Substance use is a serious concern in New York, which records one of the highest total numbers of overdose deaths in the country, driven by fentanyl. Key figures:

• 3,046 overdose deaths in New York City in 2023, down 1% from 3,070 in 2022, according to NYC Health.
• New York had 4,936 fentanyl-related deaths in 2023, the second-highest total in the nation.
• Fentanyl is the most common drug in overdose deaths.
• The 2023 decline was the first since 2018.
• Overdose deaths decreased again in 2024.
• New York’s large population drives one of the highest raw totals in the country.

New York’s large population means its overdose totals are among the highest in the nation even as its per-capita rate sits near the national average. Deaths began falling in 2023, the first decline in years.

New York expanded Medicaid in 2014 under the Affordable Care Act, and its Medicaid program covers the full range of addiction treatment. The state’s Office of Addiction Services and Supports (OASAS) oversees the addiction treatment system. Of the 629 facilities listed below, 584 accept Medicaid.