Washington, D.C. ranks among the most severely affected jurisdictions in the United States when it comes to substance abuse. Despite its status as the nation’s capital — home to federal institutions, a highly educated workforce, and substantial public resources — D.C. leads or near-leads the country in drug overdose deaths per capita, rates of heavy and binge drinking, prevalence of substance use disorder, and the gap between treatment need and treatment access. Nearly 1 in 10 residents is addicted to drugs or alcohol, and the social cost of that addiction exceeds $1.2 billion annually.
This report consolidates statistical data from multiple federal and local public health sources to present a comprehensive picture of substance abuse in the District. The data is organized into two sections: drug use and alcohol use, each broken down by substance, age group, demographics, geography, and public health impact.
Statistical Data on Drugs in Washington, D.C.
National Rankings and Overview
Washington, D.C. consistently ranks among the worst jurisdictions in the United States across virtually every metric of drug use, addiction, and overdose mortality. Below are D.C.’s rankings in key national comparisons.
- Overall severity rank: 5th nationwide for most severe drug problems
- Drug overdose deaths per capita: 1st in the nation
- Adults unable to access illicit drug use treatment: 4th in the nation
- Substance abuse treatment facilities per 100,000 residents: 7th in the nation
- Adult illicit drug use in the past month: 8th in the nation
- Teenage illicit drug use in the past month: 14th in the nation
- Share of nationwide OD deaths: 0.42% of all U.S. overdose deaths
D.C. leads or ranks near the top nationally in nearly every drug-related indicator, making it one of the most severely affected jurisdictions in the country.
Drug Overdose Deaths
Overall Overdose Mortality
D.C. has one of the highest drug overdose death rates in the nation. The following figures come from multiple reporting periods and federal data sources.
- Average annual drug overdose deaths: 451 per year
- Drug overdose deaths as a share of all D.C. deaths: 9.17%
- OD death rate per 100,000 residents: 64.3
- Difference from national OD death rate: +162.71% above the national rate
- Overdose deaths in 2023: 427
- OD death rate per 100,000 in 2023: 63
- D.C. rate vs. U.S. rate in 2023: 94% higher than the national average
- 3rd highest on record: 2023 was the 3rd highest overdose death rate since data became available in 1999
- Years with increasing OD death rate (last 24 years): 14 out of 24 years
- Increase in OD death rate since 2018: +71%
- Increase in OD death rate since 2013: 4.1× higher
The drug overdose death rate in D.C. is nearly double the national average, has risen in most years since 1999, and reached near-record levels in 2023.
Opioid Overdose Deaths
Opioids — overwhelmingly fentanyl — are the dominant driver of overdose mortality in D.C., with the crisis intensifying sharply after 2015.
- Opioid overdose deaths in 2023: 350 (federal data) / 518 (D.C. local report)
- 2023 opioid deaths vs. 2023 homicides: 518 opioid deaths vs. 274 homicides — nearly double
- Opioid deaths per month in 2023: More than 40 per month
- Opioids as a share of all overdose deaths: 82.0%
- Synthetic opioids (e.g., fentanyl) share of all opioid OD deaths: 98.0%
- Heroin as a factor in opioid OD deaths: 12.3%
- Prescription opioids as a factor in opioid OD deaths: 6.3%
- Opioid OD mortality rate per 100,000 residents: 49.6
- Difference from national opioid OD death rate: +106.7% above the national rate
- Fentanyl involvement in opioid OD cases (approx.): ~94%
- Fentanyl involvement in fatal OD cases in 2016: 60%
- Fentanyl involvement in fatal OD cases in 2018: 86%
- Start of fentanyl surge: March 2016 — over half of cases contained fentanyl from that month onward
- Fentanyl and cocaine OD death rate increase since 1999/2015: Cocaine: 6×; Fentanyl and synthetic opioids: 12×
Fentanyl now drives virtually all opioid deaths in D.C. The proportion of fentanyl-involved overdoses has risen from 60% in 2016 to approximately 94–98%, transforming the opioid crisis into a synthetic opioid emergency.
Historical Trend in Opioid Deaths
Fatal opioid overdose counts have fluctuated with a clear long-term upward trend, peaking in 2017, briefly declining, then surging to record highs by 2023.
| Year | Opioid/OD Deaths | Notes |
|---|---|---|
| 2014 | Lowest period | 122 opioids identified in fatalities — all-time low |
| 2017 | 279 total | Peak year at that time; 537 opioids identified in fatalities |
| 2018 | 191 | 24.2% decrease from 2017 |
| 2019 (first half) | ~20 per month | Higher than same period in 2018 |
| 2023 | 427–518 (multiple sources) | Record high; 3rd highest rate on record |
After a promising 24.2% decline in 2018, opioid deaths resumed their upward trajectory and exceeded all prior records in 2023.
Demographics of Overdose Deaths
Fatal overdoses are heavily concentrated among specific demographic groups. These patterns have been consistent across multiple years and data sources.
Age
- Share of fatal opioid overdoses among adults aged 40–69: 71–80%
- Most affected age group: Adults aged 50–59
- Adults aged 40–69 share of deadly overdoses: 71% (local 2023 report)
Race and Gender
- Share of fatal opioid OD deaths involving Black residents: 84%
- Share of all overdose deaths that are male: 74–81%
- Share of all opioid deaths among Black residents (2014–2019): 82%
Geography
- Wards with highest opioid overdose prevalence (2014–2023): Wards 5, 7, and 8
Duration of Use
- Victims using heroin for more than 40 years: 22%
- Victims using heroin for more than 25 years: 59%
- Victims using heroin for more than 10 years: 88%
The overdose crisis in D.C. falls disproportionately on middle-aged and older Black men in lower-income wards, and among people with multi-decade histories of opioid use.
Illicit Drug Use — General Population (Age 12+)
Past-Month and Past-Year Use Rates
Multiple national surveys consistently place D.C. drug use rates well above both state and national averages across nearly every substance category.
- Illicit drug use in the past month (age 12+): 24.91% — roughly 3× the national average of ~8–9%
- Illicit drug use other than marijuana (past month): 5.53% vs. national average of 3.33–3.58%
- Non-medical prescription drug use in the past year (adults): 12.1%
- Marijuana use in the past year (age 12+): 32.61% vs. national average of ~16%
- Marijuana use in the past month (age 12+): 22.43% vs. national average of ~10%
- Cocaine use in the past year (age 12+): 3.35%
- Hallucinogen use in the past year (age 12+): 7.09%
- Methamphetamine use in the past year (age 12+): 0.32%
- Heroin use in the past year (age 26+): 0.57% (0.66% at peak, age 26+) vs. national 0.30%
- Prescription pain reliever misuse in the past year: 2.27%
- Opioid misuse in the past year (age 12+): 2.89%
D.C. residents report past-month illicit drug use at approximately three times the national average, with marijuana being by far the most commonly used substance.
Drug Use by Age Group — Numbers (2022–2023 Annual Averages, Thousands)
The table below shows estimated numbers of D.C. residents using each substance by age group.
| Substance / Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ |
|---|---|---|---|---|
| Illicit drug use — past month | 144K | 3K | 30K | 111K |
| Marijuana use — past year | 188K | 4K | 39K | 145K |
| Marijuana use — past month | 129K | 3K | 27K | 99K |
| Illicit drug (excl. marijuana) — past month | 32K | ~0 | 5K | 26K |
| Cocaine use — past year | 19K | ~0 | 6K | 14K |
| Heroin use — past year | ~3K | — | ~0 | 3K |
| Hallucinogen use — past year | 41K | ~0 | 7K | 34K |
| Methamphetamine use — past year | 2K | ~0 | ~0 | 2K |
| Prescription pain reliever misuse — past year | 13K | 1K | 1K | 11K |
| Opioid misuse — past year | 17K | 1K | 3K | 13K |
The 26+ age group accounts for the largest absolute number of users, while the 18–25 group shows the highest rates in percentage terms.
Drug Use by Age Group — Percentages (2022–2023 Annual Averages)
The percentage breakdown by age group reveals that young adults aged 18–25 lead almost every substance category.
| Substance / Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ | Age 18+ |
|---|---|---|---|---|---|
| Illicit drug use — past month | 24.91% | 8.59% | 37.85% | 23.93% | 25.98% |
| Marijuana use — past year | 32.61% | 12.58% | 48.56% | 31.40% | 33.92% |
| Marijuana use — past month | 22.43% | 8.14% | 34.11% | 21.52% | 23.36% |
| Illicit drug (excl. marijuana) — past month | 5.53% | 1.08% | 6.88% | 5.65% | 5.82% |
| Cocaine use — past year | 3.35% | 0.05% | 6.93% | 2.98% | 3.56% |
| Heroin use — past year | — | — | 0.06% | 0.66% | 0.57% |
| Hallucinogen use — past year | 7.09% | 0.86% | 8.47% | 7.32% | 7.49% |
| Methamphetamine use — past year | 0.32% | 0.01% | 0.26% | 0.35% | 0.34% |
| Prescription pain reliever misuse — past year | 2.27% | 1.67% | 1.58% | 2.43% | 2.31% |
| Opioid misuse — past year | 2.89% | 1.69% | 3.29% | 2.92% | 2.97% |
Nearly 38% of D.C. young adults (18–25) used an illicit drug in the past month, and almost half used marijuana in the past year — rates far above all other age groups.
Drug Use Among Youth (Ages 12–17)
Current Use and Disorder Rates
D.C. teenagers use drugs at substantially higher rates than their peers nationally and regionally. Marijuana dominates youth drug use, with near-universal prevalence among those who report any illicit drug use.
- Likelihood of past-month drug use vs. average U.S. teen: 18.42% more likely
- Youth reporting past-month drug use: 8.59% — approximately 3,000 teens
- Marijuana share among youth who used any illicit drug last month: ~100%
- Marijuana use in the past year (ages 12–17): 12.58%
- Cocaine use in the past year (ages 12–17): 0.05%
- Methamphetamine use in the past year (ages 12–17): 0.01%
- Prescription pain reliever misuse in the past year (ages 12–17): 1.67%
- Alcohol use in the past month (ages 12–17): 8.58%
- Likelihood of past-month alcohol use vs. average U.S. teen: 24.75% more likely
- Met criteria for Drug Use Disorder (DUD) in past year: 7.03%
- Met criteria for Alcohol Use Disorder (AUD) in past year: 3.12%
Nearly 1 in 12 D.C. teens meets the clinical threshold for a drug use disorder — more than double the rate one might expect, given that virtually all youth illicit drug use is attributable to marijuana alone.
Historical Youth Drug Use Trends (2017–2019 vs. 2002–2004)
Trend data from the Behavioral Health Barometer shows D.C. youth drug use consistently exceeds both regional and national benchmarks.
| Measure | D.C. 2017–2019 | Regional Avg. | National Avg. |
|---|---|---|---|
| Past-month marijuana use (age 12–17) | 10.8% (~3,000) | 6.2% | 6.8% |
| Past-month illicit drug use (age 12–17) | 12.6% (~4,000) | 7.5% | 8.2% |
| First marijuana use in past year (age 12–17) | 8.4% (~3,000) | 5.0% | 5.2% |
| First alcohol use in past year (age 12–17) | 10.7% (~3,000) | 9.4% | 9.3% |
| First cigarette use in past year (age 12–17) | 2.3% (~1,000) | 2.1% | 2.3% |
D.C. youth marijuana use (10.8%) is 59% above the national average (6.8%) and 74% above the regional rate. Initiation rates are also notably elevated.
School Survey Data
School-based surveys provide additional context on substance use among D.C. students.
- Middle school students reporting current marijuana use (2017): 9.8%
- High school students reporting current marijuana use (2017): 33%
- Youth who perceive adults in their neighborhood as tolerant of youth marijuana use: 36%
- Youth who perceive great personal risk from using marijuana once or twice a week: 32%
- Adolescent respondents who used an illicit drug in the past year (household survey): 21%
- Adolescent respondents who used an illicit drug in the past month: 7%
- Adolescents who consumed alcohol in the past month: 1 in 6
Only 32% of D.C. youth see great risk in regular marijuana use, and only 36% perceive social disapproval in their neighborhood — attitudes that correlate with the area’s elevated use rates.
Drug Use Among Young Adults (Ages 18–25)
Young adults aged 18–25 represent the highest-use demographic in D.C. for nearly every measured substance category.
- Likelihood of past-month drug use vs. average U.S. peer: 41.73% more likely
- Young adults who used drugs in the past month: 30,000
Comparative Rates with Regional and National Averages
| Measure | D.C. 2017–2019 | Regional Avg. | National Avg. |
|---|---|---|---|
| Past-year marijuana use (age 18–25) | 49.0% (~43,000) | 35.0% | 35.0% |
| Past-month binge alcohol use (age 18–25) | 51.2% (~45,000) | 37.9% | 35.4% |
| Past-year marijuana use disorder (18–25) | 7.0% (~6,000) | 5.7% | 5.6% |
| Past-year illicit drug use disorder (18–25) | 9.1% (~8,000) | 7.8% | 7.5% |
| Past-year substance use disorder (18–25) | 18.3% (~16,000) | 15.1% | 14.7% |
| Past-year alcohol use disorder (18–25) | 13.5% (~12,000) | 9.8% | 9.8% |
Nearly half of D.C. young adults used marijuana in the past year — 40% above both the regional and national averages. Substance use disorder affects nearly 1 in 5 young adults in D.C.
Perceptions of Drug Risk
Risk perception data reveals that D.C. residents — especially young adults — significantly underestimate the dangers of drug use, which may contribute to elevated consumption rates.
| Risk Perception Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ |
|---|---|---|---|---|
| Great risk from smoking marijuana once/month | 14.55% | 18.52% | 9.03% | 15.21% |
| Great risk from using cocaine once/month | 53.72% | 46.99% | 53.35% | 54.28% |
| Great risk from trying heroin once or twice | 76.92% | 52.55% | 75.97% | 78.89% |
| Great risk from 5+ drinks once or twice a week | 41.56% | 39.67% | 38.00% | 42.33% |
Only 9% of young adults (18–25) see great risk in monthly marijuana use. Just over half of all teens (52.55%) perceive great risk from trying heroin — a dangerously low figure given fentanyl contamination rates.
Substance Use Disorder (SUD)
SUD Prevalence by Age Group — Numbers (2022–2023, Thousands)
| Disorder Type | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ |
|---|---|---|---|---|
| Any Substance Use Disorder | 137K | 3K | 30K | 104K |
| Drug Use Disorder | 79K | 2K | 19K | 57K |
| Pain Reliever Use Disorder | 9K | ~0 | 1K | 7K |
| Opioid Use Disorder | 12K | ~0 | 1K | 11K |
| Alcohol Use Disorder | 95K | 1K | 18K | 76K |
SUD Prevalence by Age Group — Percentages (2022–2023)
Substance use disorder is disproportionately prevalent in D.C. compared to the rest of the nation.
| Disorder Type | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ | Age 18+ |
|---|---|---|---|---|---|
| Any Substance Use Disorder | 23.73% | 9.13% | 37.26% | 22.51% | 24.68% |
| Drug Use Disorder | 13.61% | 7.03% | 24.22% | 12.29% | 14.04% |
| Pain Reliever Use Disorder | 1.53% | 1.17% | 1.33% | 1.59% | 1.55% |
| Opioid Use Disorder | 2.11% | 1.18% | 1.30% | 2.32% | 2.17% |
| Alcohol Use Disorder | 16.46% | 3.12% | 22.45% | 16.45% | 17.33% |
More than 23% of all D.C. residents aged 12+ meet the criteria for a substance use disorder — compared to roughly 7–9% nationally. Nearly 1 in 4 residents is clinically affected.
Historical SUD Trends (Age 12+, 2017–2019 vs. Earlier Periods)
Trend data from the Behavioral Health Barometer shows D.C. consistently exceeds state and national SUD rates.
| Disorder | D.C. Rate (2017–2019) | Regional Avg. | National Avg. |
|---|---|---|---|
| Any substance use disorder (12+) | 13.4% (~80,000) | 7.0% | 7.4% |
| Illicit drug use disorder (12+) | 5.1% (~30,000) | 2.8% | 2.9% |
| Marijuana use disorder (12+) | 3.1% (~18,000) | 1.5% | 1.6% |
| Opioid use disorder (12+) | 1.3% (~8,000) | 0.8% | 0.7% |
| Past-year heroin use (12+) | 0.82% (~5,000) | 0.48% | 0.30% |
| Prescription pain reliever misuse (12+) | 4.2% (~25,000) | 3.5% | 3.7% |
D.C.’s substance use disorder rate is nearly double the national average. Illicit drug use disorder increased significantly between 2015–2017 and 2017–2019.
Drug Rehabilitation and Treatment
Treatment Access and Unmet Need
Despite an enormous population in need, only a small fraction of D.C. residents who qualify for substance use treatment actually receive it — a gap that places D.C. 4th nationally for adult treatment inaccessibility.
- Residents classified as needing substance use treatment (age 12+): 27.07% (~156,000)
- Residents who received treatment in the past year (age 12+): 5.32% (~31,000)
- Those needing treatment who did NOT receive it: 79.58% (~120,000)
- National rank for adults unable to access illicit drug use treatment: 4th
- Active rehabilitation clinics in D.C.: 31
- Annual clients serviced by D.C. rehab clinics: 1,827
- Patients enrolled in outpatient services annually: 1,671
- Patients enrolled in residential (non-hospital) services annually: 156
- Hospital drug rehab patients recorded: 0
- Facilities offering free drug rehab to all clients: 0
Nearly 80% of D.C. residents who clinically need substance use treatment are not receiving it. There are no free facilities and no hospital-based drug rehab programs.
Treatment Enrollment Trend
Enrollment in substance use treatment has declined significantly since 2015, raising serious concerns about access and capacity.
- Single-day treatment count (March 2019): 1,827 people enrolled
- Single-day treatment count (2015): 2,824 people enrolled — a 35% decline by 2019
- Patients receiving methadone in opioid treatment programs (March 2019): 908
- Patients receiving methadone (2015): 1,315 — a decrease of 407 people
- Patients receiving buprenorphine (March 2019): 128
- Patients receiving buprenorphine (2015): 104 — an increase of 24 people
Total treatment enrollment fell by over a third from 2015 to 2019. Methadone therapy declined sharply while buprenorphine access grew slightly.
Treatment Problem Focus (Single-Day Count, March 2019)
Among those enrolled in treatment on the March 2019 count day, the breakdown by primary problem was:
- Drug problem only: 67.6%
- Alcohol problem only: 13.1%
- Both drug and alcohol problems: 19.3%
Cost of Drug Rehabilitation
The cost of drug rehabilitation in D.C. varies dramatically between residential and outpatient care.
- Average individual cost — residential (non-hospital) rehab: $66,538
- Average individual cost — outpatient rehab: $1,382
- D.C. rank among states for residential rehab cost: #1 most expensive
- D.C. rank among states for outpatient rehab cost: 2nd cheapest
- Total public spending on outpatient services in D.C.: $2.31 million (0.1% of U.S. total)
- Total public spending on residential treatment in D.C.: $10.38 million (0.2% of U.S. total)
Residential drug treatment in D.C. is the most expensive in the nation, while outpatient care is among the cheapest — creating a severe imbalance in available resources.
Most Commonly Treated Substances (2010–2011 Admissions)
Based on treatment admission data from D.C. rehab facilities:
- Heroin: 1,188 admissions in 2010; 32% of all admissions in 2011; largest age group: 51–55; gender split: 67.4% male / 32.6% female
- Cocaine/Crack: 521 admissions in 2010 (483 smoked + 38 other); 32% of all admissions in 2011
- Marijuana: 509 admissions in 2010; 79.8% male / 20.2% female
- Alcohol: 360 admitted for alcohol only; 335 for alcohol + secondary drug; ~82% male
Heroin and cocaine each accounted for 32% of all D.C. drug treatment admissions in 2011 — together representing nearly two-thirds of the total caseload.
Public Health Consequences of Drug Use
Infectious Disease and Neonatal Impact
Intravenous drug use drives significant rates of infectious disease transmission in D.C.
- Neonatal opioid withdrawal syndrome (per 1,000 births, 2020): 5.3 per 1,000
- New hepatitis C cases linked to intravenous drug use (2022): 12.5
- New HIV/AIDS diagnoses connected to intravenous drug use (2023): 12.1
- Cumulative AIDS cases in D.C. related to injection drug use (historical): ~27%
- AIDS cases related to injection drug use as of 2004: nearly 1 in 4
Drug-Related Infectious Disease Cases (2000–2004)
The following table tracks AIDS, hepatitis B, and hepatitis C cases in D.C., with estimated drug-related shares based on established attribution rates.
| Year | AIDS Cases | Acute Hep B (Total) | Hep B Drug-Related (30%) | Chronic Hep C (Total) | Hep C Drug-Related (20%) |
|---|---|---|---|---|---|
| 2000 | 873 | 35 | ~11 | 1,436 | ~287 |
| 2001 | 863 | 13 | ~4 | 2,572 | ~514 |
| 2002 | 926 | 22 | ~7 | 2,245 | ~449 |
| 2003 | 965 | 9 | ~3 | 2,086 | ~417 |
| 2004 | 992 | 19 | ~6 | 1,655 | ~331 |
AIDS cases rose steadily from 2000–2004. Chronic hepatitis C cases peaked in 2001 at 2,572 and declined to 1,655 by 2004, though drug-related cases still represented approximately 331 new infections in that final year.
Emergency Department and EMS Data (2017, D.C. Opioid Dashboard)
In 2017, D.C. emergency services were responding to opioid crises at the following rates:
- Total opioid overdose deaths (D.C. area): 279
- Opioid overdose deaths — D.C. residents only: 213
- Opioid overdose mortality rate per 100,000 (D.C. residents): 31.61
- Emergency department opioid visits (total): 1,261
- ED opioid visits — D.C. residents only: 1,034
- ED opioid visit rate per 100,000 (D.C. residents): 363.6
- EMS naloxone administrations: 1,556
- Hepatitis C reported new cases: 1,268
- Hepatitis C new case rate per 100,000: 117.8
- HIV reported new cases: 365
- HIV new case rate per 100,000: 50.97
Drug-Related Crime and Arrests
Drug use has a substantial impact on crime and public safety in D.C. The following figures primarily reflect 2005 data.
- Total drug-related arrests in D.C. in 2005: 8,050 (down from 8,394 in 2004)
- Arrests involving opium or cocaine: 56% of all drug-related arrests
- Arrests involving marijuana: ~40% of all drug-related arrests
- Possession-related arrests (2004–2005): slightly more than half of all drug arrests
- Juvenile drug arrests for sales/manufacturing: nearly three-quarters of all juvenile drug arrests
- Juvenile drug arrests that were marijuana-related: more than half
- Property crimes in 2005 that were drug-related (estimated): 5,843 out of 25,200 (23.2%)
- W/B HIDTA drug seizures in D.C. in 2005: more than $26 million; 99% marijuana and powder cocaine
- DEA fentanyl seizures nationwide in 2024: over 380 million lethal doses
Drugs in Homicide Toxicology Cases (D.C., 2010 — 134 Cases Screened)
The Office of the Chief Medical Examiner analyzed toxicology in 134 of 135 homicide cases in 2010:
| Drug Found | Cases | % of 134 Homicide Cases |
|---|---|---|
| Marijuana Metabolites | 32 | 23.8% |
| Ethanol (Alcohol) | 30 | 22.4% |
| Phencyclidine (PCP) | 11 | 8.2% |
| Cocaine | 10 | 7.4% |
| Morphine | 5 | 3.7% |
| MDMA | 3 | 2.2% |
Drugs were absent in only 48 of 134 homicide cases — meaning drugs were detected in 64% of homicide victims. Marijuana metabolites and alcohol were the two most commonly detected substances.
Traffic Deaths Involving Drugs (D.C., 2010 — 25 Total Traffic Deaths)
| Drug Found | Cases | % of Traffic Deaths |
|---|---|---|
| Ethanol (Alcohol) | 7 | 18.9% |
| Morphine | 5 | 13.5% |
| Cocaine | 3 | 8.1% |
| Marijuana | 2 | 5.4% |
Alcohol was the most commonly detected substance in D.C. traffic fatalities in 2010, present in nearly 1 in 5 traffic deaths. Drugs of some kind were detected in 17 of 25 (68%) of all traffic deaths that year.
Broader Social and Economic Costs
The toll of substance abuse in D.C. extends far beyond individual health — it pervades criminal justice, child welfare, public safety, and economic productivity.
- D.C. residents addicted to illegal drugs or alcohol: ~60,000 — nearly 1 in 10
- Emergency room visits related to drug and alcohol abuse: 40% of all 1.3 million ER visits
- Motor vehicle crashes associated with substance abuse: 50%
- New mothers reporting illicit drug use during pregnancy: ~15%
- Foster care placements connected with substance abuse: 85%
- Annual social cost of drug and alcohol abuse: over $1.2 billion; over $1.7 billion including tobacco
- Return on investment for addiction treatment: $12 saved per $1 invested; $7.46 in crime and productivity savings alone
- Annual D.C. government spending on treatment, prevention, and law enforcement (FY 2003): $289 million local + $61 million federal + $7 million other = $356 million total
- Of $356 million total, amount dedicated primarily to substance abuse programs: $53 million (15%)
- Of $53 million, amount solely for direct treatment provision: $35 million
Despite hundreds of millions in annual spending, only a small fraction of D.C.’s substance abuse budget flows directly to treatment — while the societal costs exceed $1.2 billion per year.
Statistical Data on Alcohol in Washington, D.C.
National Rankings and Overview
Washington, D.C. is a national leader in alcohol consumption, binge drinking, and alcohol-related mortality. The following rankings place D.C. at or near the top of every major alcohol indicator.
- Percentage of heavy drinkers: #1 in the nation (11.1% of adults)
- Percentage of binge drinkers: #1 in the nation (25.5% of adults)
- Percentage of adults who consume alcohol: #2 in the nation (65.9%), second only to Wisconsin at 67.3%
- Rate of increase in alcohol-related deaths: Fastest growth of any U.S. state
- 5-year increase in per capita excessive alcohol death rate (2015–2019): up to 82.9%
D.C. leads the country in both the percentage of heavy drinkers and binge drinkers, with an alcohol-related mortality rate growing faster than any U.S. state.
Alcohol-Related Mortality
Key Mortality Statistics
Excessive alcohol use kills hundreds of D.C. residents every year and generates enormous health and economic losses.
- Average annual alcohol-attributable deaths: ~392–450+
- Male share of alcohol-related deaths: 67.6%
- Deaths from chronic causes (e.g., AUD): 53.3%
- Deaths among adults aged 35 and older: 82.1%
- Deaths involving those under age 21: 3.3%
- Deaths per 10,000 adults aged 18+: 6.95
- Ratio of residents per alcohol death: 1 death for every 1,759 adults aged 18+
- Estimated years of potential life lost annually to excessive alcohol use: 10,473
- Rate of increase in per capita alcohol-related deaths (2015–2019): up to 82.9%
Excessive alcohol use kills approximately one D.C. adult for every 1,759 residents aged 18+ each year, with men, Black residents, and middle-aged adults disproportionately represented among the dead.
Alcohol-Induced Deaths by Cause of Death (D.C., 2006–2010)
The following breakdown shows the causes of 337 alcohol-induced deaths across a five-year period.
| Cause of Death | 2006 | 2007 | 2008 | 2009 | 2010 | 5-Year Total |
|---|---|---|---|---|---|---|
| Mental/Behavioral Disorders due to Alcohol Use | 43 | 23 | 28 | 19 | 33 | 146 |
| Alcoholic Liver Disease | 37 | 18 | 29 | 26 | 35 | 145 |
| Accidental Poisoning by Alcohol | 0 | 0 | 2 | 5 | 9 | 16 |
| Alcohol-Induced Acute Pancreatitis | 1 | 0 | 3 | 1 | 6 | 11 |
| Alcohol Cardiomyopathy | 0 | 3 | 4 | 0 | 2 | 9 |
| Alcohol-Induced Pancreatitis | 1 | 0 | 1 | 1 | 1 | 4 |
| Intentional Self-Poisoning by Alcohol | 0 | 1 | 0 | 0 | 0 | 1 |
| Poisoning by Alcohol, Undetermined Intent | 0 | 2 | 1 | 0 | 0 | 3 |
| Alcohol Gastritis | 0 | 0 | 1 | 0 | 0 | 1 |
| Degeneration of Nervous System due to Alcohol | 0 | 0 | 0 | 0 | 1 | 1 |
| TOTAL | 82 | 47 | 69 | 52 | 87 | 337 |
Mental/behavioral disorders and alcoholic liver disease together accounted for 291 of 337 five-year deaths (86%). Accidental alcohol poisoning deaths tripled between 2009 and 2010.
Alcohol Consumption Statistics
Overall Consumption Rates
Multiple data sources document pervasive alcohol use across all D.C. adult demographics.
- Adults who consumed at least one drink in the past month (BRFSS 2010): 62.7%
- Adults who consumed at least one drink in the past month (broader survey): 65.9%
- Adults who binge drink at least once per month: 22.5%
- Adults who binge drink (national comparison): 24% in D.C. vs. 17% nationally
- High school students who binge drink: 6% in D.C. vs. 11% nationally
- Adults classified as heavy drinkers (survey 1): 11.1%
- Adults classified as heavy drinkers (BRFSS 2010): 6.1%
- Adults classified as binge drinkers (BRFSS 2010): 15.4%
- Adults reporting excessive drinking (binge or heavy): 28.9%
- Median drinks per binge: 5.2
- Median drinks per binge among top 25% of binge drinkers: 6.7
- Median binge frequency per month: 1.5 times
- Binge frequency per month among top 25% of binge drinkers: 3.4 times
- Top 25% of binge drinkers who consume at least 7 drinks per occasion: 25%
- Top 25% of binge drinkers who binge at least 4 times per month: 25%
More than 1 in 4 D.C. adults binge drinks, and the city leads the nation in this metric. The intensity of binge drinking is also elevated, with many heavy drinkers consuming 7+ drinks per occasion.
Alcohol Use by Age Group — 2022–2023 Data
The table below shows alcohol use numbers and rates by age group across the D.C. population.
| Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ | Age 18+ |
|---|---|---|---|---|---|
| Alcohol use past month — number (thousands) | 360K | 3K | 53K | 304K | 357K |
| Binge alcohol use past month — number (thousands) | 181K | 2K | 35K | 144K | 179K |
| Alcohol use past month — % | 62.47% | 8.58% | 66.50% | 65.91% | 65.99% |
| Binge alcohol use past month — % | 31.36% | 5.52% | 43.40% | 31.27% | 33.05% |
| Alcohol use past month — ages 12–20 (%) | 18.78% | — | — | — | — |
| Binge alcohol use past month — ages 12–20 (%) | 9.65% | — | — | — | — |
Two-thirds of D.C. adults aged 18+ drank alcohol in the past month, and more than a third engaged in binge drinking — with young adults aged 18–25 recording a 43.4% binge drinking rate.
Alcohol Consumption by Demographics (BRFSS 2010)
Drinking behavior varies significantly by demographic group. The following figures show past-30-day drinking rates.
| Category | Subgroup | Any Alcohol (%) | Heavy Drinker (%) | Binge Drinker (%) |
|---|---|---|---|---|
| Gender | Male | 68.3% | 5.3% | 19.4% |
| Gender | Female | 57.9% | 6.7% | 12.0% |
| Race | White/Caucasian | 86.7% | 10.3% | N/A |
| Race | African American | 43.8% | 3.6% | N/A |
| Education | College Graduate | 77.3% | 7.4% | 18.1% |
| Education | Less than High School | 26.8% | 6.2% | 9.3% |
| Income | $75,000+ | 83.5% | 8.4% | 19.2% |
| Income | Less than $15,000 | 34.9% | 4.0% | 12.4% |
White residents and high-income earners report far higher rates of alcohol consumption overall, while female residents and lower-income groups show relatively less drinking but higher rates of associated risk factors.
Alcohol Consumption by Ward (BRFSS 2010 — Past 30 Days)
| Ward | Any Alcohol (%) | Ward | Any Alcohol (%) |
|---|---|---|---|
| Ward 1 | 69.0% | Ward 5 | 53.2% |
| Ward 2 | 74.8% | Ward 6 | 69.8% |
| Ward 3 | 82.7% | Ward 7 | 38.4% |
| Ward 4 | 61.8% | Ward 8 | 40.9% |
Ward 3 has by far the highest rate of alcohol consumption (82.7%), while Wards 7 and 8 — which have the highest rates of drug overdose deaths — have the lowest alcohol use rates.
Alcohol Abuse or Dependence by Ward (2002–2004)
In contrast to general consumption, alcohol abuse or dependence (clinical criteria) is concentrated in different wards.
| Ward / Area | Alcohol Abuse/Dependence (Age 12+, %) |
|---|---|
| Citywide | 9.39% |
| Ward 1 | 11.47% |
| Ward 2 | 11.92% |
| Ward 3 | 10.73% |
| Ward 4 | 7.58% |
| Ward 5 | 8.11% |
| Ward 6 | 9.45% |
| Ward 7 | 7.36% |
| Ward 8 | 7.58% |
Wards 1 and 2, which have the highest overall drinking rates, also lead in clinical alcohol dependence — at more than 11% of residents aged 12 and older.
Youth Alcohol Use
Current Youth Drinking Statistics
Alcohol use among D.C. youth is higher than national averages, and teens here are disproportionately likely to drink compared to their national peers.
- Youth (12–17) who used alcohol in the past month (2022–2023): 8.58%
- D.C. teens vs. average U.S. teen: likelihood of past-month alcohol use: 24.75% more likely
- High school students who were binge drinkers in 2017: 8.2%
- High school students who used alcohol in the past month in 2017: 20.5%
- Middle school students who used alcohol in the past month in 2017: 9%
- LGB youth share of high school population in 2017: 15.1%
- LGB youth share of those who drink alcohol in 2017: 23.2% — disproportionately high
- Youth who say it would be very easy to get alcohol: 10.2% citywide (range: 7.6% in Ward 8 to 18.9% in Ward 6)
- Youth who believe close friends would strongly disapprove of daily drinking: 43%
- Youth who believe parents would disapprove of daily drinking: ~80%
Despite strong perceived parental disapproval, D.C. teens drink at rates above national averages, and LGB youth are particularly over-represented among youth drinkers.
Historical Youth and Young Adult Trends (2017–2019 vs. Earlier Periods)
| Measure | D.C. Rate | Regional Avg. | National Avg. |
|---|---|---|---|
| Past-month alcohol use (age 12–17) | 11.1% (~4,000) | 9.1% | 9.4% |
| Past-month binge alcohol use (age 18–25) | 51.2% (~45,000) | 37.9% | 35.4% |
| Past-year alcohol use disorder (age 18–25) | 13.5% (~12,000) | 9.8% | 9.8% |
| Past-year alcohol use disorder (age 12+) | 10.7% (~64,000) | 5.1% | 5.3% |
D.C.’s youth alcohol rate is similar to the national average, but young adult binge drinking (51.2%) is roughly 45% above the national rate, and overall alcohol use disorder (10.7%) is double the national figure of 5.3%.
Alcohol Use Disorder (AUD)
AUD Rates by Age Group (2022–2023)
| Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ | Age 18+ |
|---|---|---|---|---|---|
| Alcohol Use Disorder — number (thousands) | 95K | 1K | 18K | 76K | 94K |
| Alcohol Use Disorder — % | 16.46% | 3.12% | 22.45% | 16.45% | 17.33% |
| AUD among ages 12–20 — % | 5.84% | — | — | — | — |
More than 1 in 6 D.C. residents aged 12+ meets the criteria for Alcohol Use Disorder — a rate more than three times the national average of 5.3%.
Residents Living with a Problem Drinker
In 2010, 22% of D.C. respondents reported living with someone who had a drinking problem or was an alcoholic. Those more likely to report this situation include:
- Females: 23.6% vs. 20.5% for males
- Adults aged 45–54: 26.5%
- African Americans: 25.2%
- Adults with less than a high school education: 30.9%
- Households earning less than $15,000: 27.3%
- Ward 8 residents: 28.0% — the highest of any ward
The burden of living with a problem drinker falls most heavily on lower-income, lower-education, and Black residents, adding further strain to communities already facing severe substance abuse challenges.
Economic Cost of Excessive Alcohol Use
The financial burden of excessive alcohol use in D.C. vastly exceeds what is collected in alcohol taxes.
- Annual economic cost to D.C. taxpayers (2010): $918.4 million
- Same figure adjusted to 2022 dollars: $1.240 billion
- Cost per drink consumed (2022 dollars): $2.89
- Total federal and state alcohol taxes per drink (2010): $0.24 — less than 1/12th of the cost
For every dollar collected in alcohol taxes, more than twelve times that amount is spent on the consequences of excessive alcohol use — in lost productivity, healthcare, and criminal justice.
Alcohol-Related Crime and Traffic Fatalities
Alcohol and Violent Crime (2005)
- Violent crimes in D.C. in 2005: 7,717
- Violent crimes estimated as alcohol-related: 1,358 (17.6%)
- National estimate: aggravated assaults attributable to alcohol: 30%
- National estimate: forcible rapes attributable to alcohol: 23%
- National estimate: robberies attributable to alcohol: 3%
Alcohol and Fatal Traffic Crashes (2005)
- Total fatal crashes in D.C. in 2005: 44 crashes; 48 people killed
- Fatal crashes involving alcohol: 22 of 44 (50%)
- Drivers killed in fatal crashes in 2005: 19
- Killed drivers who had been drinking: 12 of 19 (63.2%)
- Individuals aged 21–29 in fatal crashes who were under the influence: 45.8% in 2004
- Alcohol-related fatal crashes (5-year range, 2000–2004): lowest: 18 in 2004; highest: 31 in 2003
DUI and DWI Arrests (D.C., 2007–2011)
DUI arrests trended upward while DWI arrests fell sharply, with open container violations consistently exceeding 2,000 per year.
| Year | DUI (Total) | DWI (Total) | DUI Refusing Test | Open Container (Total) | Under 21 in Public |
|---|---|---|---|---|---|
| 2007 | 635 | 1,222 | 282 | 2,552 | 215 |
| 2008 | 470 | 856 | 252 | 2,395 | 212 |
| 2009 | 733 | 882 | 276 | 2,310 | 203 |
| 2010 | 842 | 700 | 341 | 2,335 | 254 |
| 2011 | 1,046 | 378 | 376 | 2,588 | 153 |
| 5-Year Total | 3,726 | 4,038 | 1,527 | 12,180 | 1,037 |
DUI arrests reached a 5-year high in 2011 (1,046), while DWI arrests collapsed from 1,222 in 2007 to just 378. Open container possession resulted in over 12,000 incidents over five years — more than DUI and DWI combined.
Alcohol Treatment and Hospital Admissions
Treatment Admissions
- Total individuals in drug and alcohol treatment in D.C. (2010): 3,160
- Admitted for alcohol abuse only: 360
- Admitted for alcohol combined with a secondary drug: 335
- Male share of alcohol treatment admissions: ~82%
- Adults (21+) enrolled in APRA with alcohol as primary substance (2011): 2,183
- Youth (under 21) enrolled in APRA with alcohol as primary substance (2011): 41
Hospital Admissions for Alcohol-Related Problems (2006–2010)
Over 1,619 persons were admitted to D.C. hospitals for alcohol-related conditions during this five-year period.
| Condition (ICD Code) | 2006 | 2007 | 2008 | 2009 | 2010 |
|---|---|---|---|---|---|
| Alcohol Psychosis (ICD-291) | 238 | 191 | 117 | 181 | 105 |
| Alcohol Dependence (ICD-303) | 108 | 94 | 148 | 123 | 217 |
| Non-dependent Alcohol Abuse (ICD-305) | 38 | 39 | 41 | 37 | 54 |
Alcohol dependence hospitalizations surged by 101% from 2007 to 2010 (from 94 to 217), while alcohol psychosis admissions fell by 45%. Non-dependent abuse admissions remained relatively stable.
Perceptions of Alcohol Risk by Age Group (2022–2023)
Risk perception regarding heavy drinking is low across all age groups — consistent with D.C.’s elevated consumption rates.
| Risk Perception Measure | Age 12+ | Age 12–17 | Age 18–25 | Age 26+ |
|---|---|---|---|---|
| Great risk from 5+ drinks once or twice/week | 41.56% | 39.67% | 38.00% | 42.33% |
| Same measure — ages 12 to 20 | 40.93% | — | — | — |
Fewer than 42% of D.C. residents across all age groups perceive great risk in heavy episodic drinking. Young adults (18–25) show the lowest risk awareness at 38%, consistent with their 43.4% binge-drinking rate.
Alcohol-Related Chronic Illness
Long-term alcohol use generates significant chronic disease burden in D.C., particularly liver disease and alcohol-related mortality patterns.
- Chronic liver disease deaths in D.C. in 2003: 50 (a five-year low); rate of 8.9 per 100,000
- National chronic liver disease rate in 2003: 9.5 per 100,000 — D.C. below the national rate for the first time in 5 years
- Alcoholic liver disease as a share of chronic liver disease deaths in 2003: 82%
- Age group most affected by chronic liver disease in 2003: 35–54 years (nearly half of all deaths)
- Gender share of chronic liver disease deaths in 2003: 70% male
- Race share of chronic liver disease deaths in 2003: 90% African American
- Estimated D.C. residents with past-year alcohol abuse or dependence (2003–2004): ~45,000
- Ward with highest alcohol abuse/dependence rate (2002–2004): Ward 2 at 11.92%
- Ward with lowest alcohol abuse/dependence rate (2002–2004): Ward 7 at 7.36%
Alcohol-related liver disease and mental disorders are overwhelmingly concentrated among African American males aged 35–54. Ward 2 leads in clinical dependence while Ward 7 records the lowest rates.
Summary
The statistics assembled in this report tell a consistent and troubling story. Washington, D.C. outpaces the national average by wide margins on virtually every measure of substance abuse — not in one or two categories, but across the full spectrum of use, disorder, mortality, and cost. The opioid crisis, now driven almost entirely by fentanyl, killed more D.C. residents in 2023 than homicides and firearms combined. Alcohol use disorder affects more than 1 in 6 residents. And nearly 80% of those who clinically need substance use treatment are not receiving it.
The burden of this crisis is not shared equally. Black residents, men, adults aged 40–69, and residents of Wards 5, 7, and 8 bear a disproportionate share of overdose deaths, chronic disease, and addiction. At the same time, higher-income and higher-educated residents lead in alcohol consumption — a reminder that substance abuse in D.C. cuts across demographic lines even as its most lethal consequences concentrate among the most vulnerable.
Addressing this crisis requires not only more resources, but better-targeted ones: closing the treatment access gap, expanding residential and outpatient capacity, and confronting the structural inequalities that make certain communities far more exposed to the consequences of addiction than others.
Sources:
- Drug Overdose Death Statistics [2025]: Opioids, Fentanyl & More
- Average Cost of Drug Rehab [2026]: by Type, State & More
- Opioid Crisis Statistics [2025]: Prescription Opiod Abuse
- Teenage Drug Use Statistics [2025]: Data & Trends on Abuse
- National Survey on Drug Use and Health: 2022‑2023 State-Specific Tables of Model-Based Estimates
- Behavioral Health Barometer: District of Columbia, Volume 6
- Non-Medical Drug Use – Past Year in District of Columbia
- DC Ranks Among Worst Areas for Drug Problems in US, Study Finds
- Opioid Overdose Deaths in DC Reached Record High in 2023, New Report Shows
- Alcohol & Substance Use – Our Healthy DC
- A Substance Abuse Strategy for the District of Columbia
- Opioid Use in D.C. | Howard University Hospital
- Drug Use Statistics In Washington, DC | Recovery Connection
- How Many Drug Overdose Deaths Happen Every Year in Washington, DC? | USA Facts
- Substance Abuse in Washington, D.C.
- Addiction in the Nation’s Capital
- District of Columbia Drug Control Update
- Alcohol: An Equal Opportunity Destroyer
- Alcohol Abuse Statistics [2026]: National + State Data – NCDAS
- Drug Use Statistics In Washington, DC | Recovery Connection
- Explore Excessive Drinking in District of Columbia | AHR
- Addressing Excessive Alcohol Use: State Fact Sheets
- DC Has Highest Percentage of Heavy Drinkers – WTOP News
- Explore Alcohol Use – Youth in District of Columbia | AHR