Emergency rooms across Marietta saw notable changes in overdose presentations between 2023 and 2025, driven largely by shifts in the local drug supply.
Overdose-related ER visits in the Marietta area likely increased during this period, with the most striking rise in suspected fentanyl and opioid cases documented through Georgia’s county surveillance system.
This article breaks down what multiple data systems reveal about Marietta overdose trends, explains why different substances show different patterns, and outlines what these shifts mean for families and treatment providers in Cobb County.
Marietta Overdose Trends: The 2024-2025 Picture
Because public health agencies report overdose data by county rather than by individual cities, we use Cobb County figures to understand Marietta overdose trends 2024 and 2025. Marietta serves as the county seat, and its hospitals capture a substantial share of the county’s emergency department visits.
Three complementary surveillance systems paint the clearest picture. Georgia’s Department of Public Health publishes monthly syndromic reports that track county-level overdose ER visits in near real time. The CDC maintains two national dashboards: DOSE-SYS for syndromic surveillance updated monthly, and DOSE-DIS for discharge-based data released annually with greater detail.
When we triangulate these sources for Cobb County across 2023 through 2025, a directional pattern emerges. The weight of evidence points to higher overdose-related ER visits in 2025 compared with 2023, especially for presentations involving fentanyl. All-drug overdose ER visits ranged from flat to modestly elevated. Heroin-involved visits stayed relatively low, while stimulant-related cases showed episodic spikes tied to contaminated supplies.
This conclusion rests on continuous monthly reporting from Georgia DPH, statewide patterns visible in CDC syndromic data, and the known dominance of fentanyl in Georgia’s drug supply since 2020. Georgia’s embedded public health analysts detected and responded to overdose clusters throughout this period, which confirms that county-level signals were robust enough to guide action.
Understanding Overdose-Related ER Visits Data
The numbers behind these trends come from standardized surveillance systems that each answer slightly different questions.
Georgia DPH’s Drug Surveillance Unit releases monthly and quarterly reports covering every county, including Cobb. These reports use syndromic definitions that combine chief complaint text with diagnostic codes entered during the ER visit. This approach prioritizes speed over precision, which makes it ideal for spotting sudden increases but means some cases may be suspected rather than toxicology-confirmed.
The CDC’s DOSE system has two components. DOSE-SYS tracks rates per 10,000 total ER visits using near real-time data from 46 states and DC. DOSE-DIS uses finalized hospital discharge records and reports rates per 100,000 population, with county-level detail for participating states. A recent validation study comparing DOSE-DIS with established hospital datasets found close agreement in trends, supporting its reliability for county assessments.
Both systems track eight substance categories: all drugs, all opioids, fentanyl, heroin, all stimulants, cocaine, methamphetamine, and benzodiazepines. These categories overlap on purpose. A single ER visit involving both fentanyl and cocaine appears in the opioid count, the fentanyl count, the stimulant count, and the cocaine count. This nested design reflects how people actually use drugs today but means you can’t simply add categories together.
The table below summarizes what each system offers for understanding Marietta’s local landscape.
| System | Update frequency | Geographic detail | Best use for Marietta |
| Georgia DPH monthly reports | Monthly | County counts and percent change | Most direct view of Cobb County month-to-month patterns |
| CDC DOSE-SYS | Monthly | State and sub-state | Statewide context and cluster detection |
| CDC DOSE-DIS | Annual (with lag) | County rates per 100,000 | Year-over-year burden comparison for Cobb County |
What the Data Show for Marietta in 2024 and 2025?
Let me walk through what changed for each major substance category between 2023 and 2025, using Cobb County as the lens for Marietta.
Fentanyl and all opioids: This is where the increase is clearest. Georgia’s fatal overdose data show that fentanyl-involved deaths rose 308 percent from 2019 to 2022, from 392 to 1,601 statewide. That trajectory set the stage for elevated nonfatal ER visits in 2023 through 2025. Monthly syndromic surveillance captured ongoing fentanyl presentations with periodic spikes when especially potent batches circulated. Because fentanyl sits inside the broader opioid category, all-opioid trends closely track fentanyl trends but may show slightly smaller increases if other opioids like prescription pills declined.
All-drug overdose visits: This broad measure includes everything from prescription medications to illicit substances. The trend for all-drug visits appears more muted, with evidence pointing to flat or modestly elevated levels rather than sharp increases. That makes sense when fentanyl drives growth in one category while other substance use stabilizes or falls.
Heroin: Heroin-involved ER visits stayed comparatively low throughout 2023 to 2025, continuing a pattern visible across the Southeast as fentanyl displaced heroin in illicit markets. Georgia DPH county reports show heroin as a minor contributor compared with synthetic opioids.
Stimulants: Cocaine and methamphetamine trends showed volatility. Stimulant-involved ER visits spiked episodically, often tied to fentanyl contamination of stimulant supplies. This polysubstance pattern means stimulant users face opioid overdose risk even when they have no intention of using opioids, which complicates prevention messaging and keeps stimulant-related ER numbers elevated.
Fentanyl’s Dominant Role in Marietta Overdose Trends 2025
Fentanyl fundamentally reshaped the overdose landscape in Marietta and across Georgia after 2020. Its pharmacology explains much of what we see in the ER data.
Fentanyl is roughly 50 times more potent than heroin and 100 times more potent than morphine. Street supplies vary wildly in concentration, so people using counterfeit pills or powder they believe to be heroin may encounter doses far stronger than expected. Even experienced users can’t gauge potency by appearance or taste.
The drug also appears in substances where buyers don’t expect it. Investigators have found fentanyl in cocaine, methamphetamine, and counterfeit prescription pills across Georgia. This contamination turns stimulant use into an opioid exposure, which drives the overlapping trends visible in surveillance data. When a person arrives at a Marietta ER after using what they thought was cocaine, toxicology may reveal fentanyl, and the visit gets counted in both stimulant and opioid categories.
Georgia’s public health response infrastructure recognized this shift early. The state’s Opioid and Substance Misuse Response Program embedded public health analysts in all 18 health districts, including the district covering Cobb County. These analysts coordinate overdose cluster investigations, distribute naloxone and fentanyl test strips, and link people to medications for opioid use disorder. Their presence meant that when Cobb County saw spikes in fentanyl-involved ER visits during 2024 and 2025, rapid response teams could mobilize.
Why Do Different Substances Show Different Patterns?
The divergent trends across substance categories reflect both supply-side changes and measurement complexities.
Heroin’s decline continued as fentanyl offered suppliers a more profitable alternative. Fentanyl is easier to synthesize, transport, and distribute than heroin, and its potency means smaller volumes yield more doses. For buyers, the shift was often involuntary. Many people seeking heroin in 2024 and 2025 encountered fentanyl instead, which explains why heroin-specific ER visits stayed low even as opioid visits overall increased.
Stimulant patterns reflect genuine growth in methamphetamine and cocaine use in some populations, overlaid with fentanyl contamination. Someone using methamphetamine regularly may have multiple ER visits over two years, some involving only stimulants and others involving fentanyl-contaminated methamphetamine. Surveillance systems capture both, which produces the episodic volatility visible in stimulant series.
The nested definitions also shape how trends appear. An ER visit involving fentanyl, cocaine, and a benzodiazepine appears in five categories: all drugs, all opioids, fentanyl, all stimulants, and cocaine. If such polysubstance events increased from 2023 to 2025, multiple categories would show growth even though the absolute number of people affected might have risen more modestly. This design choice prioritizes sensitivity for public health action over simplicity for communication.
Data quality factors matter too. Georgia improved diagnostic coding completeness during the pandemic, and hospitals onboarded to syndromic surveillance systems at different times. Some of the increase in counted ER visits may reflect better capture rather than purely epidemiologic change, though Georgia DPH’s continuous monthly reporting since 2023 minimizes this concern within the focal period.
What’s Driving the 2023-2025 Shift?
Several forces combined to produce higher fentanyl-related ER visits in Marietta by 2025.
Supply dynamics: Illicit fentanyl production and distribution networks consolidated after 2020, increasing availability in suburban markets like Cobb County. Counterfeit pill presses improved in sophistication, making fake oxycodone or Xanax harder to distinguish from legitimate prescriptions. This expanded the population at risk beyond people who knowingly use injection drugs.
Harm reduction expansion: Georgia scaled up naloxone distribution and syringe services through 2024 and 2025, which likely prevented some fatal overdoses but didn’t eliminate nonfatal events requiring ER care. Successful naloxone reversals in the community sometimes lead to ER visits for monitoring, which would appear in surveillance data as nonfatal overdoses even though the intervention worked as intended.
Polysubstance use: The rise of fentanyl-stimulant combinations introduced new risks. People using stimulants to stay alert during work or social activities faced unexpected opioid exposure, and the physiological effects of combining a stimulant with a powerful depressant increased medical complications requiring emergency care.
Cluster events: Cobb County experienced periodic spikes when batches of unusually potent fentanyl or novel fentanyl analogs circulated. Georgia’s Drug Surveillance Unit has documented such clusters statewide, including a notable counterfeit Percocet event in Macon in 2017. Similar localized outbreaks likely occurred in Marietta during 2024 and 2025, temporarily elevating ER visit counts before response efforts were able to spread.
What Does This Means for Marietta Families and Providers?
These trends carry practical implications for anyone concerned about overdose risk in Marietta and surrounding Cobb County communities.
For families, the message is that fentanyl exposure can happen through multiple pathways. A young adult buying what they believe to be a prescription painkiller, a college student trying cocaine at a party, or a person with long-term opioid use disorder all face fentanyl risk. Keeping naloxone accessible at home and knowing how to use it matters more now than in 2023, given the increased presence of fentanyl in local ER data.
For healthcare providers, the overlapping substance categories mean that stimulant-related ER visits warrant opioid harm reduction conversations. Offering fentanyl test strips and naloxone training to patients who use stimulants can prevent future overdoses, even when the presenting concern is methamphetamine or cocaine.
For treatment programs, the persistence of fentanyl through 2025 underscores the value of medications for opioid use disorder. Buprenorphine, methadone, and naltrexone reduce overdose risk and support long-term recovery in ways that counseling alone cannot match for opioid use disorder. The surveillance data showing continued fentanyl-involved ER visits argue for maintaining and expanding access to these medications.
For public health agencies, the county-level monthly surveillance outputs proved their worth during 2023 to 2025. Timely data enabled cluster detection and response, and the nested definitions helped analysts understand polysubstance patterns that earlier systems might have missed.
If you or someone you care about is struggling with substance use in the Marietta area, reaching out for Summit’s evidence-based addiction treatment connects you with therapies proven to work, including medication options for opioid use disorder and integrated support for co-occurring mental health needs.
