Fatal substance-involved overdoses have significantly worsened over the COVID-19 pandemic. Long a major public health concern in the Central East region and nationwide, fatal overdoses are growing faster than rates of substance use. Overdoses are occurring across all ages, races, ethnicities, genders, and geographic areas ^[CDC]. Fentanyl is the largest driver of the explosion in overdoses. But overdoses of other substances—particularly methamphetamine—have also increased dramatically.

In 2020, the Central East contained 9 of the 10 counties and independent cities with the highest fatal overdose rates in the United States. Over 80% (87) of the counties and cities in the region with reliable data had an overdose rate above the national average. The overdose rate in 31 jurisdictions was at least double the national average. And the fatal overdose rate was three to six times the national average in 11 counties in West Virginia; in Baltimore City and Cecil County, Maryland; and in Petersburg City, Virginia.