More Americans are dying from drug overdoses than ever before. There were an estimated 100,306 fatal overdoses over the 12 months through April 2021 — the most ever reported in a 12-month period and more than double the annual number of car accidents and firearm deaths combined. 

The record number of deadly overdoses marks a 29% increase from the same period a year earlier and is more than double the number reported as recently as 2014. Public health experts attribute the surge to the proliferation of fentanyl — a synthetic opioid reported to be 50 to 100 times more potent than morphine — as well as the COVID-19 pandemic. The pandemic has isolated many Americans struggling with addiction while reducing their treatment options and care resources. 

While no corner of the country has been spared from the scourge of substance abuse and addiction, overdose deaths during the COVID-19 pandemic have hit some states especially hard. 

Using data from the Centers for Disease Control and Prevention, 24/7 Wall St. identified the states where fatal overdoses are rising fastest. States are ranked on the change in deadly overdoses between the 12 months through April 2021 and the same period one year earlier. 

The year-over-year change in overdose deaths varies considerably by state. Only four states reported a decline in overdose deaths, while in 11 states, fatal overdoses spiked by over 45%. Most of the states with the largest increases in overdose deaths are located in the South. Similarly, most of the states with the highest overdose rates — overdose deaths per 100,000 people — are also in the South. 

The surge in overdose deaths nationwide was driven by synthetic opioids, a drug classification that includes fentanyl. Overdose deaths increased in other drug classifications as well, including natural and semi-synthetic opioids, cocaine, and methadone — a drug used to treat heroin and opioid addiction. Heroin was the only drug classification identified by the CDC with a decline in fatal overdoses nationwide. Here is a look at the 25 most dangerous drugs. 

Click here to see the states where fatal drug overdoses are rising the fastest
Click here to read our detailed methodology