Substance use is a serious concern in Ohio, which has long posted one of the highest overdose death counts in the nation. After peaking earlier in the decade, deaths have now fallen for two straight years. Key figures:

• 4,452 unintentional drug overdose deaths in 2023, a 9% decrease from 2022, according to the Ohio Department of Health.
• 2,931 unintentional overdose deaths in 2024, down 34% from 2023, outpacing the national decline of 25%.
• Fentanyl was involved in 69% of unintentional overdose deaths in 2024.
• Opioids make up 82% of overdose deaths, with fentanyl the main culprit.
• Overdose deaths have fallen for two consecutive years.
• Naloxone distribution rose 520% from 2019 to 2023, with more than 291,000 kits distributed and over 20,000 known overdose reversals.

Ohio’s overdose deaths climbed sharply through the early 2020s before turning a corner. Declines in 2023 and 2024 have outpaced the national average, even as fentanyl remains the dominant driver of fatal overdoses.

Ohio expanded Medicaid in 2014 under the Affordable Care Act, and its Medicaid program covers the full range of addiction treatment. The Ohio Department of Mental Health and Addiction Services (OhioMHAS) oversees the addiction treatment system. Of the 474 facilities listed below, 445 accept Medicaid.