Substance Use Statistics in Texas
Texas is experiencing a drug poisoning epidemic. Understanding the scope of the crisis is the first step toward finding help and supporting recovery.
The Scope of the Crisis
76,000+
Texans have lost their lives to drug overdoses since 1999—along with hundreds of billions in economic and medical costs.
Source: Dallas Federal Reserve, 2025
68%
Increase in Texas drug poisoning deaths from 2019 to 2024. The state is experiencing an ongoing epidemic.
Source: Texas DSHS
12%
Decline in Texas drug deaths in 2024 after peaking in 2023—a hopeful sign, though rates remain above pre-pandemic levels.
Source: Dallas Federal Reserve, 2025
#1
Drug poisoning is the leading cause of injury-related death for Texans aged 24-69 (as of 2023).
Source: Texas DSHS
The Opioid Crisis in Texas
3,172
Opioid-related overdose deaths in Texas in 2022
58%
Of all Texas drug overdoses involve opioids
1 in 4
Texans has experienced an opioid overdose or knows someone who has
Fentanyl's Role
Fentanyl has been a principal driver of overdose deaths nationwide. While a smaller share of Texas overdoses involve fentanyl compared to the national average, it remains a significant threat. Illicitly manufactured fentanyl is often mixed into other drugs without the user's knowledge—one pill can kill.
Source: Texas HHS - One Pill Kills
Source: NAMA Recovery
Alcohol Use in Texas
57%
Of Texas residents aged 12+ reported using alcohol within the past month (2021). Alcohol remains the most widely consumed substance in the state.
17%
Texas binge drinking rate—exceeding the national average of 15.3%.
$25.4 Billion
The cost to Texas taxpayers due to excessive alcohol use (2022 adjusted). This includes healthcare, lost productivity, criminal justice, and other costs.
Source: NAMA Recovery
Who Is Most Affected
By Gender
Males have drug poisoning death rates more than twice as high as females.
By Race/Ethnicity
Non-Hispanic whites have the highest total counts of fatal and non-fatal drug poisonings, while non-Hispanic Blacks have the highest rate of fatal and non-fatal drug poisonings among Texas residents.
By Age
Drug poisoning is the leading cause of injury-related death for Texans aged 24-69, affecting people in their prime working and family-raising years.
Regional Variation
Dallas County has seen a 61% increase in overdose mortality rates between 2018 and 2024 (from 12.9 to 20.8 per 100,000)—significantly outpacing both the Texas average (49.5% increase) and the national average (9.9% increase).
Source: Dallas County 2024 Report
The Treatment Gap
Despite the scale of the crisis, most Texans who need treatment don't receive it.
3.95%
Of Texans with opioid use disorder accessed treatment services in 2022. Over 96% did not receive specialized care.
77%
Of Texans needing alcohol use disorder treatment did not receive specialty care.
Why the Gap Exists
- • Limited access to medication-assisted treatment (MAT) programs
- • Insurance barriers and high out-of-pocket costs
- • Stigma around seeking help for substance use
- • Shortage of treatment providers, especially in rural areas
- • Co-occurring mental health conditions that complicate treatment
Source: NAMA Recovery
Substance Use & Mental Health
Substance use and mental health are deeply connected. Many people use substances to cope with anxiety, depression, trauma, or other challenges. Effective treatment often needs to address both simultaneously.
Common Co-Occurring Conditions
- • Depression and alcohol use
- • Anxiety and prescription drug misuse
- • PTSD and opioid dependence
- • ADHD and stimulant misuse
Integrated Treatment
The most effective approach treats both conditions together. This might include therapy for underlying mental health issues, medication-assisted treatment for substance use, and support groups for ongoing recovery.
Texas Resources for Help
Crisis & Immediate Help
- 988 Suicide & Crisis Lifeline (24/7, also helps with substance use crises)
- SAMHSA 1-800-662-4357 — National Helpline for substance use (24/7, free, confidential)
- Naloxone Available at many Texas pharmacies without a prescription. Can reverse opioid overdose.
Texas Treatment Programs
- • Texas Targeted Opioid Response (TTOR) — Expands access to prevention, treatment, and recovery services. Learn more
- • OSAR (Outreach, Screening, Assessment & Referral) — Call to speak with a trained counselor who can assess needs and refer to treatment, including telehealth options.
- • 2-1-1 Texas — Dial 2-1-1 or visit 211texas.org to find local treatment resources
Support Groups
- • Alcoholics Anonymous (AA) — aa.org
- • Narcotics Anonymous (NA) — na.org
- • Al-Anon (for families) — al-anon.org
- • SMART Recovery (science-based alternative) — smartrecovery.org
Related Resources
Mental Health Access in Texas →
Why Texas ranks last for mental health access and where to find help.
Depression Statistics in Texas →
Depression often co-occurs with substance use. Understanding the connection.
Anxiety Statistics in Texas →
Anxiety and substance use are frequently linked.
Find a Licensed Therapist →
Connect with therapists who specialize in substance use and mental health.
Recovery Is Possible
If you or someone you love is struggling with substance use, help is available. Treatment works, and recovery is possible.
Statistics cited are from publicly available sources and may have been updated since publication. Always verify current data with original sources. If you're experiencing a substance use crisis, call SAMHSA's National Helpline at 1-800-662-4357 (free, confidential, 24/7).