Which States Have the Highest Opioid Related Overdoses??

In order to determine which state has the highest opioid-related overdose rate, we need to be able to compare states’ overdose numbers consistently. This requires consistent:

• Overdose counts
• Overdose rates
• Years of data reported
• Methodology used to count the number of overdose deaths

Looking at raw counts of overdose deaths is not enough to determine which state has the highest overdose rate. As the Centers for Disease Control and Prevention (CDC) explains: “Realizing that rates do not describe the magnitude of a problem is important. Case counts state the size of a health problem. Rates describe the intensity, or severity, and the relative frequency with which events occur.” Since some states have far larger populations than others, raw counts alone are not enough to tell which state has the highest opioid overdose rate.

Also, looking at reported overdose rates can be misleading because reported overdose numbers generally fail to explain the methodology used to come up with that number. For example, if reporting agencies have different standards for counting opioid-related overdose deaths, they will produce different results. Are overdose deaths caused by fentanyl or other types of synthetic opioid drugs included as opioid overdose deaths? This type of methodological detail is crucial for calculating accurate overdose statistics, but this information is missing from reported data.

Because of these issues, and others, most claims made about opioids in the United States, including claims that overdoses are the leading cause of death among certain demographic groups, are nearly impossible to determine. The lack of accompanying data and definitions makes it difficult to evaluate these claims or determine how accurate they are. If a claim is made that overdose deaths constitute the leading cause of death in a particular state, that claim must be supported by data that also include definitions that explicitly describe how those deaths were counted.

Many of the articles on the Spodek Law Group blog contain overdose figures. While we strive to keep this information up to date, these figures should not be taken as scientific evidence of opioid overdose rates in the United States. The articles and infographics on our website are examples of marketing materials, and while we do provide links to the source of our data to facilitate easy reading, they are not in-depth epidemiological studies. They provide summaries of data we have gathered from government sources. We do this to make our information accessible and easy to understand for people who are concerned about the opioid overdose epidemic, and we do not intend to present an epidemiological analysis of state-level opioid overdose rates in the United States.

Can the Available Evidence Identify the Hardest-Hit State or City?

If we want to identify which states have the most opioid-related overdose deaths, we need to look at reported data. However, as noted above, reported data is often plagued by inaccuracies. This includes discrepancies in reporting timelines, methodology, and definitions. Because of this, look at raw overdose totals is not sufficient to identify which states are hardest-hit.

The same applies to any attempts at identifying which state, city, or county in the U.S. has the fewest opioid-related overdose deaths. Identifying these locations also requires the use of consistent, comparable, and complete state-level reporting. This is not always possible, as reporting rates and methodologies vary significantly across different regions. Due to inconsistencies or gaps in some reporting, conclusions regarding which areas are least affected by the opioid crisis should be drawn from data with stated methods and limitations.

While available data fails to provide enough precision to identify a hardest-hit state or city, it nonetheless offers significant insights. The reported figures highlight the immense scale of the drug overdose crisis in the United States. For instance, the Centers for Disease Control and Prevention (CDC) reported that estimated drug overdose deaths exceeded 100,000 during the 12-month period from May 2020 through April 2021. This staggering figure reflects the immense scope of the drug overdose crisis on a national scale, and underscores the urgency of finding an effective solution.

These numbers also indicate the significant human toll of the crisis. Drug overdoses have become a leading cause of death in the U.S., with a particularly devastating impact on those ages 18-44. This highlights the widespread nature of the epidemic and the catastrophic consequences for millions of American families.

Synthetic opioids other than methadone, primarily illicitly manufactured fentanyls, were involved in 64.0% of overdose deaths during May 2020 through April 2021. The CDC reported that 64.0% of overdose deaths during May 2020 through April 2021 involved synthetic opioids other than methadone, primarily illicitly manufactured fentanyls. While fentanyl was initially used only to treat severe pain in patients who did not respond to other painkillers, its prevalence has increased dramatically in recent years. Today, fentanyl and other synthetic opioids represent a major concern not just for epidemiologists and medical researchers, but for law enforcement agencies and federal prosecutors as well. This has led to increased scrutiny and federal investigations involving pharmacies, physicians, and other providers accused of improperly contributing to the opioid epidemic.

How Does a Drug-Related Crime Ranking Differ from an Overdose Ranking?

A ranking of states based on opioid-related overdose rates differs from a ranking based on drug crimes in several key respects. While the former seeks to identify where individuals most often lose their lives to overdoses, the latter is intended to provide insight into law enforcement agencies’ investigations and prosecutions targeting drug-related crimes. As we note below, crime-related statistics can refer to arrests, convictions, or reported offenses, all of which are measured and recorded with varying degrees of accuracy and are subject to reporting delays.

A state or city’s overdose ranking does not necessarily reflect the frequency of opioid-related crimes committed in that region. However, in many cases, overdose investigations trigger larger investigations that ultimately reveal larger trafficking operations. When a user dies or is incapacitated from a drug overdose, investigators typically trace the drug back to its most immediate source. In many cases, this involves tracking the drug from the user to a street-level seller, and then from the street-level seller to whoever supplied the drug for sale. If the street-level seller was only one link in a longer distribution chain, law enforcement authorities, most often the U.S. Drug Enforcement Administration (DEA), will assume charge of the investigation. Investigations which are already underway in other jurisdictions can, and frequently do, feed into the efforts of federal law enforcement to identify and dismantle suspected trafficking networks.

Investigations for drug-related crimes will ultimately lead to drug-related charges and convictions. When these convictions target illegal drug trafficking, they can carry mandatory prison sentences. As a result, defendants who are investigated and charged with drug-related crimes in connection with suspected opioid-trafficking networks must be particularly mindful of their constitutional rights. If unlawfully obtained drug evidence is obtained, we can seek to exclude that evidence by asserting a Fourth Amendment violation. Many defendants in opioid-related prosecutions can also effectively argue that they did not have knowledge or control over the drugs in question, did not possess or own the drugs, or were coerced by third parties who are equally or more responsible.

Opioid-related prosecutions can proceed in state or federal courts depending on the nature and scope of the alleged crime, as well as the state where it is being prosecuted. Both jurisdictions enforce stringent rules and laws targeting opioid-related crimes; however, the amount of time and penalties associated with a conviction vary substantially. It is essential for anyone facing opioid-related charges to consult with a legal team that has experience navigating these types of investigations and prosecutions at both the state and federal levels.

Talk to Spodek Law Group

Every case turns on its own facts, and general information is no substitute for advice about yours. Todd Spodek, managing partner of Spodek Law Group, and the firm's attorneys defend federal criminal and white collar matters nationwide. Reach the firm at 888 348 8028.