A Divided Map of America’s Overdose Crisis

In Overdose in America The Guardian reports that drug overdose death rates in the United States are falling across most of the country. According to The Guardian's report overdose death rates have fallen nationally since 2023 mainly because of wider access to naloxone, expanded treatment options and a decline in fentanyl availability and purity in parts of the country.

However, The Guardian also notes an important geographic pattern in the data. While many eastern states are beginning to see stabilization or decline, several western and rural states are only now experiencing the peak of the epidemic.

The Guardian illustrates this national decline using a choropleth map. The map shows two choropleth views. One view visualizes the percentage change in drug overdose deaths at the county level, allowing readers to see where the overdose epidemic is waning and where it is still growing. The other view shows the overdose death rate, revealing the number of overdose deaths per 100,000 people at the county level. If you select a county on the map you can also view a graph that reveals the drug rate in the county over time, since 2020.

The Guardian investigation also includes a small multiples tile grid map to visualize the drug overdose death rates at the state level from August 2023 to April 2025. This grid map reveals that overdose death rates are trending downwards in most states - except for Alaska, Hawaii, Nevada and South Dakota, where the death rates are still rising.

According to The Guardian, in some states, such as Alaska, Hawaii, Nevada, South Dakota, and Arizona, fentanyl and methamphetamine remain prevalent - often in combination, which makes overdoses more lethal and harder to reverse. The paper also suggests that rural and western states tend to have less access to treatment, slower data systems, and more limited harm-reduction programs. 

Fentanyl first entered the U.S. illicit drug supply in the early 2010s, primarily in the eastern states - especially Appalachia, the Midwest, and the Northeast.but its impact peaked earlier in the East and is still rising in parts of the West. From a geographic viewpoint The Guardian suggests that Fentanyl’s spread from east to west hasn’t fully stabilized; and that some western regions are now experiencing its peak impact.