Substance use is a serious concern in Idaho, driven by a sharp surge in fentanyl, though the state’s overdose rate remains below the national average. Key figures:

• 20 drug overdose deaths per 100,000 people in 2023, a historic peak but below the national average.
• Fentanyl deaths surged roughly tenfold from 2012 to 2023.
• The fentanyl overdose rate peaked at 10.0 per 100,000 in 2023, then fell 36% in 2024, according to the Idaho State Police.
• Methamphetamine deaths increased 4.2-fold since 2013.
• Synthetic opioid (fentanyl) deaths rose 5.8-fold since 2016.
• Idaho’s overall overdose rate remains below the national average.

Idaho’s crisis is relatively recent but sharp. Fentanyl deaths exploded over the past decade before peaking in 2023 and beginning to fall, while methamphetamine use has also climbed.

Idaho expanded Medicaid in 2020 after voters approved it by ballot initiative in 2018, extending coverage to adults up to 138% of the federal poverty level. The Idaho Department of Health and Welfare administers the program. Of the 82 facilities listed below, 76 accept Medicaid.