Substance use is a serious concern in Virginia, which saw overdose deaths peak in 2021 before falling sharply. Key figures:

• 1,548 drug overdose deaths in 2024, a 37% decrease from 2023, according to the Virginia Department of Health.
• Drug overdose deaths peaked in 2021 at 2,622.
• 68% of overdose deaths involved fentanyl or a fentanyl analog.
• 1,939 fatal fentanyl overdoses in 2023, falling 44% to 1,086 in 2024.
• Deaths have fallen every year since 2021.
• Virginia was among the states with the steepest overdose declines in 2024.

Virginia’s overdose deaths peaked during the height of the fentanyl wave and have since declined for several consecutive years. Fentanyl remains involved in roughly seven in ten overdose deaths even as the overall count falls.

Virginia expanded Medicaid in 2019, and its Medicaid program covers the full range of addiction treatment, including the Addiction and Recovery Treatment Services (ARTS) benefit. The Department of Behavioral Health and Developmental Services (DBHDS) oversees the addiction treatment system. Of the 181 facilities listed below, 161 accept Medicaid.