Same report as the executive summary; its method pages state that 2014-2024 growth uses crude rates and 2024 projected (provisional) counts.
Retrieved November 3, 2026. All rights reserved (quoted for review). Linked, not hosted.
Reliability:
News report.
Article by host John Curley quoting Zimmerman directly, July 19, 2026.
Limitations and reproducibility
Reproducible: build.js (Node.js, no dependencies) rebuilds every table and saved-analysis result from the CDC and Census files listed in sources, fetched October 18 to November 3, 2026. U.S. 2024 final figures are typed from NCHS Data Brief 549.
Age-adjusted rates (CDC's standard for comparing states) and crude rates (deaths divided by population) rank states slightly differently. Washington's 2014 rank is 32nd on age-adjusted rates and 29th on crude rates.
Final CDC counts are by state of residence. The 2024 provisional counts are by the state where the death happened, so states with many visitors, such as Nevada, show higher provisional rates (Nevada: 1,510 provisional vs 1,237 final deaths in 2024).
CDC's state map data file (Drug_Overdose_dfe.json) swaps Arizona's and Arkansas's 2014 values: it shows Arizona with 356 deaths and Arkansas with 1,211. CDC's detailed table (data.cdc.gov xbxb-epbu) has Arizona 1,211 and Arkansas 356, consistent with both states' other years. This dataset uses the detailed table for every 2014 value. With the map file's values, Arizona would wrongly rank 4th in growth.
2024 crude rates use Census Bureau Vintage 2024 population estimates; CDC WONDER may use a slightly different population vintage, which can move crude rates by about 0.1 per 100,000.
Growth rankings depend on the start year. Washington ranks 1st from 2014 but 3rd, behind Alaska and Oregon, for windows starting in 2015, 2019 or 2020.
These are descriptive counts and rates. Nothing in this dataset estimates the effect of State v. Blake, drug possession laws or any other policy.
Washington's first place is in percentage growth. Measured as deaths added per 100,000, Alaska rose more (+28.3 vs +24.3, age-adjusted).
states-2014-2024.csv
text/csv · 5.7 KB (5,838 bytes)
