Substance use is a concern in Mississippi, where methamphetamine is the biggest drug threat and fentanyl drives many deaths. Key figures:

• 702 overdose deaths annually, up 127% since 2012.
• Methamphetamine is the biggest drug threat in Mississippi, according to the state’s Department of Mental Health.
• Fentanyl and synthetic opioids drive many overdose deaths.
• Synthetic opioid deaths have dropped faster than meth deaths since the 2021 peak.
• Roughly 327,000 Mississippians who needed substance use treatment did not receive it.
• The drug mix is shifting toward meth even as the total falls.

Mississippi’s crisis has been shaped by a shifting drug mix. Methamphetamine remains the biggest threat, while fentanyl drove a surge that has since begun to ease, leaving meth as a growing share of deaths.

Mississippi is one of the states that has not expanded Medicaid under the Affordable Care Act, so many low-income adults fall into a coverage gap. The state’s Department of Mental Health oversees substance use treatment. Of the 82 facilities listed below, 55 accept Medicaid.