Substance use is a serious concern in Oregon, which has been hit hard by fentanyl and methamphetamine. After years of rising deaths, the state recorded its first decline since 2016. Key figures:

• 1,833 drug overdose deaths in 2023, according to the Oregon Health Authority.
• 1,544 drug overdose deaths in 2024, a 16% decrease from 2023.
• The 2024 decline was the first since 2016.
• More than 90% of overdose deaths involved fentanyl, methamphetamine, or a combination of both.
• 62.2% of 2024 overdose deaths involved multiple substances, most commonly fentanyl and methamphetamine together.
• 10,365 overdose-related emergency room visits in 2024, plus 4,193 in-patient overdose-related hospitalizations.

Oregon’s overdose deaths climbed for years as fentanyl and methamphetamine spread across the state. The decline in 2024 marked a turning point, but deaths remain far above pre-pandemic levels.

Oregon expanded Medicaid in 2014 under the Affordable Care Act, and its Medicaid program covers the full range of addiction treatment. The Oregon Health Authority (OHA) oversees the addiction treatment system. Of the 187 facilities listed below, 165 accept Medicaid.