Rhode Island Drug and Alcohol Statistics - Methadone dot org (NAMA Recovery)

Statistical Data on Drugs in Rhode Island

Rhode Island faces significant challenges with substance abuse and drug overdoses, though recent trends show encouraging signs of improvement. The state has historically ranked above national averages in several drug use categories, with opioids—particularly fentanyl—driving the overdose crisis for years. However, 2024 marked a turning point, with overdose deaths declining for the second consecutive year. This comprehensive statistical overview examines drug use patterns, overdose trends, treatment access, and demographic variations in substance abuse across Rhode Island, drawing from state surveillance data, federal crime statistics, and public health surveys from 2022-2024.

Overdose Death Statistics

Overall Overdose Deaths (2022-2024)

2022: 436 deaths
2023: 404 deaths (7.3% decrease from 2022)
2024: 329 deaths (18.6% decrease from 2023; 25% decrease from 2022)

Rhode Island has achieved remarkable progress toward its goal of reducing overdose deaths by 30% by 2030. The state has already reduced deaths by 25% from the 2022 baseline in just two years, demonstrating that prevention and intervention strategies are working effectively.

Overdose Death Rates

Metric	Rhode Island	National Average	Difference
OD death rate (per 100,000)	38.1	32.7	+16.35% higher
Opioid OD death rate (per 100,000)	32.2	24.0	+34.2% higher
Annual OD deaths	424	–	–
Percentage of all deaths from OD	4.06%	–	–
RI’s share of nationwide OD deaths	0.39%	–	–

Despite recent improvements, Rhode Island’s overdose death rates remain significantly above national averages, indicating the state continues to be disproportionately affected by the substance abuse crisis.

Overdose Deaths by Substance Type

2024 Substance Involvement

Cocaine-related deaths: 61% (first time surpassing fentanyl since 2013)
Fentanyl-related deaths: 57%
All opioid-related deaths: 69% (down from 85% in 2023)
Deaths involving both cocaine and fentanyl: 118 cases
Xylazine involvement in opioid deaths: 37%

Rhode Island Overdose Deaths by Substance Type

Historical Comparison (2023 vs. 2024)

Opioid-related overdoses: 85% (2023) → 69% (2024)
This represents a significant shift in the overdose landscape

Long-term Trends in Drug Types

2009: Prescription drugs accounted for 62% of overdose deaths
2020: Prescription drugs dropped to 9%; illicit drugs (fentanyl, cocaine) rose to 72%
2024: Combinations of illicit and prescription drugs: 34% (highest since at least 2009)

A major trend reversal occurred in 2024, with cocaine overtaking fentanyl as the most common substance in fatal overdoses. However, the high rate of polysubstance use (118 deaths involving both cocaine and fentanyl) complicates attribution and highlights the dangers of drug mixing.

Opioid-Specific Statistics (2023 Data)

Total opioid overdose deaths: 347
Opioids as factor in all OD deaths: 84.0%
Synthetic opioids (e.g., fentanyl) in opioid deaths: 91.4%
Prescription opioids in opioid deaths: 12.4%
Prescription rate: Doctors write enough prescriptions for 30.5% of residents

Rhode Island Opioid Specific Statistics

Synthetic opioids, particularly fentanyl, dominate the opioid crisis, being involved in over 9 out of 10 opioid deaths. The relatively low prescription opioid involvement suggests the crisis is driven primarily by illicit drug markets rather than medical prescribing.

Overdose Demographics and Circumstances (2024)

By Race/Ethnicity

Non-Hispanic white Rhode Islanders: 73% of overdoses (also most likely to have history of substance use treatment)

Location and Circumstances

Died in private settings (home, garage, camper): 80%
Died alone (no bystander present): 60%

The majority of overdoses occur in private, isolated settings, limiting opportunities for bystander intervention and naloxone administration. The fact that white Rhode Islanders comprise the largest share of deaths despite higher treatment engagement suggests potential barriers to treatment effectiveness or ongoing accessibility issues.

2007 Mortality Comparison

Cause of Death	Number
Drug-induced deaths	142
Motor vehicle accidents	85
Firearms	37

Even in 2007, drug deaths significantly exceeded both traffic fatalities and gun deaths, demonstrating that the overdose crisis has been a long-standing issue in Rhode Island, not just a recent phenomenon.

Historical Drug Use Patterns

Specific Rankings:

Highest in the nation for heroin use
Among highest rates for cocaine use across three age groups (12-17, 18-25, 26-30)
Among highest rates for marijuana use for all age groups
Among 18 states with more drug-induced deaths than other causes of death

Rhode Island historically ranked above the national average for illicit drug use and was in the top fifth for drug use in the nation (2007 data).

Youth Substance Abuse (Ages 12-17)

Rhode Island vs. National Average

Drug use likelihood: Teenagers in Rhode Island are 1.73% more likely to have used drugs in the last month than average American teens (older data)
Updated comparison: RI teenagers are 15.71% more likely to have used drugs than average American teens
Alcohol use likelihood: RI teens are 21.52% more likely (older data) or 20.39% more likely (updated) to use alcohol than average American peers

Rhode Island teenagers consistently show elevated rates of both drug and alcohol use compared to national averages, indicating a need for targeted youth prevention programs.

Youth Drug Use Statistics (2022-2023)

Past Month Use

Illicit drugs: 5,000 teens (7.38%)
Marijuana: Nearly 100% of teen drug users reported marijuana use
Alcohol: 5,000-7,000 teens (8.36% or 11.02% depending on data source)

Past Year Use

Marijuana: 13.22%
Cocaine: 0.25%
Methamphetamine: 0.08%
Pain relievers: 1.64%

High School Student Substance Use (2023 Youth Risk Behavior Survey)

Current alcohol consumption: 18%
Current marijuana use: 20%
Current e-cigarette use: 17%
Current binge drinking: 9%
Current cigarette use: 3%
Ever misused prescription pain medication: 11%

E-cigarettes and marijuana show nearly equal prevalence among high schoolers, suggesting vaping has become as normalized as traditional substance use among teens.

Youth Substance Use Disorders (2022-2023)

Drug Use Disorder (DUD): 7.49% of 12-17 year-olds
Alcohol Use Disorder (AUD): 3.19% of 12-17 year-olds

Historical Youth Drug Use Trends

Past-Month Marijuana Use (2017-2019)

Rhode Island: 9.3%
Regional average: 10.8%
National average: 6.8%
RI higher than national but lower than regional

Past-Month Illicit Drug Use (2017-2019)

Rhode Island: 10.8%
Regional average: 12.1%
National average: 8.2%
RI higher than national but lower than regional

National Ranking

Illicit Drug Use (12-17): Rhode Island ranks 48th (10.3% prevalence)

While Rhode Island youth drug use exceeds national averages, it falls below regional (New England) averages, suggesting the issue is partly regional rather than state-specific.

Youth Substance Initiation (First Use, 2017-2019)

Among youth aged 12-17 in Rhode Island

Alcohol: 9.6% used for first time (similar to regional 11.5% and national 9.3%)
Marijuana: 6.8% used for first time (similar to regional 8.1% and national 5.2%)
Cigarettes: 2.5% used for first time (similar to regional 2.4% and national 2.3%)

Alcohol remains the most common substance of first use among Rhode Island youth at nearly 10%, exceeding both marijuana (6.8%) and cigarette (2.5%) initiation rates, though these rates align closely with national patterns.

Young Adult Substance Use (Ages 18-25)

Comparative Risk Assessment

Young adults (18-25) in Rhode Island are 29.32% more likely to use drugs than the average American in the same age group.

Young Adult Statistics (2022-2023)

Used drugs in last month: 42,000 (34.54%)
This age group shows the highest substance use rates across all categories

Historical Young Adult Trends (2017-2019)

Past-Year Marijuana Use

Rhode Island: 45.8%
Regional average: 46.4%
National average: 35.0%
No significant change from 2002-2004 levels

Past-Year Marijuana Use Disorder

Rhode Island: 7.0% (9,000 individuals)
Regional average: 6.7%
National average: 5.6%
Decreased from 2002-2004 levels

Past-Year Opioid Use Disorder

Rhode Island: 0.9% (1,000 individuals)
Regional average: 1.2%
National average: 1.0%
No significant change from 2015-2017

Past-Year Illicit Drug Use Disorder

Rhode Island: 9.3% (12,000 individuals)
Regional average: 9.1%
National average: 7.5%
No significant change from 2015-2017

Past-Year Substance Use Disorder

Rhode Island: 19.9% (25,000 individuals)
Regional average: 19.8%
National average: 14.7%
No significant change from 2015-2017

One in five young adults in Rhode Island has a substance use disorder, significantly higher than the national rate. This age group represents a critical intervention point, as they show the highest use rates but relatively lower disorder rates compared to usage levels.

Adult Substance Use Patterns

Non-Medical Drug Use (Past Year)

Rhode Island Value: 11.7% of adults reported using prescription drugs non-medically (including pain relievers, stimulants, and sedatives) or illicit drugs (excluding cannabis) in the last 12 months
National Ranking: 7th highest in the nation

Rhode Island’s ranking as 7th highest for non-medical drug use indicates that prescription drug misuse and illicit drug use (beyond marijuana) remain significant problems compared to other states.

Polysubstance Use Among Adults (2021 Behavioral Risk Factor Surveillance System)

Survey Details

5,639 individuals completed BRFSS
Representing 889,340 adults (weighted population)

Overall Polysubstance Use: 13.7% of adults

Number of Substances Used

None: 66.8%
One substance: 19.5%
Two substances: 10.4%
Three substances: 2.8%
All four assessed: 0.5%

Individual Substance Prevalence (2021)

Excessive alcohol use: 19.5%
Marijuana use: 15.8%
Cigarette use: 12.4%
E-vape use: 6.2%

Polysubstance Use Patterns

Among polysubstance users:

Most common substance: Marijuana (77.0%)
Most common combination: Marijuana and excessive alcohol use (46.0%)

Nearly half of polysubstance users combine marijuana with excessive alcohol, creating compounded health and impairment risks.

Substance Use Prevalence

Illicit Drug Use by Age Group (2022-2023 Annual Average)

Age Group	Past Month Use (Number)	Past Month Use (%)	Past Year Use (%)
12+	195,000	20.53%	–
12-17	5,000	7.38%	–
18-25	42,000	34.54%	–
26+	147,000	19.53%	–
18+	189,000	21.62%	–

Young adults (18-25) show dramatically higher rates of illicit drug use, with over one-third using in the past month—nearly five times the rate of teenagers and almost double the rate of adults 26+.

Marijuana Use Statistics (2022-2023)

Past Year Marijuana Use

Age Group	Number	Percentage
12+	256,000	26.93%
12-17	10,000	13.22%
18-25	59,000	47.89%
26+	187,000	24.86%
18+	246,000	28.07%

Past Month Marijuana Use

Age Group	Number	Percentage
12+	174,000	18.32%
12-17	5,000	7.24%
18-25	41,000	33.35%
26+	128,000	16.95%
18+	169,000	19.23%

First Use Among Those at Risk

12+: 15,000 (3.39%)
12-17: 3,000 (5.20%)
18-25: 6,000 (10.65%)
26+: 6,000 (1.77%)

Nearly half of young adults (18-25) used marijuana in the past year, representing the highest usage rate across all age groups. The high initiation rate among 18-25 year-olds (10.65%) suggests this is a critical period for first-time use.

Youth Marijuana Use (Ages 12-17)

Comparison Between Time Periods (2002-2004 vs. 2017-2019)

No significant change in past-month marijuana use
2017-2019 Rate: 9.3%
Regional average: 10.8%
National average: 6.8%

Despite legalization trends, youth marijuana use rates in Rhode Island have remained relatively stable over 15+ years, though consistently above the national average.

Overall Population Marijuana Use (Ages 12+)

Comparison (2002-2004 vs. 2017-2019)

Past-year marijuana use INCREASED between these periods
2017-2019 Rate: 22.7% (207,000 people)
Regional average: 21.4%
National average: 16.2%

While youth rates remained stable, overall adult marijuana use increased significantly, likely reflecting changing legal status and social acceptance.

Other Illicit Drug Use (Past Month, 2022-2023)

Age Group	Number	Percentage
12+	33,000	3.49%
12-17	1,000	1.80%
18-25	7,000	5.40%
26+	25,000	3.35%
18+	32,000	3.63%

Cocaine Use (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	22,000	2.28%
12-17	<500*	0.25%
18-25	6,000	4.98%
26+	15,000	2.04%
18+	21,000	2.45%

*Note: “<500” indicates suppressed data due to small numbers

Heroin Use (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	Data suppressed	–
12-17	Data suppressed	–
18-25	<500*	0.31%
26+	3,000	0.37%
18+	3,000	0.36%

Reported heroin use is extremely low across all age groups, with most data suppressed due to small numbers. This may reflect declining heroin availability as fentanyl has largely replaced it in illicit drug markets.

Past-Year Heroin Use Trends (Ages 12+)

Comparison (2002-2004 vs. 2017-2019)

No significant change
2017-2019 Rate: 0.23% (2,000 people)
Regional average: 0.46% (Rhode Island lower than region)
National average: 0.30%

Rhode Island’s heroin use rate is actually lower than the regional average, despite the state’s historical reputation for high heroin use and current high overdose rates. This paradox likely reflects the replacement of heroin with fentanyl in the illicit drug market.

Hallucinogen Use (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	38,000	4.04%
12-17	1,000	1.37%
18-25	12,000	9.77%
26+	25,000	3.36%
18+	37,000	4.26%

Methamphetamine Use (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	6,000	0.61%
12-17	<500*	0.08%
18-25	<500*	0.35%
26+	5,000	0.71%
18+	6,000	0.66%

Methamphetamine use remains relatively rare in Rhode Island compared to other substances and other regions of the country.

Prescription Pain Reliever Misuse (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	29,000	3.04%
12-17	1,000	1.64%
18-25	3,000	2.54%
26+	25,000	3.25%
18+	28,000	3.15%

Opioid Misuse (Past Year, 2022-2023)

Age Group	Number	Percentage
12+	33,000	3.50%
12-17	1,000	1.66%
18-25	3,000	2.50%
26+	29,000	3.84%
18+	32,000	3.66%

Adults 26+ show slightly higher rates of prescription opioid misuse compared to younger age groups, which may reflect chronic pain management issues or long-term patterns of misuse.

Prescription Pain Reliever Misuse Trends

Overall Population (Ages 12+, 2015-2017 vs. 2017-2019)

No significant change between time periods
2017-2019 Rate: 3.5% (32,000 people)
Regional average: 3.1%
National average: 3.7%

Rhode Island’s prescription pain reliever misuse rates are comparable to national averages, suggesting this is a widespread problem not unique to the state.

Substance Use Disorders

Overall Population (Ages 12+, 2022-2023)

Disorder Type	Number	Percentage
Substance Use Disorder	207,000	21.78%
Drug Use Disorder	111,000	11.69%
Pain Reliever Use Disorder	20,000	2.08%
Opioid Use Disorder	22,000	2.28%

By Age Group

Age	Substance Use Disorder	Drug Use Disorder
12-17	9.30%	7.49%
18-25	34.95%	22.71%
26+	20.85%	10.32%
18+	22.81%	12.04%

Over one in five Rhode Islanders aged 12+ has a substance use disorder. The extraordinarily high rate among young adults (34.95%) indicates that more than one-third of this age group meets criteria for SUD.

Demographic Variations in Substance Use (2021)

By Sex

Category	Males	Females
No substance use	61.7%	71.5%
One substance	21.4%	17.8%
Polysubstance use	16.9%	10.8%

By Sexual Orientation/Gender Identity

Category	LGBTQ+	Straight & Cisgender
No substance use	54.2%	67.1%
One substance	24.8%	19.7%
Polysubstance use	21.1%	13.3%

By Age Group

Age	No Substance	One Substance	Polysubstance
18-24	56.9%	17.1%	26.0%
25-34	56.8%	23.4%	19.6%
35-44	68.1%	22.4%	9.6%
45-64	82.1%	14.4%	3.6%
65+	82.1%	14.4%	3.6%

By Race/Ethnicity

Race/Ethnicity	No Substance	One Substance	Polysubstance
White, Non-Hispanic	64.5%	21.2%	14.3%
Black, Non-Hispanic	74.2%	15.8%	10.0%
Other, Non-Hispanic	74.1%	13.1%	12.8%
Hispanic	71.2%	16.3%	12.4%

By Household Income

Income	No Substance	One Substance	Polysubstance
< $25,000	69.2%	15.4%	15.4%
$25,000-49,999	62.4%	20.7%	16.9%
$50,000-74,999	63.9%	20.8%	15.3%
≥ $75,000	64.0%	23.7%	12.3%

By Education Level

Education	No Substance	One Substance	Polysubstance
Less than High School	68.7%	14.4%	16.9%
High School	63.2%	20.0%	16.9%
Some College	64.2%	20.0%	15.8%
College Graduate	71.5%	20.6%	8.0%

Substance use patterns reveal stark demographic disparities, with males, LGBTQ+ individuals (21.1% polysubstance use vs. 13.3%), and young adults aged 18-24 (26.0%) showing the highest rates, while use decreases significantly among college graduates (8.0%) and adults over age 44.

Historical SUD Trends (2017-2019)

Past-Year Marijuana Use Disorder (Ages 12+)

Rhode Island: 2.1% (20,000)
No significant change from 2002-2004

Past-Year Opioid Use Disorder (Ages 12+)

Rhode Island: 0.6% (5,000)
Regional: 0.9%
National: 0.7%
No significant change from 2015-2017

Past-Year Illicit Drug Use Disorder (Ages 12+)

Rhode Island: 3.1% (29,000)
Regional: 3.4%
National: 2.9%
Decreased from 2015-2017

Past-Year Substance Use Disorder (Ages 12+)

Rhode Island: 8.7% (79,000)
Regional: 8.7%
National: 7.4%
No significant change from 2015-2017

While Rhode Island’s illicit drug use disorder decreased from 2015-2017, the overall substance use disorder rate of 8.7% remains above the national average of 7.4%, with marijuana use disorder (2.1%) being the most prevalent specific disorder, followed by opioid use disorder at rates below both regional and national averages.

Risk Perceptions (2022-2023)

Marijuana (Smoking Once a Month)

Age Group	Number	Percentage
12+	154,000	16.26%
12-17	12,000	17.09%
18-25	10,000	7.87%
26+	132,000	17.55%
18+	142,000	16.19%

Cocaine (Using Once a Month)

Age Group	Number	Percentage
12+	579,000	61.09%
12-17	32,000	43.72%
18-25	67,000	54.40%
26+	481,000	63.82%
18+	548,000	62.51%

Heroin (Trying Once or Twice)

Age Group	Number	Percentage
12+	768,000	81.01%
12-17	38,000	52.91%
18-25	92,000	75.38%
26+	637,000	84.55%
18+	729,000	83.27%

Risk perceptions are lowest among young adults (18-25) across all substances, which correlates with their higher usage rates. Only about 1 in 6 Rhode Islanders perceive marijuana as presenting great risk, while more than 4 in 5 perceive heroin as highly risky.

Treatment Access and Utilization

Treatment Gap (2022-2023)

Age Group	Received Treatment	Classified as Needing	Not Receiving Among Those Needing
12+	49,000 (5.17%)	231,000 (24.29%)	183,000 (78.70%)
12-17	4,000 (5.33%)	8,000 (11.26%)	5,000 (57.91%)
18-25	6,000 (4.57%)	44,000 (36.31%)	38,000 (86.47%)
26+	40,000 (5.26%)	178,000 (23.60%)	140,000 (77.85%)
18+	45,000 (5.16%)	222,000 (25.37%)	177,000 (79.55%)

The treatment gap represents a critical failure in Rhode Island’s substance abuse response system. Despite high rates of substance use disorders, the vast majority of those needing help are not accessing treatment services.

Substance Abuse Treatment Facilities and Capacity

Current Infrastructure

61 active substance abuse clinics in Rhode Island
8,609 patients serviced annually for drug rehab
No facilities offer free drug rehab treatment for all patients

Treatment Modality Breakdown (Annual)

Outpatient services: 8,286 patients
Residential (non-hospital) services: 265 patients
Hospital-based drug rehab: 58 patients

Rhode Island Substance Abuse Treatment Facilities Statistics

The overwhelming majority (96.2%) of treatment occurs in outpatient settings, with very limited residential and hospital-based capacity.

Treatment Enrollment Trends

Single-Day Count Comparison

2015: 14,269 people enrolled in substance use treatment
2019: 8,609 people enrolled
Change: 40% decrease in enrollment

Treatment Focus (March 2019 single-day count)

Drug problem only: 65.7%
Alcohol problem only: 11.0%
Both drug and alcohol problems: 23.3%

The dramatic 40% decline in treatment enrollment from 2015 to 2019 is concerning, especially given persistently high overdose rates. This may reflect barriers to access, changes in treatment modalities, or data collection issues.

Medication-Assisted Treatment (MAT)

Methadone Treatment (Single-Day Counts)

2015: 6,213 people receiving methadone in opioid treatment programs
2019: 4,222 people
Change: 32% decrease

Buprenorphine Treatment (Single-Day Counts)

2015: 1,078 people receiving buprenorphine
2019: 814 people
Change: 24% decrease

The significant decreases in both methadone and buprenorphine treatment are alarming given the ongoing opioid crisis. This may reflect funding cuts, facility closures, or shifts to other treatment modalities.

Historical Treatment Admissions

2010 Admissions Data

Total admissions: 10,147
Gender breakdown: 70.3% men, 29.7% women

2010 Admissions by Substance

Heroin: 1,993 admissions
Marijuana: 1,577 admissions
Prescription opioids (non-heroin): 1,323 admissions
Cocaine: 869 admissions

Co-Occurring Mental Health Issues

1992: 4.5% of treatment admissions had co-occurring psychological problems
2006: 26% had co-occurring psychological problems
Change: Nearly 6-fold increase

The dramatic rise in co-occurring mental health and substance use disorders highlights the need for integrated treatment approaches.

Treatment Costs

Average Individual Treatment Costs

Treatment Type	Rhode Island Cost
Residential Treatment	$58,755
Outpatient Treatment	$1,673

National Cost Rankings

Residential treatment: Rhode Island ranks 39th (cheapest to most expensive)
Outpatient treatment: Rhode Island is among the top 10 most expensive states

Public Spending on Treatment

Outpatient Services

Rhode Island spending: $13.86 million
Percentage of U.S. total: 0.6%

Residential Treatment

Rhode Island spending: $15.57 million
Percentage of U.S. total: 0.3%

While residential treatment costs are moderate nationally, Rhode Island’s outpatient treatment is among the most expensive in the nation, which may contribute to access barriers despite lower per-person costs.

Health Outcomes Associated with Substance Use

Adjusted Odds Ratios for Health Outcomes (2021)

Health Indicator	One-Substance Use (AOR)	95% CI	Polysubstance Use (AOR)	95% CI
Fair/Poor Overall Health	1.20	0.89-1.62	1.86	1.26-2.76
Frequent Mental Distress	1.67	1.25-2.23	2.69	1.88-3.87
Diagnosed with Depression	1.47	1.17-1.84	1.92	1.42-2.59
Chronic Disease	1.19	0.96-1.48	1.45	1.05-2.00
Obesity	1.03	0.83-1.29	0.80	0.58-1.11

Polysubstance users are 1.86 times more likely to report fair/poor overall health
Polysubstance users are 2.69 times more likely to experience frequent mental distress
Polysubstance users are 1.92 times more likely to be diagnosed with depression
Polysubstance users are 1.45 times more likely to have chronic disease

Polysubstance use is strongly associated with worse health outcomes, particularly mental health. The association with frequent mental distress is especially pronounced, suggesting either that substance use exacerbates mental health issues or that individuals with mental health problems are more likely to use multiple substances.

Hepatitis C and HIV/AIDS Related to Drug Use

Hepatitis C (2022)

Estimated 7.3 new cases per 100,000 residents linked to intravenous drug use

HIV/AIDS (2023)

Approximately 4.1 new diagnoses per 100,000 residents connected to intravenous drug use

While these rates may seem modest, they represent ongoing public health challenges associated with injection drug use. These infectious disease complications add to the overall burden of the substance abuse crisis.

Federal Drug Crime Statistics

2023 Federal Prosecutions in Rhode Island

Total federal criminal cases: 106
Drug-related offenses: 33% of all federal prosecutions

Drug Types Found in Federal Drug Cases

Drug Type	Percentage
Powder cocaine	26.5%
Crack cocaine	26.5%
Methamphetamines	23.5%
Fentanyl	14.7%
Marijuana	5.9%
Heroin	2.9

Cocaine (both powder and crack combined) accounts for more than half (53%) of federal drug prosecutions in Rhode Island, while fentanyl—despite being the leading cause of overdoses—represents only 14.7% of federal cases. This may reflect the difficulty in prosecuting fentanyl cases or differences between state and federal enforcement priorities.

Marijuana-Related Arrests

Marijuana Possession Arrests

2012: 2,092 arrests
2023: 92 arrests
Change: Over 95% decrease

State law amendments, including decriminalization and legalization measures, have dramatically reduced marijuana-related arrests. This represents one of the most significant criminal justice shifts in Rhode Island’s drug policy landscape.

Rhode Island is making significant progress in reducing overdose deaths, achieving a 25% decline from 2022 to 2024, yet the state still faces overdose rates 16-34% higher than national averages and a critical treatment gap where nearly 80% of those needing help don’t receive it. Young adults (18-25) are disproportionately affected, with over one-third having substance use disorders but the worst treatment access at only 13.5%. The recent shift from fentanyl to cocaine as the leading overdose substance, combined with high rates of polysubstance use and the concentration of deaths among isolated individuals, demonstrates that Rhode Island’s substance abuse crisis remains complex and requires continued expansion of treatment capacity, harm reduction efforts, and targeted interventions for high-risk populations.

Statistical Data on Alcohol in Rhode Island

Rhode Island confronts substantial alcohol-related public health concerns despite its small size, with nearly 500 annual deaths attributable to excessive alcohol use and consumption rates persistently higher than national averages. The state demonstrates troubling patterns in young adult binge drinking, significant disparities across demographic groups, and a critical shortage in substance abuse treatment access. The data reveals both declining trends in youth alcohol use and alarming increases in alcohol-attributable mortality, particularly among women and veterans, while exposing a treatment gap affecting thousands of residents. This comprehensive analysis examines drinking behaviors, mortality patterns, treatment needs, demographic disparities, and risk perceptions across Rhode Island’s population from 2002 to 2023.

Overall Alcohol-Related Deaths

Total annual deaths attributable to excessive alcohol use: 493
Deaths under age 21: 1.4% (approximately 7 deaths)
5-year average annual rate increase (2015-2019): 39.2%
Death rate: 5.57 deaths per 10,000 adults (1 death per 2,226 people aged 18+)
Male deaths: 67.5%
Deaths from chronic causes (e.g., Alcohol Use Disorder): 59.8%
Deaths among adults 35+ years: 87.4%
Deaths under age 21: 1.42%
Years of potential life lost annually: 12,094
Economic cost (2010, adjusted to 2022 dollars): $1.197 billion ($2.46 per drink)

Rhode Island Overall Alcohol Related Deaths Statistics

Rhode Island experiences a substantial burden from excessive alcohol use, with nearly 500 deaths annually. The mortality rate has shown a concerning upward trend, with a 39.2% increase in per capita deaths over a five-year period. Males comprise the vast majority of these deaths, and most fatalities occur among older adults. Notably, underage drinking deaths remain relatively rare, representing only 1.42% of total alcohol-related deaths.

Fully Alcohol-Attributable Chronic Condition Deaths (2018-2022)

Annual Death Statistics

Year	Total Deaths (All Causes)	Alcohol-Attributable Deaths	Percentage
2018	9,703	354	3.6%
2019	9,806	361	3.7%
2020	11,328	434	3.8%
2021	10,875	357	3.3%
2022	10,518	328	3.1%
5-Year Average	10,446	367	3.5%

Causes of Death

Alcoholic liver disease: 63.2%
Alcohol dependence syndrome: 22.2%
Alcohol abuse: 8.3%
Age-adjusted death rate: 28.8 deaths per 100,000 people
No substantial monthly or seasonal changes observed

Monthly Distribution (5-Year Average)

Month	Average Deaths	Percentage
January	34	9.2%
February	31	8.4%
March	32	8.8%
April	34	9.3%
May	34	9.2%
June	26	7.0%
July	33	9.1%
August	31	8.4%
September	26	7.1%
October	32	8.7%
November	27	7.3%
December	27	7.4%

Deaths from fully alcohol-attributable chronic conditions represent a significant portion of all mortality in Rhode Island, averaging 367 deaths annually (3.5% of all deaths). The number peaked at 434 deaths in 2020 before declining to 328 in 2022. Alcoholic liver disease is the leading cause of these deaths, accounting for nearly two-thirds of fatalities. Most victims are middle-aged or older white males, though the proportion of female deaths has increased substantially over the study period.

Gender Distribution

Year	Male Deaths	Female Deaths	Male:Female Ratio
2018	278 (78.5%)	76 (21.5%)	3.7:1
2019	273 (75.6%)	88 (24.4%)	3.1:1
2020	347 (80.0%)	87 (20.0%)	4.0:1
2021	269 (75.4%)	88 (24.6%)	3.1:1
2022	226 (68.9%)	102 (31.1%)	2.2:1
5-Year Average	279 (76.0%)	88 (24.0%)	3.2:1

Increase in female deaths (2018-2022): 34.2%
Overall ratio: 3.2 male deaths for every 1 female death

Male deaths outnumber female deaths by more than 3:1 overall, though this gap has narrowed significantly over the five-year period. The female death count increased by 34.2% from 2018 to 2022, aligning with national trends showing increases in women’s drinking frequency, binge drinking, and alcohol-related mortality.

Age Distribution (5-Year Average)

Age Group	Average Deaths	Percentage
0-24	5	1.3%
25-34	23	6.2%
35-44	47	12.8%
45-54	69	18.7%
55-64	121	33.1%
65+	103	28.0%

Ages 55+: Over 60% of deaths
Ages 65+ in 2018: 21.5%
Ages 65+ in 2022: 33.2%

Most deaths occur among middle-aged and older adults, with over 60% of decedents aged 55 or older. The proportion of deaths among individuals 65+ increased substantially during the study period, rising from 21.5% in 2018 to 33.2% in 2022. Deaths among young adults (under 35) remain relatively rare, representing less than 8% of total fatalities.

Race/Ethnicity Distribution (5-Year Average)

Race/Ethnicity	Average Deaths	Percentage
White, Non-Hispanic	297	80.9%
Black, Non-Hispanic	17	4.5%
Hispanic	30	8.2%
Other, Non-Hispanic	24	6.4%

The vast majority of deaths (80.9%) occur among non-Hispanic white individuals, followed by Hispanic individuals (8.2%). This distribution has remained relatively stable throughout the study period.

Marital Status Distribution (5-Year Average)

Marital Status	Average Deaths	Percentage
Single	128	35.7%
Married/Civil Partnership	89	25.1%
Widowed	27	7.6%
Divorced/Separated	112	31.5%

Single individuals represent the largest group of decedents (35.7%), followed by divorced/separated individuals (31.5%). Combined, unmarried individuals (single, divorced/separated, and widowed) account for nearly three-quarters of all deaths.

Veteran Status

Veteran deaths (5-year average): 46 (12.8%)
Non-veteran deaths (5-year average): 313 (87.2%)
Veteran population in Rhode Island: 6%
Disproportionate impact: Veterans represent 12.8% of deaths but only 6% of population
Veterans reporting past-month alcohol use: 67%
Veterans reporting past-month binge drinking: 19%

Veterans are disproportionately affected by alcohol-attributable chronic conditions. While only 6% of Rhode Islanders are veterans, they represent 12.8% of deaths from these conditions (14.5% when considering all veterans in the analysis). Nationally, veterans report higher rates of both alcohol use and heavy drinking compared to non-veterans, a pattern that continues in Rhode Island where 67% of veterans report past-month alcohol use and 19% report binge drinking.

Adult Drinking Patterns (2016-2023)

Adults reporting any alcohol use in past 30 days: 54.92% (521,000 people aged 12+)
Rhode Island consistently reports 5.5-7% higher drinking rates than US median
Adults over 18 who binge drink monthly: 17.8%
Median drinks per binge: 5.4 drinks
Median drinks per binge (top 25% of drinkers): 7.2 drinks
Median binge frequency: 1.6 times per month
Median binge frequency (top 25% of drinkers): 3.8 times per month
Binge drinking in past month (all adults 12+): 25.67% (243,000 people)
Binge drinking in past month (adults 18+): 27.47% (241,000 people)
Excessive drinking rate (2023): 18.0% (decreased from 18.9% in 2022)
National rank for excessive drinking: 34th
Alcohol-related death rate: 15.3 per 100,000 population

Rhode Island adults consistently drink more than the national median, with rates 5.5-7% higher depending on the year. Binge drinking is most prevalent among younger adults and decreases with age. The state’s excessive drinking rate of 18.0% in 2023 shows a slight improvement from the previous year, ranking Rhode Island 34th nationally. However, binge drinking remains a significant public health concern, with adults averaging 1.6 binge episodes per month.

Age-Specific Patterns

Youth (Ages 12-17)

Past-month alcohol use: 8.36% (6,000 youth)
Past-month binge drinking: 3.79% (3,000 youth)
Alcohol use disorder: 3.19% (2,000 youth)
Past-month alcohol use (2017-2019 average): 10.1% (7,000 youth) – decreased from 2002-2004
Comparison: Similar to regional average (12.6%) and national average (9.4%)

Youth alcohol use in Rhode Island has shown positive trends, with substantial decreases in past-month alcohol consumption between 2002-2004 and 2017-2019. Current rates are similar to national averages, though binge drinking and alcohol use disorder remain concerns for this age group, affecting thousands of young people.

Ages 12-20

Past-month alcohol use: 20.10% (23,000 people)
Past-month binge drinking: 11.20% (13,000 people)
Alcohol use disorder: 7.07% (8,000 people)
Perception of great risk from binge drinking: 41.83% (49,000 people)

This age group, which spans both adolescence and early young adulthood, shows concerning patterns of alcohol use despite being below the legal drinking age. More than one in five individuals aged 12-20 report past-month alcohol use, with about half of those engaging in binge drinking.

Young Adults (Ages 18-25)

Past-month alcohol use: 58.02% (71,000 young adults)
Past-month binge drinking: 37.28% (46,000 young adults)
Past-month binge drinking (2017-2019 average): 46.7% (58,000 young adults) – no significant change from 2015-2017
Comparison: Similar to regional average (46.6%) but higher than national average (35.4%)
Alcohol use disorder: 19.17% (23,000 young adults)
Alcohol use disorder (2017-2019 average): 14.4% (18,000 young adults) – decreased from 2002-2004
Comparison: Similar to regional average (13.7%) but higher than national average (9.8%)
Perception of great risk from binge drinking: 40.45% (50,000 young adults)
Binge drinking most common in ages 18-34: approximately 30%

Young adults in Rhode Island show particularly high rates of problematic alcohol use compared to national averages. Binge drinking affects nearly half of this age group, significantly exceeding the national rate. The alcohol use disorder rate of 19.17% is especially concerning and substantially higher than the national average of 9.8%.

Adults (Ages 26+)

Past-month alcohol use: 58.89% (444,000 adults)
Past-month binge drinking: 25.88% (195,000 adults)
Alcohol use disorder: 12.43% (94,000 adults)
Perception of great risk from binge drinking: 47.45% (358,000 adults)

Alcohol use remains prevalent among older adults, with nearly 60% reporting past-month use. However, both consumption and disorder rates are lower than among young adults. Binge drinking decreases notably after age 35, though alcohol use disorder still affects over 94,000 adults in this age group.

Demographic Disparities in Alcohol Use

Gender Differences

Males – past-month alcohol use: 66.2%
Females – past-month alcohol use: 56.9%
Males – past-month binge drinking: 17.5%
Females – past-month binge drinking: 9.4%
Male binge drinking rate is nearly 2x female rate

Significant gender disparities exist in Rhode Island’s drinking patterns. Men report both higher rates of any alcohol use and nearly double the rate of binge drinking compared to women. These differences persist across most measures of alcohol consumption and problematic use.

Sexual Orientation

Gay/Lesbian – past-month alcohol use: 66.1%
Bisexual – past-month alcohol use: 64.4%
Straight/Heterosexual – past-month alcohol use: 61.5%
Bisexual – past-month binge drinking: 20.9%
Gay/Lesbian – past-month binge drinking: 16.4%
Straight/Heterosexual – past-month binge drinking: 12.6%

Alcohol use varies significantly by sexual orientation, with LGBTQ+ adults reporting higher rates of both general alcohol use and binge drinking compared to heterosexual adults. Bisexual adults show the highest rate of binge drinking at 20.9%, while gay/lesbian adults show the highest rate of any alcohol use at 66.1%.

Race and Ethnicity

Non-Hispanic White – past-month alcohol use: 63.7%
Non-Hispanic Black, Hispanic/Latinx, Non-Hispanic other/multiple races – past-month alcohol use: approximately 50%
Non-Hispanic Black – past-month binge drinking: 13.7%
Non-Hispanic other/multiple races – past-month binge drinking: 13.8%
Hispanic/Latinx – past-month binge drinking: 14.3%

Drinking patterns show notable variation across racial and ethnic groups. Non-Hispanic white adults report the highest rates of any alcohol use (63.7%), significantly exceeding rates among Black, Hispanic/Latinx, and multiracial adults (all around 50%). However, binge drinking rates are more consistent across groups, with slightly higher rates among non-white populations.

Disability Status

No disability – past-month alcohol use: 62.7%
Hearing disability – past-month alcohol use: 62.8%
Cognitive disability – past-month alcohol use: 54.6%
Vision disability – past-month alcohol use: 52.1%
Physical disability – past-month alcohol use: 45.7%
Cognitive disability – past-month binge drinking: 18.3%
No disability – past-month binge drinking: 13.6%
Vision disability – past-month binge drinking: 11.1%
Multiple disabilities – past-month binge drinking: 7.9%
Hearing disability – past-month binge drinking: 7.8%
Physical disability – past-month binge drinking: 5.3%

Alcohol consumption patterns vary substantially by disability type. Adults without disabilities and those with hearing disabilities show the highest rates of alcohol use (approximately 63%), while those with physical disabilities report the lowest (45.7%). Notably, adults with cognitive disabilities show the highest binge drinking rate at 18.3%, exceeding the rate for adults without disabilities.

Smoking Status

Current smokers (some days) – past-month binge drinking: 24.3%
Current smokers (every day) – past-month binge drinking: 22.9%
Former smokers – past-month binge drinking: 12.9%
Never smokers – past-month binge drinking: 10.5%
Current smokers (every day) – past-month alcohol use: 55.1%
Current smokers (some days) – past-month alcohol use: 64.3%
Former smokers – past-month alcohol use: 63.0%
Never smokers – past-month alcohol use: 60.5%

A strong association exists between cigarette smoking and alcohol use patterns. Current smokers report binge drinking at approximately twice the rate of non-smokers. Interestingly, daily smokers report lower overall alcohol consumption than occasional smokers or non-smokers, while still maintaining high binge drinking rates.

Risk Perception

Perception of Great Risk from Binge Drinking (5+ drinks once or twice per week)

Age Group	Number	Percentage
12+	437,000	46.11%
12-17	30,000	41.68%
18-25	50,000	40.45%
26+	358,000	47.45%
18+	407,000	46.47%
12-20	49,000	41.83%

Perceptions of risk from heavy drinking vary by age, with older adults and youth more likely to perceive binge drinking as risky compared to young adults. Notably, less than half of Rhode Islanders aged 12+ perceive great risk from having five or more drinks once or twice per week, suggesting a potential disconnect between actual health risks and public awareness.

Alcohol Use Disorder and Treatment Needs

Alcohol Use Disorder Prevalence (2022-2023)

Age Group	Number with AUD	Percentage with AUD
12+	119,000	12.59%
12-17	2,000	3.19%
18-25	23,000	19.17%
26+	94,000	12.43%
18+	117,000	13.37%
12-20	8,000	7.07%

Overall Population (Ages 12+) – 2017-2019

Alcohol use disorder: 6.5% (59,000 people) – decreased from 2002-2004
Comparison: Similar to regional average (6.4%) and national average (5.3%)

Treatment Access and Gaps

Received substance use treatment: 5.17% (49,000 people aged 12+)
Classified as needing treatment: 24.29% (231,000 people aged 12+)
Not receiving treatment among those needing it: 78.70% (183,000 people aged 12+)
Youth (12-17) not receiving needed treatment: 57.91% (5,000 youth)
Young adults (18-25) not receiving needed treatment: 86.47% (38,000 young adults)
Adults (26+) not receiving needed treatment: 77.85% (140,000 adults)
Number of alcohol and drug rehabs in Rhode Island: 60
National ranking: Among top 10 highest for unmet treatment needs, especially for 18-25 age group

Rhode Island faces a significant treatment gap, with nearly 80% of those classified as needing substance use treatment not receiving it. Young adults aged 18-25 face the highest rates of both alcohol use disorder and unmet treatment needs. The state ranks among the top 10 nationally for unmet treatment needs, particularly in the 18-25 age group, indicating a critical service delivery challenge.

Treatment Admission Trends

Alcohol abuse treatment admissions (1992): 53%
Alcohol abuse treatment admissions (2006): 29%
Drug-only treatment admissions (1992): 21%
Drug-only treatment admissions (2006): 46%
Gender composition: Men comprise the majority of alcohol abuse treatment admissions (primary or secondary substance)

Rhode Island has experienced a dramatic shift in the composition of substance abuse treatment admissions since 1992. Alcohol-only treatment admissions have declined substantially (from 53% to 29%), while drug-only admissions have doubled (from 21% to 46%) during the same period. Men continue to represent the majority of those seeking treatment for alcohol abuse, whether as a primary or secondary substance.

Rhode Island faces significant alcohol-related public health challenges, with consumption rates consistently exceeding national averages and an alarming treatment gap affecting nearly 80% of those who need help. Young adults aged 18-25 are particularly at risk, showing binge drinking rates nearly 50% and alcohol use disorder rates of 19% that far surpass national benchmarks. While some positive trends exist, such as declining youth alcohol use and a recent decrease in excessive drinking rates, the 39% increase in alcohol-attributable deaths from 2015-2019 and the disproportionate impact on vulnerable populations—including women (whose deaths increased 34% from 2018-2022), veterans, and LGBTQ+ individuals—demonstrate an urgent need for expanded prevention, treatment, and targeted intervention programs across the state.

Conclusion

In general, Rhode Island confronts a multifaceted substance abuse crisis characterized by overdose rates 16-34% higher than national averages, though the state has achieved encouraging progress with a 25% reduction in overdose deaths from 2022 to 2024. Despite this improvement, critical challenges persist: nearly 80% of those needing substance use treatment are not receiving it, young adults aged 18-25 face extraordinarily high rates of both alcohol use disorder (19%) and substance use disorder (35%), and vulnerable populations including LGBTQ+ individuals, veterans, and women show disproportionately high rates of problematic use and mortality. The dramatic shift from opioid-dominant to cocaine-involved overdoses, combined with widespread polysubstance use (particularly marijuana and alcohol combinations), underscores the evolving complexity of the crisis and the urgent need for expanded treatment capacity, harm reduction strategies, and targeted interventions addressing the specific needs of high-risk demographic groups across all age ranges.