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Opioid trends across Washington state

Insights from mortality, treatment, and crime lab data

Opioid use, morbidity, and mortality have increased nationally and across Washington State. To provide insights into how and where changes are occurring, we visualize several data sources on this site. We show heroin and prescription-type and other opioids as those using these drugs often use them interchangeably, and interventions, treatment, and the opioid overdose antidote naloxone, work equally well for all opioids. For more on opioid treatment and naloxone, go to

Crime lab data for police evidence testing indicate a 186% increase in the number of cases positive for opioids statewide between 2002-2004 and 2018-2020, with increases in most counties. See our new and emerging drugs in crime lab evidence page for an explanation of why crime lab cases dropped in 2021. Publicly funded drug treatment admissions for opioids as the primary drug increased 257% statewide between 2002-2004 and 2013-2015 (the last year available, so we are phasing out presentation of treatment data), with increases in 38 of 39 counties. Drug-caused deaths involving opioids increased 190% statewide between 2003-2005 and 2020-2022, with increases in most counties. These increases in counts far exceed population growth.

The total number of drug-caused deaths involving opioids in 2019 was 852, a 10% increase over 2018. Deaths increased by over 35% in both 2020 and 2021, with a 25% increase to 2022. Controlling for population growth, the annual rate of opioid deaths changed little from 2005 to 2018, but the share of these deaths involving heroin versus other opioids changed. (Many deaths involve both.) Across these three data sources a similar pattern emerges with prescription-type opioids peaking between 2008 and 2010, while heroin continues to increase, especially since 2008. More recently, the rise of synthetic opioids, mostly fentanyl, have contributed to increases in deaths involving non-heroin opioids. See our other pages for more investigation of this phenomenon.

Data on this page are presented as counts, while data in the source-specific pages (see menu or landing page) are usually in rates, estimated as per 100,000 residents in the county or state to control for changes in population. Note that Washington has several counties with small populations, which may make rates unstable: A small change in the numerator (an increase in the count of 3 or a decrease of 2, for example, in a population of 5000) could result in a relatively large change in the rate. Garfield, Wahkiakum, Columbia, and Ferry Counties each have well under 10,000 residents.

Many of the charts on these pages are interactive. You can move your pointer over or click on a data point to see the count or rate, or on an item in the legend to highlight that data series. Click on a legend entry to turn that series on or off to better see the data. We will update the site as we get more data.

Statewide trends over time

Data sources: Division of Behavioral Health and Rehabilitation, Washington State Department of Social and Health Services (treatment), Center for Health Statistics, Washington State Department of Health (deaths), and Washington State Patrol Forensic Laboratory Services Bureau (crime lab cases). Crime lab case counts for 2021 and onward are impacted by the 2/25/2021 Washington State v Blake decision.

For more statewide information, see the source-specific and other detail pages: