Updated Drug and Alcohol Statistics for Massachusetts

Substance use patterns across Massachusetts have shifted dramatically over the past two decades. Understanding these changes through data provides a clearer picture of where efforts have been most effective and where challenges persist.

From pronounced rises in opioid-related fatalities to consistently high rates of alcohol misuse, Massachusetts stands at a crossroads between ongoing public health concerns and signs of statistical improvement. This article compiles key data points that illustrate the current landscape of drug and alcohol use in the state.

Key Figures at a Glance

Below are four data points that offer a quick snapshot of Massachusetts’ substance use trends:

• Opioid Fatalities in 2023: Decreased by 10% but remain double the national average.
• Binge Drinking Prevalence: 25% of adults reported past-month binge drinking in 2023, compared to 17% nationally.
• Peak Opioid Mortality: Reached 33.5 deaths per 100,000 in 2022, more than double the U.S. average at the time.
• Youth Drug Use: Past-month illicit drug use among adolescents dropped from 13% in 2014 to 3.4% in 2024.

These statistics demonstrate both positive developments—like decreasing overdose rates—and ongoing challenges in alcohol misuse. The following sections provide a deeper look at the data behind these trends.

Overall Substance Use Patterns

Understanding the broad scope of substance use helps contextualize specific trends across different substances.

• The prevalence of opioid use disorder in Massachusetts was 4.60% in 2015 among residents aged 11 or older.
• Polysubstance use remains a concern, with 53% of opioid fatalities in 2022 involving cocaine and 28% involving alcohol.
• In 2017, 58,280 individuals received state-funded substance use services, compared to an estimated 259,000 people in need of treatment for opioid use disorder.
• Young adults aged 18–25 have elevated risk factors, including higher rates of both binge drinking and illicit drug use.

These figures reveal gaps between treatment needs and availability, along with shifting consumption patterns. Below is a table showing overall substance-related hospital encounters from recent years.

Notably, alcohol-related admissions decreased by 18% between 2017 and 2021, whereas drug-related hospital encounters rose by 36% in the same period.

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Opioid Overdose Rates

Opioids have been a leading driver of substance-related harm in Massachusetts for more than a decade.

• Opioid fatalities peaked at 33.5 deaths per 100,000 people in 2022, with illicit fentanyl contributing to over 90% of these fatalities.
• State data for 2023 shows an additional 10% reduction in opioid-related overdose deaths.
• Despite the decline, the opioid mortality rate in 2023 remained 50% higher than the national average.
• Prescription opioid misuse was a leading factor in early phases of the epidemic, ranking Massachusetts as the 16th highest state for per capita opioid prescriptions in 2008.

Fentanyl’s rapid emergence contributed to sharp increases in deaths, even as prescribing reforms reduced high-dose opioid availability. The table below compares overdose rates across selected New England states.

The regional comparison highlights an ongoing concentration of fentanyl-driven overdose deaths in New England.

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Alcohol Consumption

Massachusetts has also contended with persistent alcohol misuse, driven by high binge drinking rates across various populations.

• 25% of Massachusetts adults reported past-month binge drinking in 2023, above the 17% national benchmark.
• Between 2017 and 2019, 45.9% of young adults (18–25) reported past-month binge drinking, approximately 10 percentage points higher than the U.S. rate.
• 1 in 20 deaths annually in the state is attributed to chronic heavy drinking, encompassing liver disease, certain cancers, and alcohol poisoning.
• 38% of adults reported increased alcohol consumption during COVID-19 lockdown periods.

Many hospitals saw downward trends in alcohol-specific admissions, but the wider population’s binge and heavy drinking rates remain an ongoing concern. The table below details self-reported alcohol use from a recent statewide survey.

Although overall alcohol admissions decreased, high-risk behaviors continue to affect a significant segment of the population.

Demographic Disparities

Substance use does not affect all communities equally. Differences in race, age, and socioeconomic status highlight critical areas for targeted interventions.

• 70% of opioid fatalities in Massachusetts involve males, yet female overdose rates increased by 150% between 2005 and 2020.
• Black residents accounted for 25% of Boston’s opioid deaths in 2021 but only make up 8% of the city’s population.
• 52.8% of adults with mental illness received treatment in 2019, dropping to 35% in low-income areas.
• Youth illicit drug use among adolescents declined from 13% in 2014 to 3.4% in 2024, contrasting with the rise seen in older demographics.

These disparities indicate that certain populations face unique risk factors. The table below shows a breakdown of overdose rates by age group.

The data suggests elevated rates among young and middle-aged adults, underscoring a need for continued attention to demographic variations.

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Polysubstance Use and Hospital Encounters

Multiple substances often overlap, creating more complex treatment demands and higher hospitalization rates.

• By 2022, 93% of opioid-related overdose deaths involved fentanyl, with many cases also including other substances.
• 53% of fatal opioid overdoses involved cocaine and 28% included alcohol in 2022.
• Stimulant complications contributed to a 36% rise in drug-related hospital admissions between 2017 and 2021.
• Methamphetamine use among adolescents showed an uptick, reaching 8% for nonprescription drug use in 2024.

These figures highlight how various drugs, including synthetic opioids and stimulants, drive Massachusetts’ ongoing public health challenges. The table below illustrates recent polysubstance overdose data.

Polysubstance scenarios complicate treatment protocols, emphasizing the importance of integrated care for overlapping substance use.

Key Statistics Summary

• Opioid-related fatalities dropped by 10% in 2023 yet still remain significantly above the national average.
• 25% of adults in Massachusetts engaged in binge drinking in 2023.
• Drug-related hospital admissions increased by 36% between 2017 and 2021, while alcohol-related admissions decreased by 18%.
• 70% of opioid overdose victims are men, though female overdose rates climbed substantially over 15 years.
• Youth illicit drug use declined from 13% in 2014 to 3.4% in 2024.

From persistently high alcohol misuse to complex polysubstance trends, the data underscores both strides made in addressing the opioid crisis and areas where challenges remain. Keeping track of shifting substance use patterns—through metrics like overdose rates, hospital admissions, and demographics—can help refine strategies aimed at reducing these longstanding public health burdens.

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