Drug related ER visits Atlanta residents experience reflect a complex overdose crisis shaped by prescription opioids, fentanyl exposure, and polysubstance patterns.
In 2022, DeKalb County recorded 309.4 emergency department visits due to drug overdose per 100,000 residents, slightly below Georgia’s statewide rate of 318.6 but amid wide variation across counties.
This article synthesizes the latest surveillance data to help you understand what’s driving Atlanta’s nonfatal overdose burden in 2025 and what it means for your community.
Drug Related ER Visits Atlanta: Current Landscape
Understanding the scope of drug related ER visits Atlanta faces starts with geography and data. The City of Atlanta spans Fulton and DeKalb counties, and publicly available city-level emergency department surveillance remains limited. In 2022, DeKalb County’s ED visit rate due to drug overdose stood at 309.4 per 100,000 population. The Georgia statewide rate was 318.6 per 100,000, but county-level variation ranged from 62.2 to 651.4, underscoring substantial geographic differences that likely exist within Atlanta’s neighborhoods.
While these 2022 figures provide a baseline, 2025 trends need newer surveillance tools. With SAMHSA’s Drug Abuse Warning Network (DAWN) discontinuing new data collection in June 2025, Atlanta stakeholders now rely more heavily on CDC’s Drug Overdose Surveillance and Epidemiology system and Georgia Department of Public Health analytics for timely monitoring.
The South Census Region, which includes Atlanta, shows distinct substance involvement patterns compared with other parts of the country. National DAWN data from 2024 reveal the South has the highest share of any opioid and prescription opioid involved emergency department visits, even as fentanyl and opioid not otherwise specified involved ED visit shares peak in the West. This regional profile suggests Atlanta’s 2025 overdose picture balances persistent prescription opioid concerns with ongoing fentanyl risks.
Regional Patterns Shaping Atlanta’s Profile
Atlanta’s drug related ER visits reflect broader Southern trends. Between 2021 and 2024, the South maintained the highest shares of prescription opioid involved ED encounters among U.S. Census regions. Meanwhile, the Northeast saw the highest heroin involved shares, and the West led in fentanyl and opioid NOS categories.
For Atlanta, this translates to a dual challenge. Prescription opioid misuse remains a comparatively prominent driver of ED visits, requiring continued focus on opioid stewardship, chronic pain alternatives, and post discharge linkage to medications for opioid use disorder. At the same time, fentanyl contamination of the illicit drug supply means every overdose needs naloxone readiness and harm reduction counseling.
Seizure data paint a vivid picture of supply dynamics. Nationally, fentanyl seizures involving pills rose from 10.3 percent in 2017 to 49 percent in 2023, with 115.6 million pills seized that year. Most powder seizures occurred in the South by 2023, according to research published in the International Journal of Drug Policy. This concentration of powder fentanyl in Southern states suggests Atlanta’s market carries significant exposure risk to both powder and counterfeit pill forms.
Fentanyl and Opioid Trends in 2025
Syndromic surveillance offers the most current window into fentanyl trends. CDC’s Morbidity and Mortality Weekly Report analyzed suspected fentanyl involved nonfatal overdose ED visits from October 2020 through March 2024. Rates increased 8.7 percent per quarter from the fourth quarter of 2020 to the third quarter of 2023, rising from 1.4 to 3.5 per 10,000 ED visits. Then, a decline began: rates dropped 11 percent per quarter through the first quarter of 2024, reaching 2.9 per 10,000 ED visits.
Entering 2025, this tentative decline suggests a conditional easing of suspected fentanyl involved nonfatal ED visits in many communities, though baseline rates remain high. Atlanta likely experienced a similar pattern, with some neighborhoods seeing modest improvements while others face persistent exposure. The MMWR study found elevated rates and increases among non Hispanic American Indian or Alaska Native persons, highlighting the need for culturally responsive strategies within Atlanta’s diverse population.
Fatal overdose data adds context. National overdose deaths declined from about 114,000 in October 2023 to 87,000 in September 2024, a reduction of roughly 27,000 deaths. This near 24 percent drop, noted by the National Governors Association, reflects changing mortality risk even as nonfatal ED visits remain a pressing concern. The disconnect between falling deaths and persistent ED encounters may indicate better naloxone distribution, faster EMS response, or shifts in drug potency and mixing.
Polysubstance Patterns Complicating Care
Polysubstance involvement stands out as a defining feature of Atlanta’s 2025 drug related ER visits. DAWN’s 2024 national report explicitly provides polysubstance estimates, enabling analysis of combinations such as methamphetamine with opioids and cocaine with alcohol. These patterns carry substantial clinical implications, from respiratory depression risks when benzodiazepines are mixed with opioids to cardiovascular complications when stimulants combine with alcohol.
Emergency departments must prepare for complex presentations. A patient arriving with suspected opioid overdose may also have stimulant induced sympathomimetic toxicity or benzodiazepine co exposure that complicates resuscitation and discharge planning. Naloxone administration remains critical for opioid reversal, but staff need protocols for managing mixed drug toxicity and extended observation periods.
DAWN’s 2025 Network Watch, a targeted quarterly release, tracks emerging drug terms and combinations. The second quarter 2025 report highlighted slang like “Boo” for methamphetamine plus marijuana. While vernacular varies locally, awareness of evolving terminology helps Atlanta ED teams improve patient communication and risk screening.
Benzodiazepine co involvement deserves special attention. When present with opioids, benzodiazepines synergistically depress respiration, raising fatal overdose risk. ED discharge planning must include take-home naloxone, education on overdose recognition, and referrals to harm reduction services for anyone with polysubstance exposure patterns.
Drug Related ER Visits Trends in Atlanta
Tracking trends needs integrated surveillance. Georgia’s public health infrastructure includes monthly county level syndromic reports that capture suspected nonfatal overdose ED visits. These reports provide near real time visibility into fluctuations, allowing public health officials to detect clusters, identify high burden neighborhoods, and deploy resources strategically.
The CDC operates two complementary systems under the Drug Overdose Surveillance and Epidemiology program. DOSE SYS uses syndromic ED data updated monthly from 46 states and DC as of September 30, 2025. It reports suspected nonfatal overdose ED visit rates per 10,000 total ED visits, optimized for rapid trend detection. Case definitions are nested and not mutually exclusive, meaning a single visit may count in multiple categories when opioids and stimulants are both involved.
DOSE DIS provides finalized ED and inpatient discharge data, updated annually with about an eight month lag. The May 30, 2025 update included data through 2023 from 34 states and DC. County level views allow visualization of all drug ED visits, supporting historical benchmarking for Fulton and DeKalb counties even though 2025 counts are not yet available in this system.
A recent validation study compared DOSE DIS discharge data with the Healthcare Cost and Utilization Project datasets across 18 states from 2018 to 2020. Results showed 82 percent of ED quarterly rates and 93 percent of inpatient rates matched within plus or minus 0.5 per 100,000 population, affirming DOSE’s reliability for state level nonfatal overdose burden estimation.
For Atlanta in 2025, integrating DOSE SYS trends with Georgia’s monthly county reports offers the best real time picture, while DOSE DIS provides validated historical context once finalized data become available.
Surveillance Systems Tracking the Crisis
Multiple data sources triangulate to reveal Atlanta’s drug related ER visits landscape. Each system has distinct strengths and limitations that shape what we can know about 2025.
Georgia OASIS via Network of Care hosts county level indicators attributed to Georgia’s Online Analytical Statistical Information System. It offers drug overdose ED visit rates by county, demographics, and time period. The 2022 DeKalb County rate came from this source, providing a grounded local baseline even though real time 2025 data need other systems.
CDC DOSE SYS delivers speed at the cost of preliminary diagnosis codes and reliance on electronic health record text queries. Suspected overdose classifications occur without confirmatory lab toxicology in many ED settings, and facility participation may vary over time. Still, standardized syndrome definitions enable consistent month to month comparisons, essential for detecting emerging threats like novel synthetic opioids or xylazine.
CDC DOSE DIS offers completeness and population based rates but arrives about eight months after year end closeout. The system uses ICD 10 CM coded discharge records, applying consistent case definitions that improved substantially over ICD 9 CM by encoding substance and intent in single T codes (T36 through T65). This granularity supports drug specific analyses, from heroin to methamphetamine to benzodiazepines.
The table below summarizes how these systems complement each other:
| System | Update Frequency | Geography | Best Use for Atlanta 2025 |
| Georgia OASIS | Yearly | County level | Baseline context (2022 data) |
| DOSE SYS | Monthly | State; some county views | Near real time trends |
| DOSE DIS | Annually (8 month lag) | State and county | Historical validation (through 2023) |
| DAWN 2024 | No new collection after June 2025 | National/regional | Regional comparisons (South profile) |
With DAWN’s discontinuation, the importance of DOSE SYS and DOSE DIS has grown. Atlanta stakeholders should give priority to these CDC dashboards alongside Georgia’s monthly syndromic reports for ongoing situational awareness.
What These Numbers Mean for Atlanta Residents?
Behind every statistic lies a person in crisis and a family seeking answers. Drug related ER visits signal acute harm but also represent intervention opportunities. Emergency departments serve as a frontline touchpoint where medical stabilization, harm reduction, and treatment initiation can converge.
Evidence shows ED initiated medications for opioid use disorder save lives. A 2025 retrospective cohort study in Connecticut followed 4,089 opioid-related overdose survivors. Those who received methadone after their index overdose had a 59 percent lower risk of subsequent overdose (adjusted hazard ratio 0.41), while buprenorphine recipients had a 28 percent lower risk (aHR 0.72). Medically supervised withdrawal and extended inpatient treatment alone did not significantly reduce subsequent overdose risk, and benzodiazepine exposure increased risk.
For Atlanta’s EDs, this underscores a critical opportunity to scale ED based buprenorphine or methadone initiation with warm handoffs to community treatment providers. Same day or next day access slots, insurance navigation, and transportation assistance remove barriers to follow through. Peer navigators who specialize in overdose response can bridge ED encounters to longer term recovery supports, addressing social determinants like housing, food security, and legal aid.
Harm reduction at discharge should be universal. Every patient with opioid involved or at risk polysubstance overdose should leave with naloxone, clear instructions on overdose recognition and response, and connections to community based harm reduction services. Where state policy permits, fentanyl test strips and education about drug checking reduce unintentional exposure to contaminated supplies.
Stimulant involved overdoses need tailored counseling. Unlike opioids, stimulants lack a reversal medication, making prevention and risk reduction even more vital. ED teams can offer motivational interviewing to address high risk use patterns, distribute safer use supplies, and link patients to stimulant specific treatment modalities.
Atlanta’s diverse neighborhoods face disparate risks. The wide county level variation in Georgia’s 2022 ED overdose rates (62.2 to 651.4 per 100,000) hints at similar within city differences. High burden ZIP codes may benefit from targeted outreach, mobile harm reduction units, and community based overdose prevention sites. Areas with lower rates still need accessible treatment and prevention infrastructure to keep crises from escalating.
Moving Forward: Data Driven Responses
Answering the question of how many drug related ER visits Atlanta experiences in 2025 needs summing monthly county level counts from Georgia Department of Public Health reports for Fulton and DeKalb. While that definitive annual total will be computable once all twelve months are published, the existing evidence points clearly to ongoing, substantial burden driven by prescription opioids, fentanyl, and polysubstance combinations.
Local decision makers should build integrated dashboards that combine DOSE SYS monthly trends, DOSE DIS annual benchmarks, and Georgia OASIS county rates. Standardized ICD 10 CM case definitions ensure comparability across time and jurisdictions. Tracking drug specific subcategories (all opioid, heroin, fentanyl, stimulants, benzodiazepines) reveals which substances are rising or falling, guiding prevention messaging and treatment capacity planning.
Quality control matters. Discharge diagnosis code completeness varies by hospital, and syndromic definitions depend on text field availability. Regular training for hospital coders, cross validation between syndromic and discharge datasets, and transparent documentation of suppression rules and data gaps strengthen confidence in the numbers.
Equity analyses must be routine. Disaggregating ED overdose counts by age, sex, race, ethnicity, and neighborhood identifies groups experiencing disproportionate harm. Culturally responsive interventions, language access, and trust building with affected communities translate data into action that reaches those who need it most.
Collaboration across sectors amplifies impact. Hospitals, public health departments, emergency medical services, harm reduction organizations, and treatment providers each hold pieces of the overdose response puzzle. Routine data exchanges, shared protocols for ED initiated treatment, and coordinated outreach to high burden areas create a continuum of care that meets people where they are.
If you or someone you care about is struggling with substance use, help is available right now. Atlanta’s drug related ER visits reflect a crisis, but they also mark moments when lives can be saved and recovery can begin. Reach out to explore our addiction treatment programs that offer evidence based therapies, holistic support, and individualized care designed for long term wellness.
