Ohio Leads Nation in Drop in Overdose Death Rate; Lake County Ranks First Among 550 U.S. Counties

Ohio’s overdose death rate has fallen by more than half since 2020, giving the state the largest percentage decline in the country, according to a new analysis of federal data.

AddictionResource.net analyzed CDC mortality records covering more than 630,000 drug overdose deaths nationwide from 2019 through 2025. The group compared overdose death rates in all 50 states and 550 counties, using provisional 2025 figures.

The analysis found Ohio’s overdose death rate fell 53.2% between 2020 and 2025, from 44.1 deaths per 100,000 residents to 20.6. The number of overdose deaths fell from 5,204 in 2020 to 2,457 in 2025.

Ohio’s rate peaked in 2021. Separate research from the Health Policy Institute of Ohio shows the state’s overdose death rate fell 43% between 2021 and 2024.

Why are overdose deaths falling?
There does not appear to be one single explanation.

The Health Policy Institute of Ohio says the improvement has occurred alongside changes in substance-use patterns and the drug supply, increased access to treatment and recovery services, and greater availability of overdose-reversal medication.

The CDC points to similar factors nationally, including widespread distribution of naloxone, better access to evidence-based treatment for substance-use disorders, changes in the illegal drug supply and the return of prevention and response programs disrupted during the pandemic.

The decline in deaths involving fentanyl is especially significant. CDC data show deaths involving synthetic opioids, primarily illegally manufactured fentanyl, have fallen sharply nationwide, and the AddictionResource.net analysis found the same pattern in Ohio.

In Ohio, deaths involving synthetic opioids fell by 2,781 between 2020 and 2025, a decline of about 67%, according to the analysis.

Lake County leads the nation
Northeast Ohio stands out in the county-level numbers. Lake County recorded the largest percentage decline among all 550 U.S. counties included in the study. Its overdose death rate fell 75.2%, from 40 deaths per 100,000 residents in 2020 to 9.9 in 2025.

Summit County’s rate fell 42.3% during the same period, from 41.5 to 24 deaths per 100,000 residents. Cuyahoga County declined 33.9%, while Lorain County fell 44.1%.

Every one of the 23 Ohio counties with enough overdose deaths to be included in the analysis saw its rate decline.

The CDC cautions that 2025 figures are still provisional and may change as additional death records are processed. Nationally, however, the downward trend has continued for three consecutive years. CDC provisional data estimate nearly 70,000 U.S. overdose deaths in 2025, down almost 14% from 2024.

The improvement is substantial, but public-health experts caution that overdose deaths remain a major problem and that maintaining access to naloxone, treatment and recovery services will be important if the decline is to continue.