Substance use is a serious concern in Alaska, driven by a mix of opioids and stimulants. Fentanyl and methamphetamine have pushed overdose deaths to record highs in recent years. Key figures:

• 49.5 drug overdose deaths per 100,000 people in 2023, up sharply from 33.7 in 2022 and well above the national rate of about 31.3, according to the CDC.
• One of the fastest-rising rates in the nation in 2023, when Alaska was among only six states where the overdose rate increased.
• 286 opioid overdose deaths in 2023, the deadliest year on record, according to the Alaska Department of Health.
• 74% of overdose deaths involved fentanyl, which has replaced heroin as the primary opioid behind fatal overdoses.
• 633 opioid-involved deaths from 2018 through 2022.
• Methamphetamine is the other major driver, fueling the crisis alongside fentanyl.

Fentanyl’s arrival transformed the crisis. Until a few years ago, heroin was the main opioid behind fatal overdoses in Alaska, but fentanyl now dominates, while methamphetamine has re-emerged as a major factor.

Alaska expanded Medicaid in September 2015, so most low-income adults can qualify for coverage through the state’s Medicaid program. The Alaska Department of Health’s Division of Behavioral Health coordinates the state’s mental health and substance-use services. Of the 79 facilities listed below, 72 accept Medicaid, reflecting how central the program is to paying for treatment here.