Updated Drug and Alcohol Statistics for Tennessee
In This Article
Tennessee’s evolving patterns of substance use and overdose over the past two decades underscore a complex public health challenge. From shifts in youth behaviors to stark rises in opioid-related deaths, the data tells a story of fluctuating drug prevalence, escalating synthetic opioid impacts, and persisting demographic disparities.
Below is a comprehensive statistical overview of drug and alcohol use in Tennessee, with a focus on prevalence, demographic breakdowns, and overdose trends. The goal is to present the numbers in a clear, accessible way that helps illustrate the breadth of substance-related issues in the state.
Key Statistics at a Glance
These key data points highlight some of Tennessee’s most notable substance use findings.
- Overdose mortality rate tripled in Tennessee, from 18 per 100,000 people in 2005 to 54 per 100,000 by 2022.
- Fentanyl accounted for 74% of overdose deaths statewide in 2022.
- 11.82% of Tennesseans aged 12 and older reported past-month illicit drug use in 2021, slightly above the 11.24% national average.
- Alcohol use disorder affected around 10% of adults, with alcohol still the most commonly abused substance.
These figures underscore Tennessee’s significant issues with synthetic opioids, the continuing impact of alcohol misuse, and the ongoing challenge of higher-than-average overdose rates. Below is a deeper, data-focused exploration of these and other statistics.
Overall Substance Use Trends
Understanding the primary patterns of drug and alcohol use over time offers context for public health responses and resource allocation decisions.
- Between 2005 and 2025, Tennessee’s overdose death rate tripled, from 18 to 54 deaths per 100,000 residents.
- Past-month illicit drug use among people aged 12+ ranged from 6% to 12% over the last 20 years, spiking during two distinct opioid surges.
- Tennessee ranked worst nationwide for addiction severity by 2024, reflecting consistently high drug-induced mortality rates.
- Alcohol remained the most common substance of abuse, with an adult alcohol use disorder prevalence of around 10%.
These statewide trends reflect multiple waves of prescription opioid misuse and the dramatic rise of illicit fentanyl. The following table summarizes how drug use rates evolved over two peak periods.
| Peak Period | Dominant Substance | Approx. Illicit Use Rate |
|---|---|---|
| 2008–2014 | Prescription Opioids | Up to 12% |
| Post-2016 | Synthetic Opioids (Fentanyl) | 11–12% |
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Demographic Disparities
Shifts in substance use often differ across age groups, gender, and geographic areas. Below are statistical highlights illustrating these variations.
- Past-month illicit drug use among youth (12–17) declined from 6% to 3% between 2004 and 2014, then rose to 5.7% by 2021.
- Unintentional overdose deaths among 15–24-year-olds reached a record high of 139 deaths in 2019.
- Men account for around 70% of overdose deaths and 75% of treatment admissions.
- In older adults (50+), 74.9% of substance treatment admissions were primarily for alcohol use, with a 46.6% rise in benzodiazepine misuse (2019–2021).
- Rural Appalachian counties have methamphetamine-related death rates 3× higher than urban areas.
Such demographic differences reinforce the importance of targeted interventions. The table below shows selected disparities by age group in Tennessee.
| Age Group | Key Substance Issue | Notable Statistic |
|---|---|---|
| Youth (12–17) | Polysubstance Overdoses | 139 total overdose deaths among 15–24 in 2019 |
| Young Adults (18–25) | Binge Alcohol Use | 26.2% vs. national average of 35.4% |
| Older Adults (50+) | Alcohol + Rising Benzodiazepine Use | 74.9% of treatment admissions for alcohol |
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Opioid Epidemic and Synthetic Shifts
Prescription opioid misuse once dominated Tennessee’s drug crisis, but fentanyl and other synthetic opioids now drive the majority of overdose deaths.
- In 2010, 65% of overdose deaths were tied to prescription opioids, dropping to 20% by 2019.
- Fentanyl-related fatalities soared from 4% of overdoses in 2002 to 74% by 2022.
- Heroin-involved deaths, once rising, plateaued at 380 per year after 2017, replaced largely by cheaper fentanyl analogs.
- Methamphetamine-related deaths rose 248% between 2016 and 2019.
This significant transition from prescription drugs to synthetic opioids continues to drive Tennessee’s high overdose rates, surpassing many neighboring states.
| Overdose Type | Percentage of Deaths (2022) |
|---|---|
| Prescription Opioids | 20% |
| Fentanyl | 74% |
| Heroin | 12% |
| Methamphetamine | Significant contributor to polysubstance deaths |
Alcohol Use and DUI Trends
While opioids are frequently the focus, alcohol misuse remains a persistent challenge in Tennessee, consistently topping the list of most-used substances.
- Alcohol use disorder stands at around 10% among adults, with minimal change in recent years.
- 27,000+ annual DUI arrests in Tennessee highlight the continuing scope of alcohol misuse.
- In comparison, binge drinking among teens is 20%, exceeding their overall past-month illicit drug use rate of 5.7%.
Although less attention is sometimes paid to alcohol when discussing overdose crises, these numbers show it remains a key factor in substance-related harms statewide.
| Category | Alcohol Usage Rate |
|---|---|
| Adults (Overall Use Disorder) | ~10% |
| Binge Drinking (Teens) | 20% |
| Binge Drinking (Young Adults 18–25) | 26.2% |
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Other Emerging Substance Patterns
Beyond opioids and alcohol, other substances have become increasingly problematic, often as part of polysubstance use patterns.
- Illicit benzodiazepines appeared in 15% of 2021 overdose cases, frequently in combination with opioids.
- Psychostimulant (including methamphetamine) deaths increased 650% between 2016 and 2019.
- Methamphetamine lab seizures in Tennessee climbed 178% between 2008 and 2011, contrary to national declines.
- Marijuana use in the state (9.84% past-month use) is lower than the national average of 12.3%.
Such trends illustrate how diverse substances contribute to Tennessee’s addiction severity. Where methamphetamine once receded, it has reemerged in tandem with opioid misuse.
| Substance | Notable Trend | Statistic |
|---|---|---|
| Benzodiazepines | Illicit Use | Found in 15% of overdoses (2021) |
| Methamphetamine | Resurgence | Deaths up 650% (2016–2019) |
| Marijuana | Below National Use Rate | 9.84% in TN vs. 12.3% US |
Overdose Mortality Comparisons
Despite regional prevention efforts, Tennessee’s overdose rate surpasses many nearby states, driving significant public health burdens.
- The 2022 age-adjusted overdose rate of 54 per 100,000 outpaced Kentucky (48), South Carolina (51), and Georgia (36).
- Fentanyl’s share of total overdose deaths in Tennessee (74%) slightly exceeded the national average (70%).
- Rural Tennessee counties like Cheatham had rates of 69 per 100,000, far above more metropolitan regions.
State comparisons underscore the significance of Tennessee’s substance misuse crisis. Elevated mortality, influenced primarily by synthetic opioids and stimulant-related use, distinguishes its situation from that of many neighbors.
Key Statistics Summary
- The overdose death rate in Tennessee is 72% higher than the national average.
- Prescription opioid involvement dropped to 20% of overdose deaths by 2019, replaced by fentanyl.
- Youth substance use declined by 50% between 2004 and 2014, yet overdose deaths in young people remain a concern.
- Men make up 70% of Tennessee’s overdose fatalities.
- Benzodiazepine misuse rose 46.6% among older adults from 2019 to 2021.
Tennessee’s substance abuse data reveals a dual reality of encouraging downward trends in youth consumption alongside persistent opioid and alcohol challenges. Synthetic opioids now dominate mortality statistics, while community disparities remain stark. Alcohol-related arrests remain high, highlighting its entrenched role. Ultimately, the numbers show Tennessee consistently exceeding national averages in overdose and addiction severity, indicating the depth of the state’s ongoing substance use burdens.
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Related Articles
- Tennessee Epi Profile. ACL, Accessed 2025.
- Substance Abuse by City. American Addiction Centers, Accessed 2025.
- Teen Drug Use. Drug Abuse Statistics, Accessed 2025.
- Tennessee Addiction Statistics. JourneyPure, Accessed 2025.
- Tennessee Substance Abuse Statistics. Lakeview Health, Accessed 2025.
- State Profile: Tennessee. U.S. Government, Accessed 2025.
- Tennessee National Drug Control Update. U.S. Government, Accessed 2025.
- Benzodiazepine Trends. National Institutes of Health, Accessed 2025.
- Methamphetamine in Appalachia. National Institutes of Health, Accessed 2025.
- Opioid Overdose Regional Data. National Institutes of Health, Accessed 2025.
- Mental Health and Substance Abuse in Tennessee. The Sycamore Institute, Accessed 2025.
- Drug Trends in Tennessee. University of Tennessee, Accessed 2025.
- Tennessee Overdose Facts. USAFacts, Accessed 2025.
- Tennessee Health Statistics. Centers for Disease Control and Prevention, Accessed 2025.
- National Drug Brief. Centers for Disease Control and Prevention, Accessed 2025.
- Tennessee Ranks Worst Nationwide. Dresden Enterprise, Accessed 2025.
- NSDUH: Tennessee 2021. SAMHSA, Accessed 2025.
- Youth Substance Use Declining. Tennessee Department of Mental Health, Accessed 2025.
