Updated Drug and Alcohol Statistics for North Dakota

North Dakota has witnessed significant shifts in drug and alcohol use over the last two decades, leading to changing patterns in treatment admissions, overdose rates, and mental health impacts. The statistics below offer a detailed view of the prevalence and outcomes tied to substance use across the state’s urban, rural, and tribal populations.

From long-standing challenges with excessive alcohol consumption to surges in methamphetamine treatment admissions, these data points demonstrate the wide-ranging effects of substance use on individuals, families, and communities. Below is an in-depth look at some of the most current and noteworthy numbers shaping North Dakota’s substance use landscape.

Key Statistics

• 31.2% of adults (26 and older) reported binge drinking in 2021, ranking second highest nationally
• Over 22% of all substance abuse treatment admissions in 2022 were linked to methamphetamine
• Nearly 2.8% of adults misused prescription opioids in 2022, down from 4.5% in 2015
• The state’s suicide rate climbed 58% from 1999 to 2020, with substance use implicated in 40% of attempts

The sections that follow break down these and other data findings, including demographic patterns and historical trends. Many of these statistics highlight the distinct challenges faced by different age groups, rural counties, and Native American communities.

Alcohol Consumption in North Dakota

Alcohol has historically been the most prevalent substance of use across the state. Below are several key findings on current patterns of use, binge drinking, and associated consequences.

• 60.1% of adults (aged 26+) reported past-month alcohol use in 2021, above the national average of 53.9%
• Among youth (12–20), past-month alcohol use declined from 40% in 2006–2007 to 25.9% in 2022
• 22.5% of male middle school students reported past-month alcohol consumption, compared to 19.8% of females
• Binge drinking affected 31.2% of adults (26+) in 2021, contributing to 30% of domestic violence cases

While these trends highlight steady improvements in underage drinking, adult binge drinking rates remain substantially higher than the U.S. average. Economic impacts also persist.

Alcohol-related fatalities also accounted for 47% of North Dakota’s motor vehicle deaths, reinforcing the need for continued data-driven measures around impaired driving.

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Illicit Drug Use Patterns

Beyond alcohol, North Dakota has confronted changing patterns of illicit drug use, including opioid misuse, rising methamphetamine admissions, and steady marijuana consumption among adolescents.

• Prescription opioid misuse dropped from 4.5% in 2015 to 2.8% in 2022
• Opioid-related emergency department visits declined by 18% between 2016 and 2017
• Methamphetamine treatment admissions tripled from 2010 to 2022, now making up 22% of all admissions
• Adult cocaine use rose from 3.4% in 2015 to 5.1% in 2022, below the 6.2% U.S. rate
• Fentanyl-related fatalities reached 1.19 deaths per 10,000 residents in Sioux County by 2022, double the state average

Although statewide opioid misuse has declined, the emergence of fentanyl remains a serious concern. Meanwhile, stricter precursor regulations reduced meth lab incidents significantly, though overall demand for meth has soared.

Marijuana use among high school students holds relatively steady at 11.3%, lower than the 15.6% U.S. rate, but treatment admissions tied to cannabis have climbed from 28% in 2011 to 34% in 2022.

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Mental Health and Co-Occurring Issues

Mental health challenges often intersect with substance use. The data below reveals how addiction can compound risks such as suicidal ideation and incarceration.

• Statewide suicide rate rose 58% (1999–2020), the largest jump nationally
• Substance use contributed to 40% of suicide attempts
• 26.2% of adolescents reported persistent sadness, compared to 19.5% nationally
• 16.7% of adolescents reported attempting suicide, above the 13.5% U.S. average
• Co-occurring mental illness and substance use disorders rose from 18% in 2010 to 24% in 2022
• Nearly 68.9% of incarcerated individuals had active substance use diagnoses

As more individuals face concurrent challenges, understanding these figures highlights the importance of integrated treatment approaches.

The growing rate of co-occurring conditions suggests a broader demand for dual-diagnosis capabilities and resources, especially in areas lacking robust healthcare infrastructure.

Treatment Landscape and Service Gaps

Access to substance use disorder (SUD) treatment remains uneven statewide, with notable disparities affecting rural counties and Native American populations.

• There are 64 treatment facilities across North Dakota, serving 6,295 clients as of 2022
• 84.4% of services offered are outpatient programs
• Medication-assisted treatment (MAT) is received by 128 per 100,000 people, compared to 187 per 100,000 nationwide
• Rural counties have 37% fewer treatment beds per capita than urban centers
• Native American communities experience overdose mortality rates 2.3× higher than white populations
• Only 5% of MAT recipients are from Native American groups

Continued increases in fentanyl-related complications and methamphetamine use suggest that broader treatment capacity remains critical. The data also show that despite lower reported marijuana usage rates among youth, they account for 18% of marijuana-related admissions, indicating potential referral or diagnostic factors.

Collectively, these statistics underscore a persistent need for expanded treatment programs and culturally attuned services to address regional and demographic gaps.

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Key Statistics Summary

• Binge drinking among adults remained 31.2% in 2021, above the national benchmark
• Methamphetamine admissions increased to 22% of all SUD cases by 2022
• Fentanyl-related deaths rose to 1.19 per 10,000 in some counties
• Co-occurring disorders reached 24% in adults statewide
• Rural North Dakota has 37% fewer treatment beds per capita than urban areas

These figures reflect North Dakota’s evolving substance use profile, driven by an ongoing mix of high alcohol consumption rates, changing illicit drug trends, and rising co-occurring disorders. While some improvements are apparent—particularly the drop in prescription opioid misuse—emerging challenges, like fentanyl, continue to shape the broader public health landscape.

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