Updated Drug and Alcohol Statistics for North Carolina
In This Article
Over the past two decades, North Carolina has seen significant changes in drug and alcohol use. From prescription opioid overuse in the early 2010s to surging fentanyl-related fatalities in recent years, the statistics present a nuanced picture of the state’s evolving substance abuse landscape.
This article compiles essential data on prevalence rates, demographic factors, and health outcomes tied to substance use in North Carolina. The goal is to offer a clear, data-focused view of emerging trends and underlying challenges for anyone seeking up-to-date statistics.
Key Quick Facts
- 1.56 million adults in North Carolina needed substance use treatment in one recent year.
- Less than 20% of those who needed treatment actually received it.
- 77% of overdose deaths in 2020 involved synthetic opioids.
- Overdose deaths jumped 40% from 2019 (2,352) to 2020 (3,304).
These figures illustrate the scale of the issue and demonstrate why examining the patterns behind them is vital. Below, we break down more detailed statistics on drug and alcohol use in North Carolina, highlighting demographic differences, neighboring state comparisons, and healthcare impacts.
Opioid Trends Over Time
Understanding opioid-related patterns in North Carolina is crucial because they shape much of the state’s public health response.
- Prescription opioid deaths dominated from 2000 to 2017, especially in rural counties.
- In 2015, the state’s opioid prescribing rate reached 71.8 prescriptions per 100 persons, surpassing the national average by about 7%.
- Fentanyl-involved fatalities rose by over 1,200% between 2015 and 2022.
- By 2020, synthetic opioids contributed to 77% of all overdose deaths statewide.
After 2019, the COVID-19 pandemic accelerated these issues. Rising fentanyl availability further heightened risks, leading to record-high overdose spikes.
| Key Year | Notable Opioid Trend |
|---|---|
| 2010–2017 | Predominance of prescription opioid misuse |
| 2015 | 71.8 opioid prescriptions per 100 persons |
| 2020 | 77% of overdose deaths involve synthetic opioids |
| 2022 | Fentanyl fatalities up 1,200% from 2015 |
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Demographic Insights
Breaking down substance abuse patterns by age, race, and income level highlights where prevention and treatment needs are most pronounced.
- 62% of hospitalized opioid use disorder patients were aged 18–35, compared to 22% in non-OUD groups.
- 78% of OUD patients were white, whereas white patients comprised 56% of general hospital populations.
- 41% of individuals with OUD came from ZIP codes with notably lower median incomes than the state average.
- Black North Carolinians experienced a 58% spike in overdose mortality from 2020 to 2021, compared to 29% among whites.
These disparities reflect broader socioeconomic and racial challenges in access to healthcare, particularly in rural settings and marginalized communities.
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Comparison with Neighboring States
Comparing state-level overdose data showcases how North Carolina’s statistics stack up against regional peers.
| State | Rate per 100k | % Change (2019–2020) | Primary Driver |
|---|---|---|---|
| North Carolina | 33.1 | +40% | Synthetic opioids |
| South Carolina | 28.4 | +35% | Prescription opioids |
| Georgia | 13.1 | +18% | Methamphetamine |
| Virginia | 25.7 | +29% | Heroin |
While Georgia has a lower rate, North Carolina’s higher numbers partly stem from increased fentanyl distribution and fewer harm-reduction services in rural areas.
- North Carolina’s syringe exchange coverage reached 38% of counties, whereas Georgia achieved 62% coverage.
- Facilities per 100,000 people: North Carolina at 2.1; Virginia at 3.4; South Carolina at 1.9; Georgia at 2.3.
- Telehealth-based substance use care in North Carolina is adopted by 48% of providers, vs. 63% in Virginia.
These differences can alter both immediate and long-term outcomes for people seeking substance use services across state lines.
Healthcare System Effects
Hospitals and clinics face increased burdens from the persistent rise in substance use, especially in rural counties with limited resources.
- In one analysis of over 25,000 hospitalizations, opioid use disorder patients stayed 5.8 days on average vs. 3.1 days for non-OUD groups.
- The average charge for an OUD patient hospitalization was $18,422, compared to $12,309 in general cases.
- 78% of OUD hospital patients had at least three chronic health conditions; only 34% of non-OUD patients had three or more.
- Rural facilities with fewer than 100 beds saw 18% of overdose-related ER visits, despite making up just 9% of all hospitals.
This strain on smaller hospitals underscores the complex interplay between high acuity of care and limited medical infrastructure in certain areas.
| Facility Size | % of Hospitals Statewide | % of Overdose ER Visits |
|---|---|---|
| <100 beds | 9% | 18% |
| 100+ beds | 91% | 82% |
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Treatment Gaps
A close look at the numbers reveals persistent barriers to accessing services, especially in rural regions of the state.
- An estimated 1.56 million people in North Carolina needed treatment for a substance use disorder.
- Only about 284,000 individuals—18% of those in need—ultimately received services.
- Rural areas reported wait times averaging 23 days for medication-assisted treatment, compared to 9 days in urban counties.
- Healthcare provider shortages have been especially acute in regions hit hardest by synthetic opioid increases.
These data points reinforce how clinical bottlenecks and workforce limitations contribute to the growing treatment gap statewide.
Key Statistics Summary
- Opioid prescriptions once reached 71.8 per 100 persons in the mid-2010s.
- 40% increase in overdose deaths from 2019 to 2020 in North Carolina.
- 18% of all patients in need of SUD treatment actually obtained it.
- Fentanyl-related fatalities grew by 1,200% in just seven years.
- 62% of hospitalized opioid use disorder patients are ages 18–35.
Overall, North Carolina’s drug and alcohol misuse patterns point to steep increases in overdose risk, concentrated burdens on rural healthcare systems, and persistent challenges in treatment access. A closer look at demographic and regional variations reveals the need for continued attention to the evolving substance abuse crisis.
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Related Articles
- County-Level Opioid Prescribing Rates in North Carolina. Centers for Disease Control and Prevention, 2023.
- Drug & Alcohol Addiction Statistics. Carolina Center for Recovery, 2023.
- Georgia Drug & Alcohol Statistics. Methadone.org, 2023.
- Hospitalization of Patients with Opioid Use Disorder: A 2016 Analysis. Journal of Opioid Management, 2021.
- How Many People in North Carolina Are Facing an Addiction?. Otter House Wellness, 2023.
- North Carolina Reports 40% Increase in Overdose Deaths in 2020. North Carolina Department of Health and Human Services, 2022.
- 2021 National Survey on Drug Use and Health: North Carolina. Substance Abuse and Mental Health Services Administration, 2022.
