More Americans are dying from drug overdoses than ever before, according to the Centers for Disease Control and Prevention. There were an estimated 100,306 fatal overdoses over the 12 months through April 2021 — the most ever reported in a 12-month period and double the annual number of car accidents and firearm deaths combined.

The record number of deadly overdoses marks a 29% increase from the same period a year earlier and is more than double the number reported as recently as 2014. Public health experts attribute the surge to the proliferation of fentanyl — a synthetic opioid reported to be 50 to 100 times more potent than morphine — as well as the COVID-19 pandemic. The pandemic has isolated many Americans struggling with addiction while reducing their treatment options and care resources.

In Georgia, drug overdose deaths are rising at a faster pace than they are nationwide. There were an estimated 2,086 fatal overdoses in Georgia over the 12 months ending in April 2021, compared to 1,530 over the same period the year prior. The 36.3% increase ranks as the 16th largest of all 46 states that reported an increase in deadly overdoses.

Of all drug classifications identified by the CDC, including synthetic synthetic and semi-synthetic opioids, cocaine, heroin, psychostimulants like methamphetamine, and methadone (a drug used to treat heroin and opioid addiction), synthetic opioids had the largest increase in fatalities in the state, up 109.9% from a year earlier.

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The fatal drug overdose rate in Georgia now stands at 19.5 deaths for every 100,000 people, the 12th lowest among all states. Nationwide, the per capita fatality rate stands at 30.3 per 100,000.

All overdose data used in this story are from the National Center for Health Statistics, a division of the CDC. To account for pending investigations and incomplete counts, the numbers reported are estimates calculated by the NCHS. Population-adjusted fatality rates were calculated using population estimates from the U.S. Census Bureau’s Decennial Census.

Rank	State	1-yr change in fatal overdoses	Drug OD deaths, 12 mos. ending April 2021	Deaths per 100,000 people, 2021	Drug OD deaths, 12 mos. ending April 2020	Deaths per 100,000 people 2020
1	Vermont	69.9%	209	32.5	123	19.1
2	West Virginia	62.2%	1,607	89.6	991	55.2
3	Kentucky	54.5%	2,319	51.5	1,501	33.3
4	Louisiana	51.6%	2,218	47.6	1,463	31.4
5	Tennessee	50.1%	3,581	51.8	2,385	34.5
6	Mississippi	49.9%	637	21.5	425	14.4
7	California	47.8%	10,585	26.8	7,162	18.1
8	Alaska	46.7%	176	24.0	120	16.4
9	Kansas	45.7%	558	19.0	383	13.0
10	South Carolina	45.4%	1,907	37.3	1,312	25.6
11	Oregon	45.1%	940	22.2	648	15.3
12	Minnesota	38.5%	1,188	20.8	858	15.0
13	New Mexico	37.0%	893	42.2	652	30.8
14	North Carolina	36.9%	3,526	33.8	2,576	24.7
15	Texas	36.4%	4,687	16.1	3,437	11.8
16	Georgia	36.3%	2,086	19.5	1,530	14.3
17	Washington	35.7%	1,892	24.6	1,394	18.1
18	Nevada	35.7%	992	32.0	731	23.5
19	Virginia	35.5%	2,262	26.2	1,669	19.3
20	Colorado	34.6%	1,655	28.7	1,230	21.3
21	Arkansas	33.0%	536	17.8	403	13.4
22	Indiana	32.4%	2,487	36.7	1,878	27.7
23	Alabama	31.4%	1,110	22.1	845	16.8
24	New York	29.3%	5,496	27.2	4,252	21.0
25	Arizona	28.5%	2,768	38.7	2,154	30.1
26	Nebraska	27.9%	211	10.8	165	8.4
27	Ohio	26.6%	5,585	47.3	4,410	37.4
28	Florida	26.2%	7,892	36.6	6,256	29.0
29	Maine	24.2%	528	38.8	425	31.2
30	Wisconsin	21.8%	1,599	27.1	1,313	22.3
31	Maryland	21.0%	2,876	46.6	2,376	38.5
32	Oklahoma	20.2%	798	20.2	664	16.8
33	Michigan	19.3%	2,952	29.3	2,474	24.6
34	Idaho	18.8%	297	16.1	250	13.6
35	Utah	18.5%	674	20.6	569	17.4
36	Rhode Island	17.5%	409	37.3	348	31.7
37	Wyoming	16.9%	97	16.8	83	14.4
38	Missouri	14.6%	2,004	32.6	1,749	28.4
39	Pennsylvania	13.1%	5,410	41.6	4,784	36.8
40	Illinois	12.6%	3,601	28.1	3,197	25.0
41	North Dakota	11.9%	122	15.7	109	14.0
42	Iowa	9.5%	426	13.4	389	12.2
43	Montana	6.6%	161	14.8	151	13.9
44	Hawaii	6.3%	268	18.4	252	17.3
45	Massachusetts	5.8%	2,419	34.4	2,286	32.5
46	Connecticut	4.4%	1,409	39.1	1,350	37.4
47	New Jersey	-1.0%	2,918	31.4	2,948	31.7
48	Delaware	-1.7%	459	46.4	467	47.2
49	New Hampshire	-7.2%	372	27.0	401	29.1
50	South Dakota	-19.8%	77	8.7	96	10.8