Cocaine, Heroin & Opioid Overdose Stats in North Carolina (Annual Report)

Cocaine, Heroin & Opioid Overdose Stats in North Carolina

Highlights

  • Overdose deaths dropped significantly across North Carolina during 2024
  • More than 2,700 suspected fatal overdoses reported during 2025
  • Cocaine and opioids remain major overdose contributors statewide
  • Fentanyl drives most fatal overdose cases statewide
  • EHG of NC offers inpatient, PHP, IOP, OP, and virtual behavioral health services to treat addiction and co-occurring mental health disorders.
  • We are proud to welcome clients visiting us from Wilmington, throughout North Carolina, and across the United States

Recent opioid overdose stats reported that there are approximately 2,731 suspected overdose deaths in NC 1. Drug addiction has always been a problem in the United States. Individuals usually abuse drugs, such as cocaine, heroin, and opioids, due to their wide availability. Official data reported:

~44,5001 North Carolinians have died from overdoses since 2000
2,9342 North Carolina reported overdose deaths during 2024
38.3%2 Opioid fatal overdoses declined statewide during 2024
77%+4 Fentanyl contributed to drug poisoning deaths statewide

Are you a resident of Wilmington, NC, and need a behavioral health clinic for addiction treatment? At EHG of NC, we address substance use addiction and co-occurring mental health conditions. Call 910-335-9102 Monday through Friday from 9 AM to 5 PM for quick same-day admission.

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Overview of Cocaine, Heroin & Opioid Overdose Stats in North Carolina

~44,5001 Approximately 44,500 people in North Carolina lost their lives to drug overdose between 2000 and 2024
2,9342 In 2024 alone, approximately 2,934 deaths were reported in NC due to drug overdose
8/day1 On average, there are 8 overdose deaths per day in North Carolina
4,4423 Nearly 12 deaths were reported daily, and a total of 4,442 drug poisoning deaths in 2023
4,0414 North Carolina recorded 4,041 fatal overdoses in 2021 (the highest annual total at that time)
22%4 The overdose death rate increased by up to 22% from 2020 to 2021
77%+4 Over 77% of overdose deaths in North Carolina involved fentanyl abuse in 2021
did you know

What Are the Opioid Overdose Statistics in North Carolina?

According to the NC Office of the Chief Medical Examiner, suspected overdose deaths in North Carolina were down 10% in 2025 compared to 2024 5. Moreover, NCDHHS reported that opioid-related drug poisoning deaths had declined significantly among Black and Hispanic residents 2.

There were 3,027 confirmed poisoning deaths in 2024 and 2,731 suspected overdose deaths in 2025.5
A 38.3% decline in opioid-related fatal overdoses — from 3,656 deaths in 2023 to 2,254 deaths in 2024.2
Overall, fatal overdoses dropped by 34% in 2024, falling from 4,442 deaths in 2023 to 2,934 deaths in 2024.2
Opioid Epidemic Stats (1999-2023)
Opioid Epidemic Stats (1999-2023)

North Carolina Opioid Overdose Stats: Death Rates per 100,000 Adult Population by Age Group

As per KFF, a total of 2,112 people per 100,000 lost their lives due to opioid overdose. The states observed are 6:

Adult Age Group Category of North CarolinaNo. of People
18–25 Years177
26–44 Years1,126
45–64 Years713
65+ Years96
Total2,112

North Carolina Opioid Overdose Death Rates per 100,000 Adult Population During 5 Years

The greatest number of overdose deaths was observed during 2022, and there was a significant decline in opioid overdose-related fatalities in adults in 2024. The stats include 6:

Adult Age Group20202021202220232024
18 to 25315344341267177
26 to 441,4501,8631,9481,6301,126
45 to 647821,0321,208871713
65+768110611696
Total Overdose Deaths2,6193,3203,6032,8842,112

What Are the Cocaine Overdose Statistics in North Carolina?

North Carolina officially tracks cocaine overdose deaths using ICD-10 code T40.5 (Cocaine) in state mortality and overdose surveillance systems 7. The following are the stats:

4,2438 Suspected overdose deaths, with cocaine addiction statistics showing a major contributing factor to overdose fatalities statewide in 2022
4,1568 Suspected fatal overdoses due to cocaine and polysubstance-related fatalities in 2023
3,8539 Suspected drug overdose deaths during January–November 2023
34810 Suspected substance-related deaths due to cocaine and other stimulants in October 2023
35311 Suspected fatal overdoses statewide, with cocaine remaining one of the monitored overdose substances in September 2023
37112 Suspected overdose deaths due to elevated cocaine-related overdose surveillance activity in April 2023
Opioid Crisis (1999 - 2023)
Waves of the Opioid Crisis in the United States

What Are the Heroin Overdose Statistics in North Carolina?

North Carolina overdose surveillance specifically identifies heroin overdose death using ICD-10 code T40.1 (Heroin) 13. The stats include:

NC's toxicology surveillance reported ongoing fentanyl-positive deaths with "Other Opioid" co-occurrence, including heroin-class substances.14
Approximately 2,731 suspected overdose deaths in 2025, with heroin remaining part of the opioid overdose surveillance category tracked by the state.1

How Many Heroin-Related Emergency Department Visits in North Carolina?

As per the North Carolina Department of Health and Human Services (NCDHHS) surveillance 13:

35115 Heroin-related emergency department visits reported during the first nine months of 2020
34316 Heroin overdose emergency department visits in May 2020
32717 Heroin overdose emergency department visits statewide reported in July 2020
23918 Heroin overdose emergency department visits reported in March 2021
21413 Heroin overdose emergency department visits statewide in February 2021

North Carolina Adult Drug Addiction Statistics

9.3%3 NC adult substance use disorder prevalence in 2023
1M+3 NC adults who may experience substance use disorders
42%3 Adults with medically diagnosed SUD who received no treatment
150K2 Naloxone doses distributed through community organizations in 2024
5.6→18.819 Opioid-related fatalities rose from 5.6 to 18.8 deaths per 100,000 among adults aged 55+

How Many North Carolinians are Affected By Addiction Disorders?

North Carolina has a severe substance abuse crisis, with over 4,300 annual overdose deaths, 14.54% higher than the national average 20.

More than 36,000 North Carolinians lost their lives to drugs between 2000 and 2022.21
Native American communities of North Carolina had a 141% increase in substance abuse overdose deaths since 2019.3

What Are the Suicide Rates Due To Cocaine, Heroin & Opioid Use?

Public health experts continue linking untreated opioid addiction with increased suicide risk, depression, and fatal overdose incidents 21.

  • Drug overdose remains one of the top five causes of death in North Carolina 2.
  • Unintentional injury deaths (including overdose deaths) continue to significantly impact behavioral health outcomes statewide 2.
  • Approximately 80,391 fatal overdoses occurred nationally, mainly due to opioids, in 2024 22.
did you know

Recover From Cocaine, Opioid & Heroin Addiction at EHG of NC

Recent substance use statistics reported that 1 in 6 adults in North Carolina has a substance use disorder (SUD). Our behavioral health clinic offers the following services to treat substance use addictions, including cocaine, opioids, and heroin:

Inpatient Treatment (IP)
Partial Hospitalization (PHP)
Intensive Outpatient (IOP)
Virtual Behavioral Health
Medication-Assisted Treatment (MAT)
Cognitive Behavioral Therapy (CBT)
Dialectical Behavior Therapy (DBT)
EMDR Treatment
Dual-Diagnosis Treatment
Substance Abuse Treatment
Mental Health Treatment
Transitional Living Program

Looking for opioid addiction treatment near me in Wilmington, NC? EHG of NC offers detox programs, such as a fentanyl detox program, to take the first step towards recovery! Call us at 910-335-9102 or visit 2106 South 17th Street.

Frequently Asked Questions Regarding Cocaine, Heroin & Opioid Drug Use in NC

Individuals searching for cocaine, heroin & opioid overdose stats in North Carolina also want to know about: 

Who Has The Highest Opioid Death Rate?

As per KFF, AIAN people had the highest opioid death rate, which is 35.5 per 100,000 23. Moreover, Black people had somewhat higher rates than White people, and that is 22.8 vs. 17.5 per 100,000 23.

What Is The Current Opioid Crisis?

The total number of opioid-related fatalities remains more than six times higher than it was in 1999 24. In 2023, there were about 105,007 opioid drug poisoning deaths. Among those, 72,776 involved synthetic opioids other than methadone 24.

Which Drug Has The Highest Fatality Rate?

Fentanyl consistently ranked as the most common drug found in conjunction with others in overdose deaths, from 99.0% with xylazine to 48.3% with oxycodone 25.

Is It True That Only 1% Of Patients Get Addicted To Opioids?

Around 3-12% of people using opioids for chronic pain may develop an addiction or misuse them 26. Thus, it leads to negative effects.

What Is The Death Rate Of Cocaine?

The drug overdose death rate involving cocaine was 7.3 deaths per 100,000 standard population 27.

What Is The Relapse Rate For Heroin?

Recent heroin addiction statistics show relapse rates 28: 

  • 31.76% in the first 3 months, 
  • 93.31% within 6 months, and 96.68% within the first year

How Much Heroin Does It Take To Overdose?

Factors affecting drug effects include tolerance, substance purity, method of use, and presence of other drugs. A study on heroin-related deaths in Australia revealed that these deaths had a higher median morphine concentration (0.35 mg/l) compared to current heroin users (0.09 mg/l) 29.

Can You Overdose On Cocaine?

Yes, it is quite common to overdose on cocaine. 

How Much Cocaine Does It Take To Overdose?

Cocaine doses usually range from 30 to 70 mg, but users can develop tolerance and exceed 1 g. 

  • The lethal minimum dose is about 1.2 g, though individuals with hypersensitivity can overdose on just 30 mg. 
  • Some heavy users have reported daily intakes of 5 g, which could be fatal for most.

References

  1. https://www.dph.ncdhhs.gov/programs/chronic-disease-and-injury/injury-and-violence-prevention-branch/north-carolina-overdose-epidemic-data
  2. https://www.ncdhhs.gov/news/press-releases/2026/04/27/new-data-shows-all-time-low-infant-mortality-nc-sharp-decrease-overdose-related-deaths
  3. https://mhstats.org/north-carolina/substance-use-disorder
  4. https://www.ncdhhs.gov/news/press-releases/2023/02/21/north-carolina-reports-22-increase-overdose-deaths
  5. https://www.dph.ncdhhs.gov/office-chief-medical-examiner/ocmesuspectedodreportdecember2025pdf/open
  6. https://www.kff.org/state-health-policy-data/state-indicator/opioid-overdose-deaths-for-adults-by-age-group/
  7. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/poisoning/SummaryTableforPoisoningDefinitions.pdf
  8. https://ocme.dph.ncdhhs.gov/annreport/docs/OCME_Monthly_Suspected_OD_Report-Dec2023.pdf
  9. https://ocme.dph.ncdhhs.gov/annreport/docs/OCME-Monthly-Suspected-OD_Report-Nov2023.pdf
  10. https://ocme.dph.ncdhhs.gov/annreport/docs/OCME-Monthly-Suspected-OD_Report-Oct2023.pdf
  11. https://ocme.dph.ncdhhs.gov/annreport/docs/OCME_Monthly_Suspected_OD_Report-Sep2023.pdf
  12. https://ocme.dph.ncdhhs.gov/annreport/docs/OCME-Monthly-Suspected-OD_Report-Apr2023.pdf
  13. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/StatewideOverdoseSurveillanceReports/OpioidOverdoseEDVisitsMonthlyReports/StatewideOpioidOverdoseSurveillanceEDDataFeb2021.pdf
  14. https://www.dph.ncdhhs.gov/ocmemonthlyfentanyldeathsnov2024/open
  15. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/StatewideOverdoseSurveillanceReports/OpioidOverdoseEDVisitsMonthlyReports/StatewideOpioidOverdoseSurveillance-ED-Data-Sep2020.pdf
  16. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/StatewideOverdoseSurveillanceReports/OpioidOverdoseEDVisitsMonthlyReports/StatewideOpioidOverdoseSurveillanceEDDataMay2020.pdf
  17. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/StatewideOverdoseSurveillanceReports/OpioidOverdoseEDVisitsMonthlyReports/StatewideOpioidOverdoseSurveillance-ED-Data-July2020.pdf
  18. https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/StatewideOverdoseSurveillanceReports/OpioidOverdoseEDVisitsMonthlyReports/StatewideOpioidOverdoseSurveillanceED-Data-Mar2021.pdf
  19. https://www.yahoo.com/news/articles/opioid-overdose-death-rates-increased-131700372.html
  20. https://www.wfmh.org/stats/north-carolina-drug-alcohol-statistics
  21. https://www.ncdhhs.gov/about/department-initiatives/overdose-epidemic
  22. https://www.reuters.com/business/healthcare-pharmaceuticals/us-drug-overdose-deaths-dropped-5-year-low-2024-cdc-data-shows-2025-05-14/
  23. https://www.kff.org/mental-health/opioid-overdose-deaths-national-trends-and-variation-by-demographics-and-states/
  24. https://www.fcc.gov/reports-research/maps/connect2health/focus-on-opioids.html
  25. https://www.ncbi.nlm.nih.gov/books/NBK621252/
  26. https://www.psychiatry.org/patients-families/opioid-use-disorder
  27. https://gaspsdata.dbhdd.ga.gov/data/drug-overdose-death-rates-involving-cocaine-region
  28. https://pmc.ncbi.nlm.nih.gov/articles/PMC4772197/
  29. https://pubmed.ncbi.nlm.nih.gov/9279497/
  30. https://www.americashealthrankings.org/explore/measures/drug_use_illicit_opioids/NC
  31. https://www.washingtonpost.com/health/2025/05/14/fentanyl-overdose-deaths-decline/
  32. https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html

Medical Disclaimer:

EHG of NC aims to improve the quality of life for people struggling with substance use disorder and mental health issues. Our team of licensed medical professionals research, edit and review the content before publishing. However, this information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For medical advice, please consult your physicians or EHG of NC’s qualified staff.

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