Updated Drug and Alcohol Statistics for Alabama
In This Article
Substance use trends in Alabama have evolved dramatically over the past two decades, illustrating shifts from prescription opioids to synthetic surges while also reflecting ongoing concerns about alcohol and illicit drugs. This article examines the latest statistics on opioid-related fatalities, methamphetamine resurgence, and patterns in alcohol use to provide a data-driven snapshot of the state’s substance use landscape.
From 2005 to 2025, these changes have altered local health priorities and driven significant public attention. Below is a statistical overview of how different substances affect various demographics across Alabama, highlighting key data points that help paint a clearer picture of this complex public health issue.
Key Statistics Quick Overview
Here are four noteworthy findings that illustrate the scope of Alabama’s drug and alcohol challenges:
- 590% rise in fentanyl-related overdose deaths between 2018 and 2022
- 44% drop in prescription opioid dispensing rates from 2012 to 2022
- 5.3% of adults meet criteria for alcohol use disorder
- 8.7 methamphetamine-related deaths per 100,000 residents – higher than regional averages
These statistics underscore both the severe impact of synthetic opioids and the enduring challenges presented by alcohol and other substances. The sections below present more in-depth data and context around each topic.
Prescription Opioid and Fentanyl Trends
Prescription painkillers once drove Alabama’s opioid crisis, but synthetic opioids have rapidly become a dominant factor in overdose mortality. Below are some pivotal statistics reflecting this shift.
- Annual fentanyl overdose deaths climbed from 121 in 2018 to 835 in 2022
- Prescription opioid dispensing rates peaked at 143.8 per 100 residents in 2012, then dropped to 80.4 per 100 by 2022
- Hydrocodone and oxycodone once comprised 68% of pharmaceutical misuse admissions
- The overall overdose death rate doubled from 15.4 to 31.5 per 100,000 between 2014 and 2022
Although measures like prescription monitoring significantly cut down prescription opioid misuse, fentanyl and similar synthetics have spurred more lethal outcomes. The table below illustrates the rise in fentanyl and decline in prescription opioid rates.
| Year | Prescription Opioid Dispensing (Per 100 Residents) | Fentanyl Overdose Deaths |
|---|---|---|
| 2012 | 143.8 | NA |
| 2018 | 92.8 | 121 |
| 2022 | 80.4 | 835 |
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Alcohol Use in Alabama
Alcohol remains a consistent public health challenge statewide, impacting not only adult drinkers but also youth and young adults in college settings.
- 5.3% of adults in Alabama (roughly 218,000 individuals) meet diagnostic criteria for alcohol use disorder
- Heavy drinking rates in the 21+ population rose from 6.5% in 2013 to 8.9% in 2019
- 62% of alcohol-related treatment admissions are male, compared to 54% nationally
- Binge drinking among college students in Alabama remains about 22% higher than other states in the region
Underage drinking has decreased in some areas, but overall alcohol misuse remains a prominent source of treatment admissions and associated health consequences. The data table below highlights several alcohol trends over recent years.
| Statistic | Rate/Value |
|---|---|
| Adults Meeting Alcohol Use Disorder Criteria | 5.3% |
| Male Admissions for Alcohol Treatment | 62% |
| Decrease in Alcohol-Involved Crashes (2012–2022) | 31% |
| College Binge Drinking Above Regional Average | +22% |
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Illicit Drug Patterns: Meth and Cocaine
Methamphetamine usage continues to surge while cocaine retains a resilient presence in specific urban areas. These two substances account for a significant share of ongoing treatment admissions and overdose fatalities.
- Lab seizures plummeted from 1,243 in 2004 to 1 in 2023 due to stricter controls on precursor chemicals
- Purity levels of imported ice meth rose from 45% in 2015 to 93% in 2023
- Treatment admissions for methamphetamine increased by 384% from 2015 to 2023
- Cocaine-fentanyl mixtures led to a 127% rise in related overdose deaths from 2020 to 2023
Methamphetamine has frequently been cited as the largest contributor to violent crime in many counties, while cocaine use remains concentrated in urban areas, particularly Jefferson County. The table below compares treatment admissions and overdose rates associated with these substances.
| Substance | Treatment Admission Increase (2015–2023) | Overdose Death Growth (2020–2023) |
|---|---|---|
| Methamphetamine | +384% | Significant portion of stimulant-related deaths |
| Cocaine | Steady to Slight Rise | +127% (with fentanyl mixes) |
Demographic Disparities
Alabama’s evolving substance use problems manifest differently across age groups, racial communities, and geographic locations, reflecting pronounced gaps in treatment availability and outcomes.
- Youth (12–17) report a 7.2% illicit drug use rate, with prescription drug misuse at 5.8%
- Young adults (18–25) have an opioid use disorder rate of 2.9%, about double the national figure
- African Americans in urban counties face a 34% higher fentanyl overdose mortality rate than white counterparts
- Rural communities see 22% higher overdose death rates but have 41% fewer treatment facilities
These disparities illustrate that statewide averages only tell part of the story. Variations in treatment facility density and historical prescribing patterns have contributed to significant differences in substance-related health outcomes.
| Demographic Group | Key Statistic | Comment |
|---|---|---|
| Youth (12–17) | 7.2% illicit drug use | Prescription misuse at 5.8% |
| Young Adults (18–25) | 2.9% opioid use disorder | Double the national rate |
| Seniors (65+) | Benzodiazepine misuse tripled (2010–2020) | Under 2% of treatment admissions |
| African Americans | 34% higher fentanyl OD mortality | Urban counties |
| Rural Areas | 22% higher OD death rate | 41% fewer treatment facilities |
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Key Statistics Summary
- 835 fentanyl overdose deaths recorded in 2022
- 80.4 opioid prescriptions per 100 residents statewide after a peak of 143.8
- 5.3% of adults in Alabama qualify for alcohol use disorder
- 384% increase in meth-related treatment admissions from 2015 to 2023
- 34% higher fentanyl mortality among African Americans in urban counties
Overall, Alabama’s substance use landscape reflects a striking contrast: prescription opioid misuse has seen noteworthy reductions, yet highly potent synthetic opioids, increased methamphetamine purity, and persistent alcohol challenges continue to drive public health concerns. Different age groups and racial communities are affected in diverse ways, highlighting the importance of data-driven insights to address these issues effectively.
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Related Articles
- 2025 Drug Threat Assessment. Alabama Department of Public Health, 2025.
- 2023 Alabama Opioid Overdose and Addiction Council Report to the Governor. Alabama Department of Mental Health, 2023.
- About the Data: Opioid CDR. University of Alabama, 2022.
- Alabama Epidemiological Profile Final. State of Alabama, 2021.
- Understanding the Opioid Crisis. Alabama Department of Mental Health, 2022.
- Behavioral Health Barometer: Alabama, Volume 6. SAMHSA, 2022.
- CDC Funding for Overdose Prevention: Alabama. Centers for Disease Control and Prevention, 2023.
