Substance use is a serious concern in Maryland, though the state has seen overdose deaths fall for four straight years to a 10-year low. Key figures:

• Overdose deaths have fallen for four straight years, reaching a 10-year low, according to the Office of Governor Wes Moore.
• Fentanyl-related deaths decreased 31%, from 1,314 in 2024 to 906 in 2025.
• Opioid deaths are down 57% since the pandemic peak.
• 2,348 overdose deaths from April 2023 to April 2024.
• Decreases were seen across all major drug categories and demographic groups.
• Fentanyl still drives much of the remaining risk.

Maryland’s turnaround is one of the strongest in the nation. After peaking during the pandemic, overdose deaths have declined for four consecutive years, with fentanyl deaths falling sharply, even as the drug remains the leading threat.

Maryland expanded Medicaid in 2014 under the Affordable Care Act. The state’s Behavioral Health Administration, under the Department of Health, oversees substance use treatment. Of the 427 facilities listed below, 382 accept Medicaid.