New Mexico had the highest opioid overdose death rate in the U.S. in 2025, while Nebraska had the lowest, according to a KFF analysis of provisional CDC data.
The national opioid overdose death rate was 13.1 per 100,000 individuals in 2025. New Mexico’s rate of 33.9 per 100,000 was more than 2.5 times the national figure.
The figures are provisional and cover deaths from Jan. 1 through Dec. 31, 2025. KFF notes that provisional overdose data are often incomplete, so rates may be underestimated relative to final data. Rates are age-adjusted.
Here are 2025 opioid overdose death rates per 100,000 individuals for all 50 states and the District of Columbia, ranked from highest to lowest.
This list includes ties.
1. New Mexico: 33.9
2. Alaska: 32.7
3. West Virginia: 29.7
4. Arizona: 29.6
5. Washington: 28.1
6. Delaware: 25.3
7. District of Columbia: 24.5
8. Nevada: 20.7
9. Maine: 19.9
10. Tennessee: 19.8
11. Vermont: 19.7
12. Colorado: 19.3
13. Oregon: 18.2
14. Connecticut: 17.3
15. Maryland: 17
16. North Carolina: 16.6
17. South Carolina: 16
18. Kentucky: 15.7
19. Pennsylvania: 14.8
20. Ohio: 13.8
21. New Hampshire: 13.6
22 (tie). Massachusetts: 13.5
22 (tie). Rhode Island: 13.5
24. Indiana: 13.2
25. New Jersey: 12.7
26. Louisiana: 12.5
27 (tie). Oklahoma: 12.4
27 (tie). Utah: 12.4
29. California: 12.2
30. New York: 12.1
31. Missouri: 12
32. Minnesota: 11.7
33. Michigan: 11.6
34. Montana: 11.4
35 (tie). Alabama: 10.9
35 (tie). North Dakota: 10.9
37. Wisconsin: 10.6
38 (tie). Idaho: 10.4
38 (tie). Kansas: 10.4
40. Virginia: 10.3
41. Florida: 9.8
42. Illinois: 9.7
43. Mississippi: 9.4
44. Georgia: 8.9
45. Wyoming: 7.8
46. Texas: 6.3
47. Arkansas: 6
48. Hawaii: 5.9
49. South Dakota: 5.4
50. Iowa: 4.3
51. Nebraska: 3.5
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