Substance use is a concern in Nebraska, though the state has the lowest overdose death rate in the nation and has seen further declines. Key figures:

• 9.0 drug overdose deaths per 100,000 people in 2023, the lowest rate in the nation, according to the CDC.
• Fentanyl overdoses at 3.3 per 100,000, also the lowest in the nation.
• Overdose deaths declined 15% or more in 2023.
• Nebraska’s rate is roughly one-third of the national average.
• South Dakota (11.2) was the only other state close to Nebraska’s low rate.
• Nebraska’s rate remains among the lowest even as deaths rose nationally.

Nebraska is a bright spot in the national crisis. Its overdose death rate is the lowest of any state and has fallen further, even as the country as a whole recorded years of record deaths.

Nebraska expanded Medicaid in 2020 after voters approved Initiative 427 by ballot in 2018, though implementation was delayed by the prior administration. The state’s Department of Health and Human Services administers the program. Of the 99 facilities listed below, 92 accept Medicaid.