(The Center Square) – Louisiana opioid-related deaths have fallen 59% since 2022, even as federal survey data rank the state last among the 50 states and Washington, D.C., for opioid misuse.
The Louisiana Department of Health said opioid-related deaths declined 59% from 2022 through 2025, compared with a 46.2% decline nationally. Opioid-related emergency department visits fell 52% during the same period, while the rate of opioid prescriptions per 100 residents declined 10%.
The state's 2025 data is preliminary.
"We're seeing proven progress in behavioral health in Louisiana, and that is something worth celebrating," LDH Secretary Bruce Greenstein said.
But the latest state-level National Survey on Drug Use and Health shows Louisiana continues to face significant opioid-use challenges.
Louisiana ranked 51st for opioid misuse in the past year and 49th for opioid use disorder, according to LDH's analysis of the Substance Abuse and Mental Health Services Administration's 2023-2024 survey.
The federal survey produced estimates using responses from 1,920 Louisiana residents ages 12 and older during 2023 and 2024. SAMHSA combines survey results with other data through a small-area estimation model to produce state-level estimates.
The estimates show 4.58% of Louisiana residents ages 12 and older misused opioids in the past year, representing about 174,000 people. Among residents ages 26 and older, the estimated rate was 4.99%, or about 148,000 people.
An estimated 95,000 Louisiana residents had opioid use disorder, including about 85,000 people ages 26 and older.
The federal definition of opioid misuse includes heroin use or misuse of prescription opioids. It does not include illegally made fentanyl. Opioid use disorder is similarly based on meeting criteria for heroin or prescription opioid use disorder.
That limitation is significant because the survey's opioid use disorder measure does not capture symptoms caused solely by illegally made fentanyl. SAMHSA also notes that people may use fentanyl unknowingly when it is mixed into other illicit drugs.
Louisiana performed substantially better in the federal survey on receipt of substance-use treatment. LDH said the state ranked fifth nationally for people receiving substance-use treatment in the past year.
Still, the underlying estimates show a sizable gap between the number of residents classified as needing treatment and those receiving it.
SAMHSA estimated about 727,000 Louisiana residents ages 12 and older were classified as needing substance-use treatment in 2024. An estimated 574,000 people classified as needing treatment did not receive it. Separately, SAMHSA estimated about 179,000 Louisiana residents received substance-use treatment during the year.
SAMHSA defines people as needing substance-use treatment if they had a substance-use disorder in the past year or received substance-use treatment during the year. Treatment can include inpatient or outpatient care, medications for alcohol or opioid use disorder, telehealth treatment and treatment received in a prison, jail or juvenile detention center.
Across the behavioral-health measures reviewed by LDH, Louisiana had an average ranking of 28th among the 50 states and Washington, D.C., and ranked in the top 20 on 13 measures. The state ranked second for perceptions of great risk from using cocaine monthly and trying heroin once or twice and fifth for receipt of substance-use treatment.
LDH also pointed to Mental Health America's 2025 State of Mental Health in America report, which ranked Louisiana 27th overall. The report evaluates states using measures of mental-health prevalence and access to care. Louisiana had ranked 36th in the organization's 2023 report.
The 2025 Mental Health America report primarily uses federal data collected through 2023, meaning its ranking reflects an earlier period than some of the opioid trends reported by LDH.
SAMHSA also cautions against treating the latest opioid-misuse figures as a direct trend comparison with the previous state survey. The agency did not include opioid misuse, prescription opioid misuse or opioid use disorder in its comparisons between the 2022-2023 and 2023-2024 state estimates because comparable measures were not available for those indicators.
