Substance use is a serious concern in Pennsylvania, one of the states hit hardest by the opioid crisis. After years of high overdose counts, deaths have fallen sharply. Key figures:

• 4,719 overdose deaths in 2023, according to the Pennsylvania Department of Health.
• 83% of 2023 overdose deaths were opioid-related, and nearly 77% involved fentanyl.
• Overdose deaths fell more than 30% from 2023 to 2024, one of the steepest declines in the nation.
• Philadelphia recorded 1,315 overdose deaths in 2023, with fentanyl involved in 79% of them.
• Overdose rates among Black, Indigenous, and People of Color are higher than among white and non-Hispanic residents.
• Preliminary data points to about 1,500 deaths in 2025, the lowest level in a decade.

Pennsylvania’s overdose deaths peaked in the early 2020s before beginning a steep decline. Fentanyl remains the leading driver, but the state has seen one of the fastest reductions in overdose deaths in the country.

Pennsylvania expanded Medicaid in 2015 under the Affordable Care Act, and its Medicaid program covers the full range of addiction treatment. The Department of Drug and Alcohol Programs (DDAP) oversees the addiction treatment system. Of the 479 facilities listed below, 409 accept Medicaid.