Massachusetts Drug and Alcohol Statistics

Statistical Data on Drugs in Massachusetts

Massachusetts confronts a severe substance abuse crisis with overdose deaths at 32.1 per 100,000 residents—55% above the national average—as fentanyl dominates 90% of the state’s 2,125 annual opioid fatalities. The emergency extends beyond opioids with stimulant deaths surging 650% since 2000, youth drug use rates 33% higher than national peers, and a staggering $37 billion annual economic impact. Despite operating 487 treatment facilities and achieving a historic 10% reduction in opioid deaths in 2023, Massachusetts continues battling contaminated drug supplies and rising poly-drug use as synthetic substances reshape the state’s addiction landscape.

Overdose Deaths and General Statistics

• Annual overdose deaths: 2,210
• Percentage of all deaths from overdose: 3.74%
• Death rate trend: Decreasing at 0.85% annually over the last 3 years
• Death rate: 32.1 deaths per 100,000 residents (55.07% higher than national average)
• Massachusetts share of nationwide overdose deaths: 3.14%

While Massachusetts has a significantly higher overdose death rate than the national average, the declining trend over recent years indicates that intervention efforts may be having a positive impact.

Opioid Crisis Statistics

Opioid-Related Deaths (2023)

• Total confirmed opioid deaths: 2,104 (with additional estimated 13-32 deaths)
• Estimated total opioid deaths: 2,125
• Death rate: 30.2 per 100,000 people (10% decrease from 2022)
• Percentage of all overdose deaths: 88% are opioid-related
• Gender distribution: 72% male, 28% female
• Age distribution: 48% between ages 25-44, 43% between ages 45-64

The 10% decrease in opioid deaths represents the largest single-year decline since 2009-2010, indicating significant progress in addressing the opioid crisis.

Substances Present in Opioid Deaths (2023)

Substance	Percentage Present
Fentanyl	90%
Cocaine	54%
Alcohol	26%
Benzodiazepines	25%
Amphetamines	11%
Xylazine	9%
Prescription opioids	7%
Heroin	5%

Fentanyl’s presence in 90% of opioid deaths demonstrates its dominance in the drug supply, while the significant presence of cocaine indicates dangerous poly-drug use patterns.

County-Level Opioid Deaths (2023)

County	Deaths	% Change from 2022
Suffolk	330	+8.6%
Worcester	278	-16.0%
Middlesex	301	-20.8%
Bristol	261	-5.4%
Hampden	231	+0.4%
Essex	217	-21.7%
Norfolk	165	+3.1%
Plymouth	154	-18.9%
Barnstable	72	-17.2%
Berkshire	48	+2.1%
Franklin	28	+7.7%
Nantucket	4	+100.0%
Dukes	6	0.0%

Most counties showed decreases in opioid deaths, with Essex, Middlesex, and Plymouth counties showing the most significant improvements. Suffolk County remains the highest in absolute numbers.

Stimulant-Related Deaths

Stimulant Death Trends

• 2000 stimulant deaths: 188 (0.3% of all deaths)
• 2021 stimulant deaths: 1,411 (2.2% of all deaths)
• Annual increase 2000-2021: 0.86% per year
• Annual increase 2013-2021: 1.4% per year
• Opioid co-occurrence: 82% of stimulant deaths also included opioids (2019-2021)

Demographics of Stimulant Deaths

• Gender ratio: Males have 2.7 times higher death rates than females
• Highest risk age group: 35-44 years (29% of all stimulant deaths)

Age-specific increases 2019-2021:

• Ages 35-44: 63% increase
• Ages 45-54: 30% increase
• Ages 55-64: 81.4% increase

Stimulant-related deaths are rapidly increasing, particularly among middle-aged adults, with the concerning trend of opioid co-occurrence suggesting contaminated drug supplies.

Youth Substance Use (Ages 12-17)

Drug Use Statistics

• Teens using drugs in past month: 53,000 (11.11%)
• Massachusetts vs. national average: 33.37% more likely to use drugs
• Marijuana use among drug users: 86.79%
• Past-year marijuana use: 16.14%
• Cocaine use (past year): 0.42%
• Methamphetamine use: 0.21%
• Heroin use: Up to 0.10%
• Pain reliever misuse: 1.89%

Substance Use Disorders Among Teens

• Illicit Drug Use Disorder (IDUD): 3.35%
• Alcohol Use Disorder (AUD): 1.68%

Massachusetts youth show significantly higher rates of substance use compared to national averages, with marijuana being the predominant illicit substance used.

Young Adults (Ages 18-25)

Substance Use Patterns (2017-2019)

Likelihood vs. national average: 42.17% more likely to use drugs

• Past-month drug use: 367,000 individuals
• Past-year marijuana use: 46.2% (365,000 individuals)
• Marijuana use disorder: 5.8% (46,000 individuals)
• Opioid use disorder: 1.2% (9,000 individuals)
• Overall substance use disorder: 19.0% (150,000 individuals)

Young adults in Massachusetts show concerning rates of substance use disorders, with nearly one in five experiencing some form of substance use disorder.

Adult Population (Ages 12+)

General Substance Use (2017-2019)

• Past-year marijuana use: 21.7% (1.3 million)
• Marijuana use disorder: 2.2% (132,000)
• Heroin use: 0.47% (28,000)
• Prescription pain reliever misuse: 2.9% (171,000)
• Opioid use disorder: 1.0% (59,000)
• Overall substance use disorder: 8.7% (516,000)

Adult substance use rates in Massachusetts consistently exceed national averages, indicating a systemic issue requiring comprehensive intervention strategies.

Treatment and Healthcare Statistics

Rehabilitation Costs

• Average residential treatment cost: $56,725 per individual
• Average outpatient treatment cost: $1,703 per individual
• State ranking for cost: 27th (cheapest to most expensive)

Treatment Capacity and Utilization

• Active substance abuse clinics: 487
• Annual patients treated: 66,912
• Outpatient services enrollment: 62,250 annually
• Residential services enrollment: 3,431 annually
• Hospital-based treatment: 1,231 patients
• Free treatment facilities: 16

Treatment Funding (2023)

• U.S. public spending on MA outpatient services: $106 million (4.59% of national total)
• U.S. public spending on MA residential treatment: $194.6 million (3.75% of national total)

Massachusetts has substantial treatment infrastructure, though the high costs and demand indicate ongoing challenges in accessibility and capacity.

Prescription Monitoring Program Data (2024 Q1)

Statewide Schedule II Opioid Prescriptions

• Total prescriptions: 432,462
• Total dosage units: 21,470,262
• Individuals receiving prescriptions: 200,333 (2.8% of population)
• Individuals with concerning activity: 162 (0.8 per 1,000)

 

County Distribution (Top 5 by prescription volume)

County	Prescriptions	Individuals Receiving	% of Population
Worcester	56,591	26,008	3.0%
Middlesex	75,622	38,441	2.4%
Essex	51,020	24,100	3.0%
Bristol	48,911	20,210	3.5%
Plymouth	37,507	17,477	3.3%

Prescription monitoring shows controlled distribution with relatively low rates of concerning activity, suggesting effective oversight mechanisms.

Emergency Medical Services Data

Opioid-Related EMS Incidents (2023)

• Total incidents: 17,706
• Gender distribution: 68% male, 32% female

Age distribution:

• Ages 25-34: 5,398 incidents
• Ages 35-44: 3,302 incidents
• Ages 15-24: 4,252 incidents
• Ages 45-54: 2,442 incidents

Severity Trends

• 2018 acute overdoses: 54.6% of incidents
• 2023 acute overdoses: 58.7% of incidents
• 2018 dead on arrival: 1.2%
• 2023 dead on arrival: 1.7%

While total EMS incidents are decreasing, the proportion of severe cases is increasing, indicating that those who overdose are experiencing more dangerous episodes.

Economic Impact

Direct Costs (2017)

• Opioid use disorder cases: 67,000 (costing $14.8 billion)
• Fatal overdose costs: $22 billion
• Total economic impact: Nearly $37 billion
• Healthcare system costs: $985 million
• Criminal justice system costs: $466 million
• Treatment expenses: $111 million
• Productivity losses: $985 million

Recent Prevention Investment (FY2023)

• Total funding allocation: $597.2 million
• Naloxone distribution: 210,000+ kits since March 2020

Specific investments:

• Naloxone access expansion: $1.7 million
• Medication-assisted treatment: $3 million
• Low-threshold housing: $5 million

The economic burden of substance abuse in Massachusetts is substantial, but significant investments in prevention and treatment demonstrate commitment to addressing the crisis.

Treatment Programs

Medication-Assisted Treatment (MAT)

• Methadone recipients (2019): 19,830 (increased from 17,633 in 2015)
• Buprenorphine recipients (2019): 11,316 (increased from 4,113 in 2015)

Historical Treatment Admissions (2010)

Total admissions: 87,754

Primary substance categories:

• Heroin: 35,593 admissions
• Other opiates: 5,658 admissions
• Marijuana: 3,840 admissions
• Cocaine (smoking): 2,269 admissions
• Cocaine (other): 1,623 admissions

The dramatic increase in MAT recipients indicates growing acceptance and utilization of evidence-based treatments for opioid use disorder.

Intervention Outcomes and Progress

Recent Positive Trends

• Naloxone distribution (2023): 196,500+ kits distributed
• Overdose reversals: 10,206+ documented reversals
• Fentanyl test strips distributed: 504,000+ kits
• Housing placements: ~600 individuals since 2021
• BIPOC-focused grants: $2.9 million to 20 organizations
• Mobile treatment programs: 5 programs serving rural/urban areas

Prescription Reduction Success

• Opioid prescription decrease: 48% reduction (Q1 2015 to Q3 2022)
• 2019 prescription rate: 35.4 per 100,000 (down from 47.1 in 2016)

Comprehensive intervention strategies including harm reduction, treatment expansion, and prescription monitoring are showing measurable positive outcomes in reducing both overdose deaths and prescription misuse.

This data demonstrates that while Massachusetts continues to face significant substance abuse challenges, multi-faceted intervention approaches are yielding encouraging results, particularly in reducing opioid-related deaths and expanding access to evidence-based treatments.

Statistical Data on Alcohol in Massachusetts

Alcohol abuse represents a significant public health crisis in Massachusetts, with the state recording 2,760 annual alcohol-related deaths and consistently exceeding national averages across multiple risk categories. Massachusetts residents show particularly concerning patterns, including binge drinking rates of 21.1% among adults and 45.9% among young adults aged 18-25, both substantially higher than national figures. The economic burden is staggering, with alcohol abuse costing Massachusetts taxpayers over $7.6 billion annually when adjusted for inflation, while underage drinking alone generates $592 million in sales and causes over $1.4 billion in societal costs. These statistics reveal a complex web of health, safety, and economic impacts that demand comprehensive intervention strategies to address what has become a pervasive challenge affecting communities across the Commonwealth.

Overall Alcohol Death Statistics

Annual Alcohol-Related Deaths

• Total annual deaths: 2,760
• Under-21 deaths: 1.9% of total alcohol deaths
• Death rate per 100,000 residents (2020): 11.3 (lower than national average of 13.1)
• Deaths per capita: 1 death for every 2,547 people aged 18+
• Deaths per 10,000 adults: 4.88

Demographics of Alcohol Deaths

• Male deaths: 68.4% of excessive alcohol use deaths
• Female deaths: 31.6% of excessive alcohol use deaths
• Age distribution: 84.4% are adults aged 35 years and older
• Under-21 percentage: 1.88% of alcohol deaths

Massachusetts has a lower alcohol death rate than the national average, but the 2,760 annual deaths represent a significant public health burden, with males disproportionately affected and most deaths occurring in older adults.

Leading Causes of Alcohol Deaths

Cause	Annual Deaths
Alcohol poisoning	641
Alcoholic liver disease	350
Alcohol-attributable cancers	294
Liver cirrhosis	211

5-Year Averages (2015-2019)

Cause	Average Annual Deaths
All alcohol-attributable causes	1,123
Coronary heart disease (alcohol-related)	163
Alcohol suicides	159
Alcohol Dependence Syndrome	128
Alcohol homicides	70

Demographics of 5-Year Average Deaths

• Male over 21: 830 deaths
• Female over 21: 294 deaths
• Male under 21: 37 deaths
• Female under 21: 12 deaths

Alcohol poisoning is the leading cause of alcohol deaths, while chronic conditions like liver disease and cancer represent significant long-term health consequences.

Binge Drinking Statistics

Adult Binge Drinking

• Adults over 18 who binge drink monthly: 21.1%
• Past-month binge drinking (alternative measure): 22.96%
• National comparison: Massachusetts rate (21.2%) vs. national rate (16.2%)
• Median drinks per binge: 5.4
• Top 25% of active drinkers: 7.0 drinks per binge
• Median binge frequency: 1.5 times monthly
• Top 25% frequency: 3.6 times monthly

City-Specific Binge Drinking Rates

• Boston: 22.8% of adults
• Cambridge: 20.6% of adults

Young Adults (18-25) Binge Drinking

• Past-month binge drinking rate (2017-2019): 45.9% (362,000 individuals)
• Regional average: 46.6%
• National average: 35.4%

Massachusetts consistently shows binge drinking rates significantly higher than national averages across all age groups, with young adults showing particularly concerning rates approaching nearly half the population.

Health Trends and Changes

Temporal Changes

• Death and disability increase (2009-2019): 57.2%
• Rate faster than: Lung cancer, diabetes, hypertension, dietary risks, tobacco use
• Pandemic impact: 38% of Massachusetts adults increased drinking
• Nationwide alcohol deaths increase (2019-2020): 25.5%
• Alcohol addiction increase (2002-2013): More than 20%

Risk Perception

Adults perceiving 5+ drinks as great risk: 40.07%

Policy Context

• State alcohol policy restrictiveness ranking: 17th among 50 states
• Alcohol tax value decline since last raise: 72%
• Current tax amount: Less than $0.05 per drink

The increasing trend in alcohol-related deaths and disability, combined with increased drinking during the pandemic and declining tax values, suggests a need for strengthened prevention and policy interventions.

Demographics and Disparities

Binge Drinking Patterns

• Current drinkers (12+) who binge: 44%
• Current underage drinkers (12-20) who binge: 63%

Chronic vs. Acute Causes

• Chronic causes (e.g., AUD): 59.3% of deaths
• Acute causes: 40.7% of deaths

Geographic Context

• Massachusetts ranking for alcohol poisoning deaths: Top quarter of all states
• Range: 11.9-46.5 deaths per million people

The data reveals that Massachusetts has concerning patterns across multiple demographics, with particularly high rates of binge drinking among underage drinkers and significant representation in national alcohol poisoning statistics.

Youth Alcohol Use (Ages 12-17)

Recent Youth Statistics (2017-2019)

• Past-month alcohol use: 13.6% (65,000 youth)
• Regional average: 12.6%
• National average: 9.4%

Historical Youth Data (2009) – High School Students (Grades 9-12)

• Lifetime alcohol use: 71.3%
• First drink before age 13: 17.2%
• Past-month alcohol use: 43.6%
• Past-month binge drinking: 24.5%
• Alcohol use on school property: 3.8%

Current Underage Drinking (Ages 12-20)

• Past-month alcohol use: 20.40%
• Past-month binge drinking: 10.77%
• Total underage drinkers: Approximately 303,000

Youth alcohol use in Massachusetts exceeds national averages, with concerning patterns of early initiation and binge drinking behavior that can lead to long-term health and social problems.

Alcohol Use Disorders

Youth Alcohol Use Disorder (Ages 12-17)

Past-year AUD rate: 1.68%

Young Adults Alcohol Use Disorder (Ages 18-25)

• Past-year AUD rate (2017-2019): 13.9% (110,000 individuals)
• Regional average: 13.7%
• National average: 9.8%

Adult Alcohol Use Disorder (Ages 12+)

• Past-year AUD rate (2017-2019): 6.2% (369,000 individuals)
• Regional average: 6.4%
• National average: 5.3%

Adult Drinking Patterns

• Past-month alcohol use (adults 18+): 55.92%
• Heavy drinking classification: 10% of adult population
  • Men: >14 drinks per week
  • Women: >7 drinks per week
• Excessive drinking rate: 18.1% of adults

Alcohol use disorders in Massachusetts consistently exceed national averages, particularly among young adults where nearly 14% meet criteria for AUD, indicating a significant treatment need.

Treatment and Rehabilitation Statistics

Treatment Admissions (2010)

• Primary alcohol addiction: 21,624 admissions
• Alcohol plus secondary substance: 11,921 admissions
• Total alcohol-related admissions: 33,545
• Alcohol as primary substance: 25% of admissions
• Alcohol with secondary drug: Additional 13.6% of admissions

Youth Treatment (2009)

• Youth admissions (ages 12-20): 1,472
• Percentage of all alcohol treatment admissions: 4%

Alcohol represents a significant portion of substance abuse treatment needs, with over 33,000 admissions in 2010, indicating substantial treatment infrastructure utilization.

Economic Impact of Alcohol Abuse

Statewide Economic Costs

• 2010 taxpayer costs: $5.635 billion
• 2022 inflation-adjusted costs: $7.607 billion
• Cost per drink: $2.61 (2022 dollars)
• Government direct costs (2010): $2.26 billion ($345 per person, $0.77 per drink)
• Potential life years lost annually: 71,022 years

Underage Drinking Economic Impact (2010)

Problem Category	Cost (millions)
Youth violence	$959.7
Youth traffic crashes	$140.7
High-risk sex (ages 14-20)	$89.7
Youth property crime	$85.4
Youth alcohol treatment	$63.1
Youth injury	$37.5
Fetal Alcohol Syndrome (mothers 15-20)	$20.2
Poisonings and psychoses	$18.2
Total	$1,414.5

Per-Youth Costs

• Cost per youth in state: $2,193 annually
• Cost per underage drink: $3.17
• Direct costs per drink: $1.12
• Retail price per drink: $1.33
• Harm cost per youth (US prices): $1,181

The economic burden of alcohol abuse in Massachusetts is enormous, with underage drinking alone costing over $1.4 billion annually, demonstrating that prevention investments could yield substantial economic returns.

Underage Drinking Market Analysis

Sales and Consumption (2009)

• Underage consumption of total alcohol sold: 15.6%
• Total sales to underage drinkers: $592 million
• Industry profits from underage sales: $290 million
• National ranking for underage consumption: 31st
• Average annual spending per underage customer: $1,953
• Average drinks per day (underage): 4.0
• Average drinks per day (legal customers): 1.7

Underage drinkers consume alcohol at more than double the rate of legal customers, representing a significant portion of the alcohol market and generating substantial industry profits.

Traffic Safety and Crime Impact

Traffic-Related Incidents (2009)

• Alcohol-related traffic fatalities (2009): 334
• Underage drinking traffic fatalities: 13
• Underage drinking nonfatal traffic injuries: 759

Crime Attributable to Underage Drinking (2009)

• Homicides: 21
• Nonfatal violent crimes: 22,500
• Property crimes: 29,900

Other Harms (2007-2009)

• Alcohol-involved fatal accidents (burns, drownings, suicides): 5
• Teen pregnancies attributable to underage drinking: 357
• Teens engaging in risky sex: 20,420

Alcohol contributes significantly to traffic fatalities, violent crime, and risky behaviors, with underage drinking accounting for substantial harm across multiple categories of public safety concerns.

This comprehensive data demonstrates that alcohol abuse represents a major public health crisis in Massachusetts, with impacts extending across health, safety, crime, and economic domains. The consistently higher rates compared to national averages, combined with the substantial economic burden, indicate a need for enhanced prevention, treatment, and policy interventions.

In general, Massachusetts faces a severe substance abuse crisis that significantly exceeds national averages, with 32.1 overdose deaths per 100,000 residents and 2,760 annual alcohol-related deaths creating a combined economic burden of nearly $45 billion. While the state has achieved notable progress including a historic 10% reduction in opioid deaths in 2023 and extensive treatment infrastructure, concerning trends persist with fentanyl present in 90% of opioid deaths and youth substance use rates 33% higher than national averages. Despite substantial investments in prevention and harm reduction—including distributing over 210,000 naloxone kits—Massachusetts must continue expanding evidence-based interventions to address this complex public health emergency affecting every community across the Commonwealth.

Sources:

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