Baltimore Opioid Overdose Statistics: 2026 Report
This report compiles the latest Baltimore City and Maryland data on opioid overdose deaths, fentanyl-related fatalities, nonfatal overdoses, and opioid use disorder prevalence. It focuses primarily on data from 2024 through the first quarter of 2026, with earlier years included for historical comparison. Because different agencies use different measures, the report distinguishes total overdose deaths from opioid-related deaths, fentanyl-related deaths, EMS encounters, emergency department visits, and opioid use disorder estimates.
Baltimore Overdose Deaths Have Declined Since 2023
Baltimore City’s latest overdose data show a significant decline in total overdose deaths after 2023. The figures include accidental or undetermined drug and alcohol related intoxication deaths, so they shouldn’t be described as opioid-only deaths. The 2024 and 2025 figures are preliminary and may change as investigations are completed. [1]
Baltimore City Overdose Deaths by Year, 2014 to 2025
| Year | Overdose deaths |
| 2014 | 305 |
| 2015 | 393 |
| 2016 | 694 |
| 2017 | 761 |
| 2018 | 888 |
| 2019 | 914 |
| 2020 | 1,028 |
| 2021 | 1,079 |
| 2022 | 989 |
| 2023 | 1,043 |
| 2024 | 777 |
| 2025 | 602 |
Source: Maryland Department of Health Overdose Dashboard, as reported by the Baltimore City Overdose Needs Assessment Dashboard. The 2023 through 2025 figures are preliminary. [1]
Baltimore City recorded 602 overdose deaths in 2025, compared with 777 in 2024 and 1,043 in 2023. That represents a 42% decrease from 2023 to 2025, and the lowest figures since 2015. [1]
The longer-term trend should be viewed with both hope and perspective. Overdose deaths increased sharply between 2014 and 2021, reaching a high of 1,079 deaths in 2021. The 2025 total was 44% lower than that peak, but it still represented hundreds of lives lost in a single year. [1]
The city’s overdose burden has also been strongly connected to opioids. In 2020, Baltimore City recorded 1,028 drug and alcohol related intoxication deaths; 962 involved opioids. [2] The latest data shows progress, but it also reinforces the need for treatment, overdose prevention, and long-term recovery support.
Maryland Fentanyl Deaths Also Fell in 2025
Maryland has experienced a similar decline in fatal overdoses. According to the Maryland Department of Health, the state recorded 1,315 fatal overdoses in 2025. That was the lowest annual total reported in 10 years and 53% below the state’s 2021 peak of 2,800 deaths. [3]
Fentanyl-related deaths declined as well. Maryland reported 906 fentanyl-related overdose deaths in 2025, down from 1,314 in 2024: a 31% decrease in one year. [3]
Maryland Overdose and Fentanyl Statistics
| Measure | 2024 | 2025 |
| Total fatal overdoses | 1,779 | 1,315 |
| Fentanyl-related deaths | 1,314 | 906 |
| Change in total fatal overdoses | N/A | Down 26% |
| Change in fentanyl-related deaths | N/A | Down 31% |
The 2024 total in this table comes from Maryland’s finalized Vital Statistics report. The 2025 figures come from the state’s preliminary Overdose Data Dashboard and may be revised. [2] [3]
Fentanyl remains central to Maryland’s opioid crisis even as deaths decline. In the state’s finalized 2024 data, 1,463 deaths involved opioids and 1,315 involved fentanyl. Fentanyl-related deaths accounted for approximately nine out of every 10 opioid-related intoxication deaths that year. [2]
The Baltimore City figures show the same pattern. In 2024, 704 of the city’s 777 overdose deaths involved opioids, while 663 involved fentanyl. Since one death can involve more than one substance, these categories shouldn’t be added together. [2]
Table 3: Baltimore City Opioid and Fentanyl Deaths
| Measure | 2024 deaths |
| Total drug and alcohol related intoxication deaths | 777 |
| Opioid-related deaths | 704 |
| Fentanyl-related deaths | 663 |
| Heroin-related deaths | 95 |
The state’s preliminary first quarter data also show a year-over-year decline. Baltimore City recorded 157 opioid-related deaths during the first quarter of 2025, compared with 120 during the first quarter of 2026. Fentanyl-related deaths fell from 142 to 111 during the same period. [4]
Baltimore City First Quarter Comparison
| Measure | Q1 2025 | Q1 2026 | Change |
| Total intoxication deaths | 179 | 136 | Down 24% |
| Opioid-related deaths | 157 | 120 | Down 24% |
| Fentanyl-related deaths | 142 | 111 | Down 22% |
While these early 2026 figures are preliminary, they suggest that the reduction seen in 2025 continued into the first quarter of 2026. [4]
Nonfatal Opioid Overdoses Remain a Major Concern
Fatality data tells only part of the story; EMS calls and emergency department visits show how often people experience suspected opioid overdoses and survive after receiving emergency care.
In 2024, Maryland recorded 11,391 EMS calls for suspected nonfatal opioid overdose. The state also recorded 6,481 EMS encounters during which naloxone was administered and 7,532 emergency department visits for suspected nonfatal opioid overdose. [5]
Maryland Suspected Nonfatal Opioid Overdose Activity in 2024
| Measure | 2024 total |
| EMS calls for suspected nonfatal opioid overdose | 11,391 |
| EMS naloxone administration encounters | 6,481 |
| Naloxone doses administered by EMS | 7,325 |
| Emergency department visits for suspected nonfatal opioid overdose | 7,532 |
Each measure captures something different. EMS calls represent suspected overdoses attended by emergency responders; naloxone encounters represent calls in which EMS administered naloxone at least once; emergency department visits reflect patients who received hospital-based care. [5]
Baltimore City had the highest rate of suspected nonfatal opioid overdose EMS calls among Maryland jurisdictions in 2024: 931.9 calls per 100,000 residents. The city also had the highest rate of EMS naloxone administration encounters, at 425.0 per 100,000 residents. [5]
Emergency department data showed the same geographic pattern. Baltimore City had 597.4 emergency department visits for suspected nonfatal opioid overdose per 100,000 residents. That rate was approximately twice as high among non-Hispanic Black residents as among non-Hispanic white residents: 758.0 compared with 383.4 per 100,000. [5]
The disparities were also visible in EMS data. The suspected nonfatal opioid overdose call rate was 1,100.3 per 100,000 among Black Baltimore residents, compared with 782.2 per 100,000 among white Baltimore residents. [5]
These figures serve as a reminder that a decline in overdose deaths doesn’t eliminate the need for care. People who survive an overdose may still be experiencing cravings, withdrawal, unstable substance use, or other health and life challenges. A nonfatal event can also create an opportunity to connect someone with treatment before another overdose occurs.
Fentanyl Exposure Is Still Changing in Baltimore
Annual death counts are important, but they can’t show every change in the local drug supply. Maryland’s Rapid Analysis of Drugs program provides a more current view by testing drug samples submitted through participating syringe service programs.
In the second quarter of 2025, 34.8% of drug samples tested at Baltimore City sites contained fentanyl: a 39% increase from the second quarter of 2024. During the same period, the share of samples containing cocaine decreased by 17.4%. [6]
EMS data also showed a sharp increase in naloxone activity during 2025. Baltimore City recorded 459 EMS naloxone administration encounters in the second quarter of the year and 1,020 in the third quarter. That was a 122% increase. Naloxone doses administered by EMS rose from 500 to 1,106 during the same period. [6]
Recent Baltimore City Fentanyl and Naloxone Indicators
| Indicator | Earlier period | Later period | Change |
| Baltimore City drug samples containing fentanyl | Q2 2024: 25.0% | Q2 2025: 34.8% | Up 39% |
| EMS naloxone administration encounters | Q2 2025: 459 | Q3 2025: 1,020 | Up 122% |
| Naloxone doses administered by EMS | Q2 2025: 500 | Q3 2025: 1,106 | Up 121% |
These findings add context to the decline in fatal overdose deaths. Fewer deaths can reflect improvements in prevention, naloxone access, emergency response, and treatment; at the same time, changing fentanyl exposure and rising EMS activity can signal continued danger in the local drug supply.
Opioid Use Disorder Affects Thousands of Maryland Residents
Overdose deaths and opioid use disorder are related but different measures. An overdose death count measures fatalities during a specific period, while estimated opioid use disorder measures the number of people who meet a clinical definition of problematic opioid use during a survey period.
The latest Maryland-specific estimates come from the 2023 and 2024 National Survey on Drug Use and Health. SAMHSA estimated that approximately 74,000 Maryland residents age 12 and older had opioid use disorder during that period. Approximately 70,000 adults age 18 and older were included in that estimate. [7]
Maryland Opioid Use Disorder Estimates
| Population | Estimated number with opioid use disorder |
| Maryland residents age 12 and older | 74,000 |
| Maryland adults age 18 and older | 70,000 |
| Maryland residents age 12 to 17 | 4,000 |
| Maryland residents age 18 to 25 | 5,000 |
| Maryland residents age 26 and older | 65,000 |
These are modeled survey estimates, not a registry count of every Maryland resident receiving treatment. They also don’t include a Baltimore City specific estimate in the state table. For that reason, “opioid addiction rates in Maryland” should be interpreted carefully: prevalence estimates, overdose death rates, treatment enrollment, EMS activity, and emergency department visits answer different questions.
The data still points to a clear need for accessible treatment. People may seek help after an overdose, during withdrawal, after repeated attempts to stop using, or when substance use begins affecting work, health, housing, family relationships, or legal circumstances. Early support can help someone move toward stability before the next emergency occurs.
What Baltimore’s Overdose Data Means for Getting Help
The latest statistics show meaningful progress. Baltimore City overdose deaths fell from 1,043 in 2023 to 602 in 2025, and Maryland’s total fatal overdoses reached a 10-year low. Fentanyl-related deaths also declined statewide, while preliminary 2026 data suggest that Baltimore’s opioid and fentanyl death counts continued to decrease during the first quarter. [1] [3] [4]
The remaining need is still substantial. Baltimore City had the highest rate of suspected nonfatal opioid overdose EMS calls and emergency department visits in Maryland in 2024. Fentanyl was detected in more than one-third of drug samples tested through Baltimore City sites during the second quarter of 2025. [5] [6]
These statistics describe a public health crisis, but they also describe opportunities for connection. A person doesn’t need to wait for an overdose, a legal crisis, or the loss of a job or relationship before asking about treatment. Support can begin with a conversation about withdrawal, medication, counseling, insurance, privacy, or what to expect at a first visit.
The Caring Clinics provides evidence-based outpatient care for opioid use disorder, including medication-assisted treatment and counseling. Our approach is built around clear explanations, dignity, and consistent human support. If you’re ready to learn more, call (443) 313-8475 to discuss your next steps.
Last updated: October 2026
Sources
[1] Baltimore City Overdose Needs Assessment Dashboard. “Overdose Deaths in Baltimore City.” Maryland Department of Health Overdose Dashboard data, updated June 18, 2026.
https://dashboards.mysidewalk.com/baltimorecityoverdose/overdose-deaths
[2] Maryland Department of Health, Vital Statistics Administration. Unintentional Drug- and Alcohol-Related Intoxication Deaths in Maryland, 2024. Released April 2026.
https://health.maryland.gov/vsa/Documents/Overdose/2024%20Intox%20Report.pdf
[3] Office of Governor Wes Moore. “Governor Moore Announces Maryland Overdose Deaths Falling for Fourth Straight Year, Reaching 10-Year Low.” January 30, 2026.
https://governor.maryland.gov/news/press-releases/governor-moore-announces-maryland-overdose-deaths-falling-fourth-straight-year-reaching-10-year-low
[4] Maryland Department of Health, Vital Statistics Administration. Unintentional Drug- and Alcohol-Related Intoxication Deaths in Maryland, 2026: Preliminary Data Through the First Quarter. Released July 2026.
https://health.maryland.gov/vsa/Documents/Overdose/Quarterly%20Reports/Q1_2026_IntoxQuarterlyReport.pdf
[5] Maryland Department of Health, Drug Overdose Surveillance and Epidemiology Team. Maryland Suspected Non-Fatal Opioid Overdose Trends Annual Report: Reporting Period January to December 2024. Published May 2026.
https://health.maryland.gov/bha/Documents/04.10.26%20DOSE%20Annual%20Report%20-%202024.pdf
[6] Maryland Department of Health. Baltimore City Rapid Analysis of Drugs and EMS Naloxone Administration Trends. December 18, 2025.
https://health.maryland.gov/pha/NALOXONE/Documents/RAD/Reports/2025-12-18_Baltimore-City-Fentanyl-Trend-Alert-RAD-and-DOSE.pdf
[7] Substance Abuse and Mental Health Services Administration. 2023 and 2024 National Surveys on Drug Use and Health: Maryland State-Specific Tables. Published February 2026.
https://www.samhsa.gov/data/sites/default/files/reports/rpt56986/2024-nsduh-sae-state-tabs1/2024-nsduh-sae-state-tabs-maryland.pdf