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Colin Planalp
MPA , Research Fellow

p 612-624-4850
e cplanalp@umn.edu

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2020 U.S. alcohol-involved deaths climbed by 26.6%, and drug overdose deaths by 30.6%

February 16, 2022:

Size of alcohol, drug overdose death increases in first pandemic year were unparalleled

With the recent release of 2020 mortality data from the U.S. Centers for Disease Control and Prevention (CDC), we now know that fears that the pandemic could result in increased drug and alcohol deaths were well-founded. In just a single year, the U.S. alcohol-involved death rate increased 26.6%, and drug overdose deaths grew by 30.6% (Figure 1).

Figure 1. U.S. alcohol-involved and drug overdose death rates, 2000-2020

Overdose death rates increased significantly across most drug types (declining only for heroin), and they were led by a 55.6% increase in deaths from fentanyl and similar synthetic opioids, and a 48.2% increase in deaths from methamphetamine and other psychostimulant drugs (Figure 2).

Figure 2. Changes in U.S. drug overdose death rates by type, 2019-2020

The story was similarly grim across the states. From 2019 to 2020, forty states experienced statistically significant increases in their drug overdose death rates. Those ranged from the smallest increase of 12.9 percent in Connecticut (from 34.7 deaths per 100,000 people in 2019 to 39.1 in 2020) to the largest increase of 54.8 percent in Mississippi (from 13.6 deaths per 100,000 people in 2019 to 21.2 in 2020) (Figure 3).

Figure 3. Statistically significant state-level increases in drug overdose death rates, 2019-2020

During the same period, 44 states recorded statistically significant increases in their rates of alcohol-involved deaths, ranging from the smallest increase of 15.2 percent in Oklahoma (15.1 deaths per 100,00 people in 2019 to 17.4 in 2020) to the largest increase of 67.2 percent in Mississippi (7.0 deaths per 100,00 people in 2019 to 11.8 in 2020) (Figure 4).

Figure 4. Statistically significant state-level increases in alcohol-involved death rates, 2019-2020

While these increases in alcohol-involved and drug overdose death rates follow patterns a decade or more in the making, the twin crises of high-risk substance use clearly reached a crescendo during the pandemic, as evidenced by the unparalleled heights of substance-related death rates reported in recent decades.1,2 And though data for 2021 are not yet fully available, provisional reports indicate that drug overdose deaths continued at historically elevated levels.3 Mortality data clearly show that the fallout of the pandemic has included the exacerbation of dangerous drug and alcohol use patterns in the U.S., and it is an issue that deserves redoubled focus as the COVID-19 emergency eventually begins to ebb.

The U.S. and state-level data analyzed in this blog post are all available on SHADAC’s State Health Compare data website: http://statehealthcompare.shadac.org/.


1 Planalp, C., Au-Yueng, C.M., & Winkelman, T.N.A. (April 2021). Escalating Alcohol-Involved Death Rates: Trends and Variation Across the Nation and in the States from 2006 to 2019. State Health Access Data Assistance Center (SHADAC). https://www.shadac.org/sites/default/files/publications/Alcohol-Involved-Deaths/AID-4.21-SHADAC-Brief.pdf

2 Planalp, C. & Hest, R. (August 2020). Overdose Crisis in Transition: Changing National Trends in a Widening Drug Death Epidemic. State Health Access Data Assistance Center (SHADAC). https://www.shadac.org/sites/default/files/publications/2020%20NATIONAL_SHADAC_Opioidbrief.pdf

3 Ahmad, F.B., Rossen, L.M., & Sutton, P. (2022, January 12). Provisional drug overdose death counts. National Center for Health Statistics (NCHS). https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.
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