Substance use is a serious concern in Oklahoma, which has seen a sharp rise in fentanyl-related deaths in recent years. Key figures:

• 813 unintentional drug overdose deaths in 2023, according to the Oklahoma State Department of Health.
• 760 unintentional overdose deaths in 2024, a 7% decrease from 2023.
• 748 fentanyl-related deaths in 2023, up 21% over the prior year, according to the Oklahoma Bureau of Narcotics.
• Fentanyl has overtaken prescription opioids as the leading cause of overdose death.
• The prescription opioid overdose death rate fell 68% from 2013 to 2019.
• Medicaid expansion took effect July 1, 2021, after voters approved it in June 2020.

Oklahoma’s overdose deaths climbed sharply as fentanyl spread across the state, with fatal overdoses more than doubling between 2020 and 2022 before beginning to ease in 2024.

Oklahoma expanded Medicaid effective July 1, 2021 after voters approved it in June 2020, extending coverage to more than 200,000 adults including those with substance use disorders. The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) oversees the addiction treatment system. Of the 139 facilities listed below, 122 accept Medicaid.