Substance use is a serious concern in Arkansas, with a distinctive story: methamphetamine has now overtaken fentanyl as the drug most often involved in overdose deaths, even as overall deaths have been falling. Key figures:

• Methamphetamine now surpasses fentanyl as the leading drug involved in Arkansas overdose deaths, according to the Arkansas State Crime Lab.
• Meth involvement rose from 47% in 2023 to 54% in 2026 in drug-related deaths.
• Fentanyl involvement fell from 43% to 16% over the same period.
• 389 drug overdose deaths in 2024, down from 516 in 2023, according to the Arkansas Department of Health.
• A 13.7% drop in overdose deaths from 2022 to 2023, faster than the national decline.
• 2024 marked the lowest annual total since 2019.

Arkansas’s crisis has shifted shape. Fentanyl drove deaths for years like much of the country, but methamphetamine has now overtaken it as the dominant drug, even as the state’s overall overdose deaths have been trending downward.

Arkansas expanded Medicaid in 2014 through its unique “Private Option”, which uses Medicaid funds to purchase private insurance plans for newly eligible adults. The Arkansas Department of Human Services coordinates the state’s behavioral health and substance-use services. Of the 100 facilities listed below, 78 accept Medicaid.