Substance use is a serious concern in Massachusetts, a state hit hard by the opioid epidemic, though deaths are now falling at their fastest rate in over a decade. Key figures:

• 30.2 drug overdose deaths per 100,000 people in 2023, down from 33.5 in 2022.
• Opioid overdose deaths decreased 10% in 2023, the largest single-year decline since 2009-2010, according to the Massachusetts Department of Public Health.
• Fentanyl was present in 90% of opioid-related deaths.
• Cocaine was present in 54% of opioid-related deaths.
• 1,971 opioid-related overdose deaths in 2023.
• The decline continued into 2024.

Massachusetts was one of the original epicenters of the opioid crisis, and fentanyl now drives nearly all of its overdose deaths. After years of heavy losses, the state is finally seeing its steepest decline in more than a decade.

Massachusetts has long had near-universal health coverage through MassHealth, its Medicaid program, which predates the Affordable Care Act. The state’s Bureau of Substance Addiction Services (BSAS), under the Department of Public Health, oversees the statewide addiction treatment system. Of the 343 facilities listed below, 293 accept Medicaid.