Updated Drug and Alcohol Statistics for Maryland

Drug and alcohol misuse in Maryland has undergone significant shifts over the last two decades, with a surge in synthetic opioid use and evolving patterns of polysubstance abuse. Understanding the scope of these statistics helps illustrate the severity and progression of substance-related challenges across different demographic groups within the state.

From escalating fentanyl-involved overdoses to rising alcohol-related fatalities, Maryland’s data reveals persistent public health impacts. Overdose mortality rates, in particular, reflect alarming disparities by race, age group, and geographic location. In addition, trends in treatment admissions underscore gaps in access and capacity. By exploring the numbers across these domains, readers can gain a clearer view of Maryland’s substance use landscape.

Below are several key statistics that highlight Maryland’s current substance use profile:

• Drug- and alcohol-related deaths rose 317% statewide between 2005 and 2025, climbing from 671 fatalities in 2011 to 2,800 in 2021.
• 84% of Maryland’s 2,912 overdose deaths in 2021 involved fentanyl.
• The 55+ age group experienced a 264% increase in fatal overdoses since 2016.
• Methadone or buprenorphine-based treatment reached only 25.1% of those with opioid use disorder, mirroring national treatment gaps.

Together, these figures illuminate the gravity of Maryland’s substance use crisis. Below, the data is arranged by core themes—trends over time, demographic patterns, substance-specific findings, geographic disparities, and treatment details—to offer a comprehensive statistical picture.

Trends Over Time

Maryland’s substance use patterns have evolved considerably, particularly over the 2005–2025 window.

• Heroin admissions in 2010 reached 16,088, surpassing alcohol as the primary reason for entering rehabilitation.
• Prescription opioid misuse peaked in the late 2000s, before shifting sharply to fentanyl-related issues by 2013–2016.
• Statewide drug-induced mortality stood at 13.5 per 100,000 in 2009–2010, above the national average of 12.8 at that time.
• 90% of overdose deaths in Maryland involved synthetic opioids by 2020, demonstrating fentanyl’s rapid rise.

These shifts mark an ongoing transition from prescription-focused misuse to illicit synthetic opioids as the main driver of overdose mortality. The table below compares heroin and fentanyl deaths across several key years.

Demographic Patterns

Maryland’s age-specific and racial/ethnic data reveal important disparities.

• The <25 age group saw a 14.9% decrease in overdose deaths from 2017 to 2021.
• Among those aged 25–34, deaths peaked at 647 in 2020 then fell to 555 in 2021.
• Adults 55+ recorded a 264% jump in overdoses since 2016, highlighting rising vulnerabilities in older populations.
• Non-Hispanic Black residents accounted for 46% of the state’s cocaine-related deaths in 2021, with overdose rates 1.5× higher than whites.
• Alcohol-related deaths rose by 41% among non-Hispanic whites and 57% among Hispanic populations between 2019 and 2020.

These differences underscore the need to examine evolving substance risks within specific populations. The table below highlights overdose mortality by select demographic factors.

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Substance-Specific Overdose Findings

Maryland’s overdose profile includes opioids, stimulants, and alcohol, each contributing to overall mortality rates.

• Fentanyl-related deaths surged from 26 in 2011 to 2,344 in 2020, reflecting an annual increase of around 22%.
• Cocaine-involved fatalities rose from 148 in 2011 to 921 in 2020.
• Heroin deaths, however, dropped by 55% from 2016 to 2020 due to a shift toward fentanyl analogs.
• Alcohol misuse remains a parallel crisis, with 18.4% of high school students reporting binge drinking in earlier surveys and notable adult mortality rates.

Polysubstance combinations, especially fentanyl mixed with xylazine or stimulants, further amplify the risks. These patterns highlight the complexity of overdose events and underscore how one substance’s decline can coincide with another’s surge.

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Geographic Disparities

Maryland’s landscape of substance misuse varies across counties, with urban and rural locales facing distinct challenges.

• Central Maryland accounted for 59.77% of intoxication fatalities in 2020.
• Baltimore City saw 1,028 overdose deaths that year—36.7% of the state total.
• Baltimore County recorded 394 deaths in 2020, reflecting a 12.7% increase from the previous year.
• Rural Washington County experienced a 45.9% spike in opioid overdose deaths, underscoring treatment access gaps.

Below is an approximate breakdown of overdose mortality among Maryland’s major regions, emphasizing where interventions may be needed most.

Comparisons with National Data

When evaluated against the rest of the United States, Maryland’s substance-related metrics show higher-than-average overdose burdens.

• The state’s drug-induced mortality rate stands at 33.5 per 100,000 (2017–2019), exceeding the national average of 32.6 in 2022.
• Maryland’s 2020 overdose rate measured 45.6 per 100,000, surpassing Pennsylvania (42.4) and Virginia (31.6) but slightly lower than Delaware (48.6).
• 90% of state overdoses involve synthetic opioids, compared to 84% nationally.
• By 2022, 25.1% of Marylanders with opioid use disorder received medication for opioid use disorder, aligning with the national rate.

Maryland’s proximity to major interstate corridors intensifies the availability of fentanyl and cocaine, contributing to its elevated overdose rate. This broader national and regional context places Maryland among states significantly impacted by synthetic opioid trafficking.

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Treatment Capacity and Admissions

The state’s treatment infrastructure reflects declining admissions despite heightened mortality trends.

• In 2010, Maryland documented 61,377 substance-related treatment admissions.
• By 2021, total admissions dropped to 32,000, even as overdose deaths soared.
• Non-Hispanic Black individuals accessed buprenorphine at roughly half the rate of white counterparts, despite higher opioid overdose rates.
• Earlier periods showed 4,733 cocaine-specific treatment entries in 2010, reflecting ongoing stimulant concerns alongside opioid disorders.

Capacity constraints and demographic disparities underscore the challenges of matching public health responses with changing drug landscapes. The following table lists selected treatment and admission figures in the state across different years.

Key Statistics Summary

• Drug- and alcohol-related deaths surged 317% (2005–2025)
• Fentanyl-related fatalities grew from 26 (2011) to 2,344 (2020)
• Alcohol mortality rose 41% among non-Hispanic whites (2019–2020)
• Maryland’s overdose rate reached 45.6 per 100,000 in 2020
• Treatment admissions dropped to 32,000 by 2021 despite climbing fatalities

Overall, Maryland’s data reflects a substantial shift from prescription opioid misuse toward synthetic fentanyl, increasing cocaine involvement, and persistent alcohol abuse. Overdose deaths cut across age groups and racial categories, yet older adults and certain minority populations bear the brunt of emerging trends. These numerical insights help clarify the complexity of Maryland’s substance use challenges.

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