US Has Highest Rate of Overdose Deaths in the World: Commonwealth Fund Report

The report found that harm-reduction policies and practices are fragmented in the United States.

Bottles of prescription painkiller OxyContin made by Purdue Pharma LP sit on a shelf at a local pharmacy in Provo, Utah, on April 25, 2017. George Frey/Reuters

The United States has the highest rate of overdose deaths in the world by a substantial margin, according to a Jan. 9 report by the nonprofit Commonwealth Fund.

It ranked last on a list of 31 countries and one U.S. territory, ordered by overdose death rates from lowest to highest, with 324 deaths per 1 million people in 2022. Puerto Rico was not included in the U.S. total. The U.S. territory had 246 deaths per 1 million that year, ranking just above the United States, in the report.