Ohio Drug and Alcohol Statistics - World Forum for Mental Health

Statistical Data on Drugs in Ohio

Ohio faces one of the most severe drug crises in the United States, ranking among the top states for overdose mortality rates. The state’s drug epidemic is characterized by high rates of opioid abuse, particularly synthetic opioids like fentanyl, alongside persistent challenges with cocaine, methamphetamine, and prescription drug misuse. However, recent data shows encouraging trends, with overdose deaths declining for two consecutive years under expanded treatment access and harm reduction initiatives. This comprehensive statistical overview draws from multiple state and federal reports to provide a complete picture of substance abuse patterns, treatment infrastructure, and demographic impacts across Ohio.

Overall Drug Overdose Statistics

5,144 drug overdose deaths per year (older baseline data)
4.02% of all deaths are from drug overdose
48.1 deaths per 100,000 residents (older data)
15.25% higher than the national overdose death rate
4.77% of nationwide overdose deaths occur in Ohio

Ohio Overall Drug Overdose Statistics

Recent Trends (2021-2023)

Year	Total Deaths	Change from Previous Year	Age-Adjusted Rate per 100,000
2021	5,174	+3%	46.3
2022	4,915	-5%	43.5
2023	4,452	-9%	39.0

Key Findings:

2023: 9% decrease in deaths (Ohio’s decline vs. 2% nationally)
2022: 5% decrease in deaths (Ohio’s decline vs. 1% national increase)
2024: Estimated 35% drop statewide (biggest one-year decline since 2019)
24% decrease from Q2 to Q4 2023, showing accelerating momentum

Ohio’s overdose death rate significantly exceeds the national average, though recent years show meaningful progress. The state has achieved declining death rates for two consecutive years, outperforming national trends. The 2024 estimated decline of 35% represents the most dramatic improvement since 2019.

Demographics of Overdose Deaths

By Sex (2023)

Sex	Deaths	Rate per 100,000	Change 2022-2023
Male	3,096	54.3	-8%
Female	1,356	23.9	-14%

By Race/Ethnicity (2023)

Race/Ethnicity	Deaths	Rate per 100,000	Change 2022-2023
Black, Non-Hispanic	988	64.9	-4%
White, Non-Hispanic	3,241	37.6	-12%
Hispanic	177	33.6	+8%
Asian/Pacific Islander	8	–	–

By Race/Ethnicity and Sex (2023)

Group	Deaths	Rate per 100,000
Black Non-Hispanic Males	724	100.3
Black Non-Hispanic Females	264	33.1
White Non-Hispanic Males	2,203	50.8
White Non-Hispanic Females	1,038	24.2
Hispanic Males	140	50.7
Hispanic Females	37	14.7

By Age Group (2023)

Age Group	Deaths	Rate per 100,000	Change 2022-2023
<15	9	0.3	–
15-24	173	11.4	-31%
25-34	906	58.4	-21%
35-44	1,274	85.8	-7% (Highest rate)
45-54	936	67.0	-8%
55-64	855	56.3	+3%
65+	297	13.4	+4%

Overdose deaths disproportionately affect males, middle-aged adults, and Black non-Hispanic populations. While males consistently show higher death rates, females experienced a more dramatic 14% decline in 2023. Racial disparities remain stark, with Black non-Hispanic males having nearly twice the overdose death rate of White non-Hispanic males.

Geographic Distribution: Counties with the Highest Overdose Rates

Top 20 Counties by Overdose Death Rate (2023)

Rank	County	Deaths	Rate per 100,000	2020-2023 Average Rate
1	Scioto	81	117.9	130.1
2	Vinton	10	90.6	116.4
3	Lawrence	34	66.0	83.4
4	Gallia	16	65.4	81.5
5	Adams	17	78.3	71.7
6	Pike	18	73.6	82.0
7	Ross	49	66.5	72.8
8	Hocking	17	70.4	59.6
9	Marion	44	68.3	60.5
10	Mahoning	141	65.7	69.6
11	Trumbull	124	67.3	68.1
12	Meigs	12	63.3	94.0
13	Jackson	19	62.1	60.7
14	Brown	25	57.3	58.6
15	Clinton	19	56.2	57.9
16	Lucas	227	55.3	57.7
17	Jefferson	29	53.4	63.0
18	Montgomery	270	54.0	57.8
19	Franklin	701	51.6	56.2
20	Cuyahoga	550	43.1	43.0

Notable County Trends

Montgomery County: 293 deaths (2023) vs. 316 (2022) = 7.3% decrease
Clark County: 79 deaths (2021) vs. 52 (2020) = 51.9% increase
Stark County: 159 deadly overdoses (2022), 76% involving heroin/fentanyl
Cuyahoga County: 435 deaths (2024) showing continuing decline

Ohio Overdose County Trends Statistics

Rural and Appalachian counties in southeastern Ohio show the most severe overdose crisis, with rates far exceeding state and national averages. Scioto County’s rate of 117.9 per 100,000 is three times the state average and more than four times the national average.

Drug-Specific Statistics

Substance Use Prevalence (Ages 12+, 2022-2023)

Substance	Past Year Use	Past Month Use	Percentage (12+)
Marijuana	2,265,000	1,560,000	22.76% past year
Cocaine	196,000	–	1.97% past year
Prescription Pain Relievers (misuse)	299,000	–	3.00% past year
Methamphetamine	92,000	–	0.92% past year
Hallucinogens	239,000	–	2.40% past year
Heroin	29,000	–	0.32% past year

Overdose Deaths by Drug Category (2023)

Drug Type	Deaths	% of Total Deaths	Change 2022-2023
Fentanyl	3,486	78%	-12%
Cocaine	1,738	39%	+7%
Psychostimulants (meth)	1,267	28%	-6%
Benzodiazepines	375	8%	+4%
Natural/Semi-Synthetic Opioids	291	7%	-20%
Methadone	110	2%	No change
Heroin	75	2%	-17%
Hallucinogens	83	2%	-30%

Fentanyl Combination Deaths (2023)

79% of cocaine deaths also involved fentanyl
77% of psychostimulant deaths also involved fentanyl
73% of benzodiazepine deaths also involved fentanyl
93% of heroin deaths also involved fentanyl
61% of natural/semi-synthetic opioid deaths also involved fentanyl

While opioids dominate fatality statistics, Ohio faces a polysubstance crisis. Marijuana is the most widely used illicit substance, while cocaine and methamphetamine deaths are rising even as opioid deaths decline.

Opioid Epidemic Statistics

Opioid Overdose Deaths (2023)

3,805 people died from opioid overdose
80.2% of all overdose deaths involve opioids
34.0 deaths per 100,000 residents (41.7% higher than national rate)

Related Health Impacts

24.2 per 1,000 births diagnosed with neonatal opioid withdrawal syndrome (2020)
46.8 new hepatitis C cases per 100,000 linked to IV drug use (2022)
56.1 new HIV/AIDS diagnoses per 100,000 connected to IV drug use (2023)

Prescription Rates

40.7% of residents could have an opioid prescription (based on prescribing rates)
47.9 opioid prescriptions per 100 people (exceeds national average of 39.5)

Opioid Types Involved in Deaths

Synthetic opioids (fentanyl): 94.3% of opioid deaths
Heroin: 2.1% of opioid deaths
Prescription opioids: 8.7% of opioid deaths

Opioids remain the dominant factor in Ohio’s overdose crisis, involved in over 80% of all overdose deaths. Synthetic opioids, primarily fentanyl, have almost completely replaced heroin as the primary opioid threat. Ohio’s opioid death rate is 41.7% higher than the national average.

Historical Trends and Context

Overdose Death Trajectory (2014-2023)

Year	Total Deaths	Notable Change
2014	2,531	Baseline
2015	3,050	+20%
2016	4,050	+33%
2017	4,854	+20% (Peak pre-2020)
2018	3,764	-22%
2019	4,028	+7%
2020	5,017	+25%
2021	5,174	+3% (All-time peak)
2022	4,915	-5%
2023	4,452	-9%

Historical Context

2009-2010: Ohio ranked in top 10 states for non-medical pain reliever use among 12-17-year-olds
2008-2011: Meth lab seizures increased 36% (from 258 to 352)
2009: 1,340 drug-induced deaths (compared to 1,021 motor vehicle deaths and 991 firearm deaths)
2016: Ohio had 4th highest overdose death rate nationally (29.9 per 100,000)

Ohio’s drug crisis has evolved significantly over the past decade. The state experienced a sharp increase in overdose deaths from 2014-2017, followed by fluctuations and recent encouraging declines. Methamphetamine lab seizures have decreased from their 2011 peak, while fentanyl has emerged as the dominant threat.

Comparative National Context

Ohio vs. National Averages

Overdose Rates

Ohio: 48.1 per 100,000 (older data) vs. National: 31.3 per 100,000
Ohio is 15.25% higher than national overdose death rate
Ohio accounts for 4.77% of nationwide overdose deaths

Substance Use Prevalence

Past-month illicit drug use: Ohio 7.87% vs. National 8.82%
Past-month illicit drug use (non-marijuana): Ohio 3.48% vs. National 3.6%

Specific Substance Use (2017-2019)

Heroin use: Ohio 0.53% vs. National 0.30%
Prescription pain reliever misuse: Ohio 4.5% vs. National 3.7%
Opioid use disorder: Ohio 1.4% vs. National 0.7%
Illicit drug use disorder: Ohio 3.6% vs. National 2.9%

Recent Performance

2023: Ohio -9% vs. National -2% decline in overdoses
2022: Ohio -5% vs. National +1% (increase) in overdoses

National Ranking

6th highest drug overdose mortality rate nationally (40.8 per 100,000; 48% above national average of 27.5)
West Virginia leads nation at 65.9 per 100,000

Ohio consistently performs worse than national averages on overdose metrics but has recently shown superior improvement trends. The state’s 9% decline in 2023 far exceeded the 2% national decline, suggesting that Ohio’s comprehensive approach to the crisis is yielding results.

Youth and Young Adult Substance Use

Youth (Ages 12-17) Statistics

Drug Use

72,000 (7.89%) used drugs in the last month
8.73% more likely to have used drugs than average American teen
90.28% of teen drug users reported marijuana use
12.43% used marijuana in the past year
0.19% used cocaine in the past year
0.11% used methamphetamine in the past year
1.92% misused pain relievers in the past year

Alcohol Use

6.60% used alcohol in the last month
4.00% less likely to use alcohol than average American teen

Substance Use Disorders

7.29% met criteria for Drug Use Disorder (DUD)
3.06% met criteria for Alcohol Use Disorder (AUD)

Young Adults (Ages 18-25) Statistics

Drug Use (2022-2023 Average)

334,000 (28.11%) used illicit drugs in the past month
5.25% more likely to use drugs than average American in same age group
482,000 (40.53%) used marijuana in the past year
43,000 (3.59%) used cocaine in the past year

Substance Use Disorders

29.49% had a substance use disorder
19.63% had a drug use disorder
1.33% had an opioid use disorder
8.6% had an illicit drug use disorder (2017-2019)
15.5% had any substance use disorder (2017-2019)

Ohio teens show slightly lower drug use rates than the national average, though young adults (18-25) demonstrate elevated rates. Marijuana dominates youth substance use, with concerning rates of early initiation. Notably, Ohio teens are 4% less likely to use alcohol than their national peers.

Substance Use Disorders

Prevalence (2022-2023 Average, Ages 12+)

Disorder Type	Number	Percentage
Any Substance Use Disorder	1,828,000	18.37%
Drug Use Disorder	1,039,000	10.44%
Opioid Use Disorder	215,000	2.16%
Pain Reliever Use Disorder	212,000	2.13%

By Age Group (Percentage with Disorder)

Disorder	Ages 12-17	Ages 18-25	Ages 26+	Ages 18+
Substance Use Disorder	8.63%	29.49%	17.81%	19.35%
Drug Use Disorder	7.29%	19.63%	9.41%	10.75%
Opioid Use Disorder	0.96%	1.33%	2.43%	2.28%

Additional Context

1.4% of population has opioid use disorder (twice the national average)
13.6% of Ohio’s Medicaid population had Opioid Use Disorder
16.7% of males vs. 11.4% of females had OUD

Nearly one in five Ohio residents aged 12+ experiences a substance use disorder, exceeding the national average of 17%. The treatment gap is substantial, with three-quarters of those needing treatment not receiving it.

Prescription Drug Misuse

Prescription Statistics

47.9 prescriptions per 100 people (national average: 39.5)
53.5 opioid prescriptions per 100 persons (historical; national average: 51.4)
444,000 people (4.5%) misused prescription pain relievers in past year (2017-2019)

College Student Prescription Misuse

6.8% admitted to misusing pain medications
7.8% confessed to misusing sedatives
14.5% acknowledged misusing stimulants
11.4% find it “somewhat easy” or “very easy” to obtain pain medication for non-medical use

Stimulant Use

~3 million Ohio residents (including ~2 million Adderall users) actively use stimulants annually
Adderall is the “most frequently misused” prescription stimulant in Ohio

Overprescription remains a significant concern in Ohio, with prescription rates exceeding national averages. College students show particularly high rates of stimulant misuse (14.5%), and prescription pain relievers are accessible to many who seek them for non-medical use.

Risk Perceptions

Perception of Great Risk (Ages 12+, 2022-2023)

Substance/Behavior	Number	Percentage
Trying heroin once or twice	8,221,000	82.67%
Using cocaine once a month	6,583,000	66.17%
Smoking marijuana once a month	1,558,000	15.65%

Risk perception data reveals gaps in understanding of substance dangers, particularly regarding marijuana. Only 15.65% of Ohio residents perceive great risk from monthly marijuana use, suggesting normalization despite potential harms.

Treatment and Recovery Infrastructure

Treatment Facilities and Services

Facilities

589 active substance abuse clinics statewide
125 opioid treatment providers (up from 35 in 2019 = 250% increase)
5 facilities offer free drug rehab treatment for all patients

Annual Service Volume

66,296 total clients serviced annually
66,124 clients in outpatient services
3,653 clients in residential (non-hospital) services
519 clients in hospital services

Ohio Treatment Annual Service Volume Statistics

Treatment Enrollment (2023 Single-Day Count)

66,296 people enrolled in substance use treatment
49.0% received treatment for drug problem only
14.9% received treatment for alcohol problem only
36.1% received treatment for both drug and alcohol problems

Medication-Assisted Treatment (MAT) – 2019 Single-Day Count

13,672 people receiving buprenorphine (up from 7,347 in 2015)
5,824 people receiving methadone (down from 6,147 in 2015)

Treatment Costs

Service Type	Individual Cost	Total Public Spending	% of US Total
Outpatient	$1,705	$112.7 million	4.88%
Residential	$56,688	$207 million	3.99%

Note: Ohio ranks 25th in cheapest to most expensive state for residential drug rehabilitation

Treatment Gap (2022-2023)

2,104,000 (21.14%) classified as needing substance use treatment
528,000 (5.30%) received substance use treatment
1,548,000 (74.60%) not receiving treatment despite need
Among youth 12-17: 53.86% needing treatment did not receive it
Among young adults 18-25: 82.43% needing treatment did not receive it

Revenue Projections (2024)

Outpatient mental health and substance abuse centers: $1.4 billion
Psychiatric and substance abuse hospitals: $598.4 million
Residential mental health and substance abuse facilities: $510.4 million

Ohio has dramatically expanded its treatment infrastructure since 2019, with opioid treatment providers increasing by 250%. However, a significant treatment gap persists, with 74.6% of those needing treatment not receiving it. The state serves over 66,000 clients annually across 589 active clinics.

Harm Reduction and Prevention Efforts

Naloxone Distribution

520% increase in distribution from 2019 to 2023
291,000 kits distributed in 2023 alone
20,000+ known overdose reversals facilitated
Naloxone.Ohio.gov created in 2022 for free naloxone access

Ohio Naloxone Distribution Statistics

Law Enforcement Efforts (Since 2019)

110,000 doses of opiates removed from Ohio streets
900+ pounds of fentanyl seized
$2.4 million in grant funding awarded to 32 drug task forces (2023)

Innovative Local Programs

Stark County: Converted old newspaper vending box into anonymous Naloxone dispenser
6,000+ newly certified peer supporters for adults, families, and youth
Expanded recovery housing programs statewide

Ohio has emerged as a national leader in harm reduction, with naloxone distribution increasing 520% from 2019 to 2023. This aggressive expansion has contributed to over 20,000 known overdose reversals and is a key factor in the state’s declining death rates.

Ohio’s drug crisis, while still severe with overdose rates significantly exceeding national averages, has entered a promising phase of sustained improvement driven by aggressive harm reduction strategies, expanded treatment access, and coordinated law enforcement efforts. The state’s 9% decline in overdose deaths in 2023 and estimated 35% drop in 2024 demonstrate that comprehensive approaches combining naloxone distribution, medication-assisted treatment, and peer support can reverse even the most devastating addiction epidemics. However, substantial challenges remain, including persistent racial and geographic disparities, the evolving polysubstance crisis with rising cocaine and benzodiazepine deaths, and a critical treatment gap leaving three-quarters of those needing help without services. Continued investment in prevention, treatment infrastructure, and harm reduction will be essential to sustain this progress and address the underlying factors driving substance use disorders across Ohio’s diverse communities.

Statistical Data on Alcohol in Ohio

Alcohol abuse remains a significant public health challenge in Ohio, affecting thousands of residents across all age groups and demographics. While Ohio’s drinking patterns generally align with national averages, the state faces considerable health and economic costs from excessive alcohol consumption. This report synthesizes available data on alcohol use, abuse patterns, health impacts, and demographic trends in Ohio, drawing from multiple state and federal sources including the CDC, Ohio Department of Mental Health & Addiction Services, and various behavioral health surveys.

Mortality and Health Impact

Annual Deaths from Excessive Alcohol Use

Key Finding: An average of 5,739 deaths occur annually in Ohio due to excessive alcohol use.

This mortality rate translates to approximately one death for every 2,056 adults aged 18 and older, or 6.24 deaths per 10,000 adults. The CDC estimates that these deaths result in 151,736 years of potential life lost each year. Notably, alcohol-related deaths exceed opioid deaths in Ohio, making it a more lethal substance abuse problem than the widely-publicized opioid crisis.

Death Demographics

Demographic Category	Percentage
Male deaths	54.8%
Deaths from chronic causes (e.g., Alcohol Use Disorder)	54.8%
Deaths among adults aged 35+	83.0%
Deaths among individuals under age 21	2.63%

The majority of alcohol-related deaths affect middle-aged and older adults, with those 35 and older accounting for more than four out of five deaths. Males are disproportionately affected, representing slightly more than half of all deaths. While underage deaths represent a small percentage (2.63%), this still translates to approximately 151 young lives lost annually.

Rate Increase Over Time

Key Finding: The 5-year average annual rate of excessive alcohol deaths per capita in Ohio increased by as much as 56.1% from 2015 to 2019.

This dramatic increase indicates a worsening alcohol abuse crisis in the state during this period, suggesting that intervention efforts may have been insufficient to counteract rising consumption patterns or other contributing factors.

Historical Trends

Key Finding: The prevalence of excessive drinking declined 21% in Ohio from 2011 to 2023.

This represents significant progress in reducing excessive alcohol consumption over a 12-year period, suggesting that public health interventions and awareness campaigns may be having positive effects. However, the earlier-noted 56.1% increase in death rates from 2015-2019 indicates that while fewer people may be drinking excessively, those who do may be consuming more dangerous amounts or suffering more severe health consequences.

National Comparisons and Rankings

Ohio’s National Standing

Ohio ranks 37th for excessive alcohol use in the United States
Excessive drinking rate: 16.9% (Ohio) vs. comparable national rates
Ohio ranks 26th nationally for excessive drinking prevalence

Ohio Drinking Comparison Statistics

Ohio’s middle-ranking position indicates that while the state doesn’t have the worst alcohol abuse problems nationally, it still faces significant challenges that warrant attention and intervention.

Comparison to Regional and National Averages

Youth Alcohol Use (2017-2019)

Ohio: 9.2%
Regional average (Region 5): 9.2%
National average: 9.4%

Young Adult Binge Drinking (2017-2019)

Ohio: 38.9%
Regional average: 39.2%
National average: 35.4% (Ohio is higher)

Young Adult AUD (2017-2019)

Ohio: 10.1%
Regional average: 10.9%
National average: 9.8%

Overall AUD (2017-2019)

Ohio: 5.1%
Regional average: 5.6%
National average: 5.3%

Ohio’s rates are generally similar to regional and national averages, with the notable exception of young adult binge drinking, where Ohio significantly exceeds the national average.

Alcohol Consumption Patterns

Binge Drinking Statistics (2022-2023 Data)

Overall Population (Ages 12+)

48.51% reported alcohol use in the past month
23.74% reported binge alcohol use in the past month

By Age Group

Age Group	Past-Month Alcohol Use	Past-Month Binge Drinking
12-17 years	6.60%	3.67%
18-25 years	53.77%	32.91%
26+ years	52.56%	24.67%
18+ years (overall)	52.72%	25.76%

Young adults (18-25) show the highest rates of binge drinking at nearly 33%, significantly higher than both younger teens and older adults. More than half of all adults report past-month alcohol use, indicating widespread consumption across the adult population.

Youth and Underage Drinking (Ages 12-20)

Measure	Number (thousands)	Percentage
Alcohol use in past month	232	17.13%
Binge alcohol use in past month	141	10.37%
Underage drinkers (ages 12-17)	80+	—

Over 80,000 Ohioans aged 12-17 are underage drinkers, with more than 10% of youth aged 12-20 engaging in binge drinking. This early initiation of alcohol use is concerning as it correlates with increased risk of developing alcohol use disorders later in life.

Binge Drinking Intensity (Adult Data)

Median drinks per binge: 5.7 drinks
Top 25% most active drinkers: 8.2 drinks per binge
Median binge frequency: 1.9 times monthly
Top 25% most active drinkers: 4.4 times per month

Ohio Binge Drinking Statistics

The most active binge drinkers consume significantly more alcohol per session and binge more frequently than typical binge drinkers, indicating a subset of the population at particularly high risk for alcohol-related health problems.

Additional Consumption Data

17.2% of Ohio adults over 18 binge drink at least once per month
19.5% of Ohioan adults reported weekly binge drinking
Nearly 20% of adults in Ohio 18 and over are binge drinkers
More than 2 million residents aged 12 or older engaged in binge drinking in 2020

Various sources report slightly different percentages due to different survey methodologies and time periods, but all indicate that approximately one in five Ohio adults engages in binge drinking behavior, representing a substantial public health concern.

Alcohol Use Disorder (AUD)

Prevalence by Age (2022-2023)

Age Group	Number with AUD (thousands)	Percentage with AUD
12+ years	1,095	11.00%
12-17 years	28	3.06%
18-25 years	200	16.85%
26+ years	867	11.03%
18+ years	1,067	11.80%
12-20 years	95	7.03%

Young adults aged 18-25 show the highest prevalence of AUD at nearly 17%, more than 50% higher than the overall adult rate. The 2022 estimate indicates that 6.7% of Ohio residents struggled with AUD—exactly 1% higher than the national average of 5.7% that year. Around 10% of Ohio residents aged 12 or older experienced AUD in 2020.

Historical Trends

2017-2019 Data

Overall population (12+): 5.1% (or 503,000 people)
Young adults (18-25): 10.1% (or 121,000 people)
Youth (12-17): 9.2% past-month alcohol use

The prevalence of AUD decreased between 2002-2004 and 2017-2019 among both young adults and the general population, suggesting some success in prevention efforts during that period. However, more recent data (2022-2023) shows increases, particularly among young adults.

Excessive Drinking by Demographics (2023 Data)

Gender

Gender	Excessive Drinking Rate
Males	19.8%
Females	14.0%
Overall	16.8%

Men in Ohio are 47% more likely to drink excessively than women, consistent with national patterns of higher alcohol consumption and abuse among males.

Race/Ethnicity

Key Finding: White Ohioans are 18% more likely to drink excessively than Black Ohioans.

While the prevalence of excessive drinking did not significantly differ by race/ethnicity in statistical testing, White populations show higher rates of excessive drinking compared to Black populations in the data.

Age

Key Finding: Ohioans aged 18-44 are 200% more likely to drink excessively than those age 65 and up.

The prevalence of excessive drinking was significantly higher among Ohioans ages 18-54 compared with those age 55 and older, indicating that alcohol abuse prevention efforts should focus heavily on younger age groups.

Income

Annual Household Income	Excessive Drinking Rate
$75,000 or more	23.0%
$15,000-$74,999	Lower rates
$25,000 or less	Significantly lower

Higher-income Ohioans show substantially higher rates of excessive drinking. Those making more than $75,000 are 78% more likely to abuse alcohol than those making $25,000 or less, potentially due to greater disposable income and social drinking cultures in higher-income demographics.

Education Level

Key Finding: College graduates have a 19.9% excessive drinking rate, while those with a high school diploma or less have significantly lower rates.

College-educated Ohioans are 21% more likely to abuse alcohol than those without a college degree, which may relate to social drinking cultures in college environments and professional settings.

Risk Perceptions

Perception of Risk from Heavy Drinking

Age Group	Number (thousands)	Percentage
12+ years	3,950	39.70%
12-17 years	351	38.60%
18-25 years	409	34.40%
26+ years	3,191	40.62%
18+ years	3,599	39.80%
12-20 years	515	37.93%

Only about 40% of Ohioans perceive great risk from having five or more drinks once or twice a week. Notably, young adults (18-25) have the lowest risk perception at 34.40%, which correlates with their higher rates of binge drinking and AUD.

Treatment Needs and Access (2022-2023)

Treatment Statistics

Measure	Number (thousands)	Percentage
Received substance use treatment	528 (12+)	5.30%
Classified as needing treatment	2,104 (12+)	21.14%
Needing treatment but not receiving it	1,548 (12+)	74.60%

A critical treatment gap exists in Ohio, with approximately three-quarters (74.60%) of those needing substance use treatment not receiving it. This represents approximately 1.5 million people who need but aren’t receiving treatment.

Treatment Gap by Age

Age Group	Needing Treatment	Not Receiving Treatment (%)
12-17	104,000	53.86%
18-25	374,000	82.43%
26+	1,626,000	74.21%
18+	2,000,000	75.74%

Young adults aged 18-25 face the largest treatment gap, with more than 82% of those needing treatment not receiving it. Even among youth aged 12-17, more than half who need treatment aren’t getting it, though this age group has better access than older populations.

Alcohol and Cancer in Ohio

Overall Cancer Impact (2018-2022 Data)

Ohio’s incidence rate for all alcohol-associated cancers: 235.3 per 100,000 adults aged 30+
U.S. incidence rate: 227.2 per 100,000
Ohio’s rate is 3.6% higher than the national average

Ohio Alcohol and Cancer Statistics

Alcohol use is the third-leading preventable risk factor for cancer, following tobacco and obesity. Ohio’s higher-than-national cancer incidence rates for alcohol-associated cancers reflect the state’s alcohol consumption patterns.

Population Attributable Risk by Cancer Type

Percentage of cancers attributable to alcohol use:

Cancer Site	Males	Females	Overall
Oral Cavity	49.9%	25.1%	41.7%
Pharynx	44.6%	22.5%	40.4%
Larynx	29.5%	14.3%	26.4%
Esophagus	17.2%	24.2%	18.7%
Liver & Intrahepatic Bile Duct	22.6%	7.7%	18.8%
Female Breast	—	16.4%	—
Colon & Rectum	18.0%	6.8%	12.8%

Nearly half of oral cavity cancers and more than 40% of pharyngeal cancers in Ohio are attributable to alcohol use. Males show higher attributable risks across most cancer types, with the notable exception of esophageal cancer where females show slightly higher attributable risk.

Cancer Incidence by Demographics (2018-2022)

Average Annual Cases and Rates per 100,000

Cancer Site	Ohio Cases	Ohio Rate	U.S. Rate
All Alcohol-Associated Sites	20,402	235.3	227.2
Breast	10,194	120.1	118.0
Colon & Rectum	5,576	64.7	62.8
Esophagus	911	9.9	7.2
Larynx	572	6.2	4.3
Liver & Intrahepatic Bile Duct	1,221	12.8	16.0
Oral Cavity & Pharynx	1,929	21.5	18.9

Ohio exceeds national rates for most alcohol-associated cancers, with particularly notable differences for esophageal (37.5% higher), laryngeal (44.2% higher), and oral cavity/pharyngeal (13.8% higher) cancers. Only liver cancer shows a lower rate in Ohio compared to the U.S.

Cancer Incidence by Sex

Category	Male Rate	Female Rate
All alcohol-associated sites	155.3	309.0

The overall incidence rate for females is nearly twice that of males due to the high incidence of breast cancer. However, for individual cancer types (excluding breast), males have higher incidence rates.

Cancer Incidence by Race

Race/Ethnicity	Rate per 100,000
White	234.7
Black	233.1
Asian/Pacific Islander	98.6

White and Black populations show similar overall rates, but Asian/Pacific Islanders have rates less than half those of White and Black populations. Race-specific patterns vary by cancer type: esophageal and oral cavity cancers are higher among White people, while liver cancer is slightly higher among Black people.

Cancer Mortality (2018-2022)

Average Annual Deaths and Rates per 100,000

Cancer Site	Ohio Deaths	Ohio Rate	U.S. Rate
All Alcohol-Associated Sites	6,174	68.7	63.9
Breast	1,673	19.2	18.2
Colon & Rectum	2,112	23.8	22.0
Esophagus	752	8.2	6.4
Larynx	182	1.9	1.5
Liver & Intrahepatic Bile Duct	991	10.6	11.3
Oral Cavity & Pharynx	461	5.0	4.4

Ohio’s overall mortality rate for alcohol-associated cancers is 7.5% higher than the national average. The state exceeds national mortality rates for all alcohol-associated cancer types except liver cancer.

Cancer Mortality by Demographics

By Sex

Male mortality rate: 70.5 per 100,000
Female mortality rate: 67.3 per 100,000

By Race

Black: 81.2 per 100,000 (19.6% higher than White)
White: 67.9 per 100,000
Asian/Pacific Islander: 41.2 per 100,000

Mortality rates are similar between males and females overall, but Black populations experience significantly higher mortality rates—nearly 20% higher than White populations and almost double the rate for Asian/Pacific Islanders.

Cancer Age Distribution

Highest number of cases: Both males and females aged 65-69 years
Highest number of deaths: Males aged 65-69 years; females aged 85+ years
Incidence rates increase with age through 85+ for males, through 80-84 for females

Older adults bear the greatest burden of alcohol-associated cancers, reflecting cumulative lifetime exposure to alcohol and the latency period for cancer development.

Cancer Incidence and Mortality Trends

Increasing Incidence Rates

Breast cancer: +0.4% per year (2004-2022)
Liver & intrahepatic bile duct cancer: +4.3% per year (1996-2017)
Oral cavity & pharyngeal cancer: +1.9% per year (2000-2022)

Increasing Mortality Rates

Laryngeal cancer: +2.2% per year (2018-2022)
Liver & intrahepatic bile duct cancer: +2.8% per year (1996-2017)
Oral cavity & pharyngeal cancer: +1.8% per year (2011-2022)

Decreasing Rates

Breast cancer mortality: -2.0% per year (1996-2022)
Colon & rectum cancer incidence: -2.3% per year (2015-2022)
Colon & rectum cancer mortality: -2.0% per year (2009-2022)
Laryngeal cancer incidence: -1.2% per year (1996-2022)

While some cancers show improving trends (particularly colon/rectum), several alcohol-associated cancers show concerning increases in both incidence and mortality, particularly liver, oral cavity, and pharyngeal cancers.

Economic Impact

Costs to Ohio Taxpayers

2010 Data (adjusted for inflation):

Original cost: $8.520 billion
2022 equivalent: $11.502 billion
Cost per drink: $2.84 (in 2022 dollars)

Ohio Alcohol Costs Statistics

The economic burden of excessive alcohol use on Ohio taxpayers exceeds $11.5 billion annually when adjusted for inflation, representing substantial costs in healthcare, lost productivity, criminal justice, and other alcohol-related expenses.

Policy Implications and Interventions

Price Elasticity Research

According to U.S. Community Preventive Services Task Force review of 72 studies:

Price increases lead to consumption decreases:

10% price increase → 5.0% lower beer consumption
10% price increase → 6.4% lower wine consumption
10% price increase → 7.9% lower spirits consumption

Historical price trends:

A can of Budweiser in 2010 cost one-fifth its 1950 price
Cheap liquor in 2010 cost one-fifteenth its 1950 price

The dramatic decrease in real alcohol prices over time has likely contributed to increased consumption and abuse. Research strongly supports taxation as an effective intervention, with spirits showing the greatest price sensitivity. Higher alcohol prices could significantly reduce consumption and abuse rates in Ohio.

Ohio faces a multifaceted alcohol abuse crisis affecting all demographic groups, with particular concerns among young adults, males, higher-income populations, and college-educated individuals. While excessive drinking rates have declined 21% from 2011 to 2023, alcohol-related deaths increased dramatically from 2015-2019, and treatment access remains severely inadequate with three-quarters of those needing treatment not receiving it. The state’s alcohol-associated cancer rates exceed national averages, contributing to thousands of preventable deaths annually. Despite some progress, the $11.5 billion annual cost to taxpayers and the 5,739 yearly deaths from excessive alcohol use demonstrate that alcohol abuse remains a more lethal problem in Ohio than the opioid crisis, warranting increased attention to evidence-based interventions such as taxation, expanded treatment access, and targeted prevention efforts for high-risk populations.

Conclusion

In general, Ohio faces a dual crisis with both drugs and alcohol claiming thousands of lives annually, though recent trends show encouraging progress. Drug overdose deaths declined for two consecutive years, with a 9% decrease in 2023 and an estimated 35% drop in 2024, driven largely by a 520% increase in naloxone distribution from 2019 to 2023. However, significant challenges remain, including a critical treatment gap leaving 74.6% of those needing substance use treatment without services, and alcohol-related deaths averaging 5,739 annually—exceeding opioid deaths. Continued investment in harm reduction, expanded treatment access, and evidence-based interventions will be essential to sustain progress and address persistent disparities across Ohio’s communities.