Substance use is a serious concern in Illinois, where fentanyl drove a massive surge over the past decade, though deaths have recently begun to fall. Key figures:

• 26 opioid overdose deaths per 100,000 people in 2022, according to the Illinois Department of Public Health.
• Illinois ranked 29th nationally for drug overdose deaths, in the middle of the pack.
• Synthetic opioid (fentanyl) deaths increased 3,341% since 2013.
• Overdose deaths declined 8% in 2023.
• Fentanyl-related deaths decreased 9.5% in 2023.
• Fentanyl now dominates the crisis after the decade-long surge.

Illinois’s crisis followed a dramatic arc. Fentanyl deaths exploded by more than 3,000% over the past decade before the state finally saw a decline in 2023, with overall overdose deaths falling 8%.

Illinois expanded Medicaid in 2014 under the Affordable Care Act. The state’s Division of Substance Use Prevention and Recovery (SUPR), under the Department of Human Services, oversees substance use treatment, much of which is covered by Illinois Medicaid. Of the 560 facilities listed below, 384 accept Medicaid.