Substance use is a serious concern in Montana, driven by both methamphetamine and a recent surge in fentanyl. Key figures:

• Synthetic opioid (fentanyl) deaths more than tripled to 8.9 per 100,000 in 2023, according to the Montana Department of Public Health and Human Services.
• Stimulant (meth) deaths rose to 8.2 per 100,000 in 2023, up from 3.1 in 2014.
• Methamphetamine deaths grew from 6 in 2014 to 89 in 2023.
• Methamphetamine and alcohol remain the most prevalent substances.
• Fentanyl is the fastest-rising threat.
• Overdose deaths are now comparable to motor vehicle crashes as a cause of death.

Montana’s crisis has two fronts: a longstanding methamphetamine problem and a newer fentanyl surge. Both now kill at similar rates, while meth and alcohol remain the most widely used substances.

Montana expanded Medicaid in 2016 through its Healthy Montana Plan, a Section 1115 waiver that includes premiums and work requirements. The state’s Department of Public Health and Human Services administers the program. Of the 68 facilities listed below, 65 accept Medicaid.