Vermont ended 2024 with fewer fatal drug overdoses than at the height of its recent crisis, but newly finalized federal data show the state remained worse off than it was four years earlier—while a broad group of other jurisdictions moved sharply in the opposite direction.

The Centers for Disease Control and Prevention's State Unintentional Drug Overdose Reporting System, or SUDORS, recorded 177 overdose deaths in Vermont in 2020. The total climbed to 238 in 2021, peaked at 259 in 2022, eased to 250 in 2023 and fell to 207 in 2024.

That 2024 decline was substantial. It was not, however, enough to erase the increase since 2020. Over the full five-year period, Vermont's overdose death count rose 16.9 percent and its overdose death rate increased 10.8 percent.

Vermont Moved Against the Broader Trend

The contrast with the CDC's consistent 27-jurisdiction comparison group is stark.

Across those jurisdictions, overdose deaths declined 17.7 percent from 2020 through 2024. The overdose death rate fell 21 percent. Vermont's death count moved nearly 35 percentage points in the opposite direction from the broader group.

The CDC comparison is not a complete count of every state. SUDORS relies on participating jurisdictions that provide detailed information from death certificates, medical examiner and coroner records, toxicology reports and death-scene investigations. The 27-jurisdiction figure represents places with comparable data available throughout the entire 2020–2024 period.

Even with that limitation, the divergence is significant. Vermont improved after its 2022 peak, but the comparison group finished 2024 well below its 2020 level. Vermont did not.

Cocaine and Stimulants Reshaped the Crisis

The Vermont data also show that the state's overdose problem became increasingly tied to stimulants and combinations of drugs.

Cocaine was involved in 70 Vermont overdose deaths in 2020. By 2024, that number had more than doubled to 143, an increase of 104.3 percent. Cocaine was detected in 39.5 percent of overdose deaths in 2020 and 69.1 percent in 2024—an increase of 29.6 percentage points.

Deaths involving any stimulant increased 87.8 percent, while methamphetamine-involved deaths rose 92.3 percent. The share of overdose deaths involving both opioids and stimulants increased 19.1 percentage points. At the same time, the share involving opioids without stimulants declined 26.5 points.

Illegally manufactured fentanyl remained a major factor, but its share of Vermont overdose deaths declined 3.1 percentage points over the period. That suggests the change cannot be explained by fentanyl alone. The data increasingly describe a polysubstance crisis in which fentanyl, cocaine, methamphetamine and other drugs are found together.

Xylazine Became Far More Common

The CDC data also document the rapid appearance of xylazine, a veterinary sedative that has increasingly been found in the illicit drug supply.

Vermont recorded 65 more xylazine-involved overdose deaths in 2024 than in 2020. Its share of overdose deaths increased by 31 percentage points.

Because some drug categories began with small numbers, large percentage increases should be interpreted carefully. The xylazine increase, however, is notable in a state that recorded 207 total overdose deaths in 2024.

The broader pattern is not merely that more Vermonters died over the five-year period. The substances involved in those deaths also changed, with stimulants and sedatives appearing in a much larger share of cases.

More Deaths Included an Opportunity for Intervention

SUDORS tracks circumstances that may represent a potential opportunity to prevent a death. These can include a prior overdose, current or previous substance-use treatment, medication for opioid-use disorder, or the presence of another person who might have intervened.

Between 2020 and 2024, the share of Vermont overdose deaths with at least one potential opportunity for intervention increased 9.4 percentage points. Across the 27-jurisdiction comparison group, the increase was 1.4 points.

In Vermont, the share of those who had previously overdosed increased 18.4 percentage points. The share with a potential bystander present rose 11.9 points. The share currently receiving substance-use treatment increased 11 points, while the share that had ever received such treatment rose 18.2 points. The share prescribed medication for opioid-use disorder increased 19 points.

Those figures do not establish that treatment or harm-reduction programs caused the deaths. They show that a growing portion of those who died had already come into contact with people or systems positioned to recognize the risk.

Improvement From the Peak, but Not From the Starting Point

Vermont's 2024 decline is real: overdose deaths fell by 43 from 2023 and by 52 from the 2022 peak. The finalized CDC data nevertheless place that improvement in a less favorable context.

By the end of 2024, Vermont remained above its 2020 death count and death rate while the broader reporting group had fallen substantially below both. At the same time, cocaine, methamphetamine, xylazine and opioid-stimulant combinations had become markedly more prominent.

The result is a mixed record: meaningful progress from Vermont's worst year, but a five-year trajectory that remained out of step with the broader decline reported by the CDC.

Source

Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Final Data. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2026. Accessed July 31, 2026.

All Vermont and comparison-group figures in this article are drawn from finalized SUDORS data covering 2020 through 2024. The 27-jurisdiction comparison group reflects jurisdictions with complete, comparable data for every year of the period.