Download the entire PDF report: Maine Monthly Overdose Report for January 2024
The monthly overdose report, funded jointly by the Maine Office of the Attorney General and the Office of Behavioral Health, provides an overview of statistics regarding suspected and confirmed fatal and nonfatal drug overdoses in Maine during each month. Data for the report is collected at the Office of Chief Medical Examiner and as part of the Maine Naloxone Distribution Initiative. Year-to-date numbers will be updated with each new monthly report, as cases are finalized, and their overdose status is confirmed or ruled out. The totals are expected to shift as this evolution occurs. In addition, due to the smaller sample size in any given month, totals are expected to fluctuate due to the effects of random variation.
Whereas the overall number of overdose deaths is a critical indicator of individual and societal stress, this metric itself can be quite resistant to public policy interventions due to its complexity. Overdose fatalities occur because of multiple unique and interacting factors such as underlying medical conditions and drug lethality. For that reason, this monthly report will develop ways to monitor components that can be directly affected by specific public health education and harm reduction interventions.
Overview: Composite total of fatal and nonfatal overdoses
During January 2024, there were 567 overdoses, 51 fatal and 516 nonfatal, a reduction captured to January 2023 when there were 801 overdoses, 54 fatal and 747 nonfatal. Of the 567 overdoses that occurred during January 2024, 51 (7.5%) were suspected and confirmed fatal overdoses. The remaining 516 (92.5%) were nonfatal overdoses: 270 (39.7%) emergency department visits; 211 (31.0%) EMS patents who were not transported to the emergency room, 139 (20.4%) reversals reported by community members to the Maine Naloxone Distribution Initiative, and an estimated 9 (1.3%) law enforcement reversals without EMS present. There were also an unknown number of nonfatal overdoses in which 911 was not called and no reversal report was provided to the Maine Naloxone Distribution Initiative.
| Fatal Overdoses | Emergency Department Nonfatal | EMS Not Transported to the ED Nonfatal | Reported Community Reversals Nonfatal | Law Enforcement Without EMS Nonfatal (estimated) | Total Overdoses | |
| Jan ’23 | 54 | 296 | 221 | 184 | 48 | 803 |
| Feb ’23 | 49 | 348 | 185 | 192 | 30 | 804 |
| Mar ’23 | 41 | 382 | 246 | 237 | 54 | 960 |
| Apr ’23 | 63 | 270 | 217 | 202 | 29 | 781 |
| May ’23 | 49 | 295 | 223 | 165 | 47 | 779 |
| Jun ’23 | 58 | 378 | 209 | 219 | 35 | 899 |
| Jul ’23 | 50 | 339 | 291 | 173 | 34 | 887 |
| Aug ’23 | 40 | 330 | 247 | 152 | 22 | 791 |
| Sep ’23 | 53 | 390 | 235 | 141 | 26 | 845 |
| Oct ’23 | 55 | 316 | 254 | 147 | 17 | 789 |
| Nov ’23 | 48 | 254 | 190 | 101 | 20 | 613 |
| Dec ’23 | 48 | 323 | 183 | 129 | 23 | 706 |
| 2023 Total | 608 | 3,921 | 2,701 | 2,042 | 385 | 9,657 |
| 2023 Total % | 6.3% | 40.6% | 28.0% | 21.1% | 4.0% | 100% |
| Jan ’24 | 51 | 270 | 211 | 139 | 9 | 680 |
| 2024 Total | 51 | 270 | 211 | 139 | 9 | 680 |
| 2024 Total % | 7.5% | 39.7% | 31.0% | 20.4% | 1.3% | 100% |
Number of suspected and confirmed fatal overdoses
Fatal Drug Overdoses in Maine January 2024
Fatal Drug Overdoses in Maine Jan – Dec 2023
During 2023 as a whole, fatal overdoses constituted 6.3% of all overdoses, lower than the 6.9% for the year in 2022. The total number of confirmed and suspected fatal overdoses January – December 2023 is 608, 15.9% lower than the total confirmed fatal overdoses for the same period in 2022, 723. The graph below shows the considerable monthly fluctuation since January of 2022. The range extends from 76 (December 2022) to 41 (March 2023). During 2023, fatal overdoses comprised 6.3% of all overdoses; this proportion lower than the 6.9% for 2022. There were 608 confirmed and suspected fatal overdoses in 2023; this is 15.9% lower than the 723 fatal overdoses during the same time period in 2022. Nonfatal overdoses, January – December 2023 totaled 9,049, which is 7.3% lower than the total in 2022, 9,760.
For more information regarding definitions of fatal overdoses, including data collected and case completion timelines see the full report.
Law Enforcement Response to Fatal and Nonfatal Overdose Incidents
Due to the method used to deduplicate nonfatal overdose incidents to derive a composite number of overdoses for the month, the activity of law enforcement officials and EMS is under represented in the above chart. See the full report for the process involved. The table below shows the public safety response to fatal and nonfatal overdose events in January 2024 as well as January – December 2023.
| Maine EMS | Law Enforcement | |
| Fatal Overdose Response 2023 | 482 | 564 |
| Nonfatal Overdose Response 2023 | 8,840 | 1,053 |
| Total Overdose Response 2023 | 9,332 | 1,617 |
| Fatal Overdose Response 2024 | 37 | 48 |
| Nonfatal Overdose Response 2024 | 360 | 61 |
| Total Overdose Response 2024 | 397 | 109 |
County Distribution of Suspected Nonfatal Overdoses
The following table shows the distribution of nonfatal overdoses at the county level. Due to how overdose reversals are reported by community partners and emergency departments, only EMS overdoses are included. The January 2024 monthly totals can be compared to the percentage of census population or the percentages of nonfatal overdoses during 2023. Caution must be exercised with these small numbers. They are likely to fluctuate randomly, without any significant statistical meaning. The January – December percentages for most counties fall within 0 to 1 percentage points of the 2020 census distribution. Penobscot County is 3 percentage points higher and Androscoggin County is 2 percentage points higher than the 2020 census proportion. York County is 4 percentage points lower and Sagadahoc County is 2 percentage points lower than the 2020 census proportion.
Nonfatal Drug Overdoses in Maine, January 2024
Nonfatal Drug Overdoses in Maine, Jan 2023 – Dec 2023
| % 2020 estimated Census population | Jan-Dec 2023 Est. N = 8840 | Jan 2024 Est. N = 360 | |||
| Androscoggin | 8% | 912 | (10%) | 25 | (7%) |
| Aroostook | 5% | 447 | (5%) | 21 | (6%) |
| Cumberland | 22% | 2037 | (23%) | 66 | (18%) |
| Franklin | 2% | 138 | (2%) | 10 | (3%) |
| Hancock | 4% | 255 | (3%) | 15 | (4%) |
| Kennebec | 9% | 871 | (10%) | 36 | (10%) |
| Knox | 3% | 300 | (3%) | 15 | (4%) |
| Lincoln | 3% | 185 | (2%) | 8 | (2%) |
| Oxford | 4% | 355 | (4%) | 15 | (4%) |
| Penobscot | 11% | 1253 | (14%) | 59 | (16%) |
| Piscataquis | 1% | 109 | (1%) | 2 | (1%) |
| Sagadahoc | 3% | 130 | (1%) | 4 | (1%) |
| Somerset | 4% | 431 | (5%) | 24 | (7%) |
| Waldo | 3% | 193 | (2%) | 7 | (2%) |
| Washington | 2% | 193 | (2%) | 8 | (2%) |
| York | 16% | 1031 | (12%) | 45 | (13%) |
Age and Gender Composition of Nonfatal Overdose Victims with EMS Response
The following table displays the age composition of individuals suspected of experiencing nonfatal overdoses involving EMS response in January 2024 as well as January – December 2023. Overdose reversal totals reported by community partners and emergency departments are not categorized and reported by age; only EMS case data include age frequencies at a monthly cadence. Age group totals can be compared to the 2020 census proportion by age group in the far left column or the January – December 2023 totals in the center column. When comparing the January 2024 data with 2023 data, as wellas the census population proportion, caution must be exercised as the small number of cases in each month is vulnerable torandom fluctuation that may not reflect a significant statistical trend. The age distribution for 2023 compared to the 2020 census poportion shows a disproportionately large impact of suspected nonfatal overdose victims with EMS involvement in those aged 25-44. A 3 percentage point increase in those aged 18-24, a 4 percentage point decrease in those aged 55-64, and a 14 percentage point decrease in those 65 and older.
| % 2020 estimated Census population | Jan-Dec 2023 | Jan 2024 | |||
| Est. N = 8785 | Est. N = 359 | ||||
| Under 18 | 18% | 409 | 5% | 14 | 4% |
| 18-24 | 7% | 877 | 10% | 37 | 10% |
| 25-34 | 12% | 1945 | 22% | 87 | 24% |
| 35-44 | 12% | 2375 | 27% | 107 | 30% |
| 45-54 | 12% | 1343 | 15% | 44 | 12% |
| 55-64 | 16% | 1074 | 12% | 44 | 12% |
| 65 and older | 23% | 762 | 9% | 26 | 7% |
The following table displays the reported gender of individuals experiencing nonfatal overdoses involving EMS response in January 2024 as well as January – December 2023. Overdose reversal totals reported by community partners and emergency departments, as well as fatal overdoses are not categorized by gender; only EMS case data include gender categories at a monthly cadence. Gender group totals can be compared to the 2020 census proportion by age group in the far left column or the January – December 2023 totals in the center column. When comparing the January 2024 with 2023, as well as the census population proportion,caution must be exercised as the small number of cases in each month is vulnerable to random fluctuation that may not reflect asignificant statistical trend. Males represent 49% of the 2020 estimated census population and 60% of the nonfatal overdose victims with EMS involvement during 2023.
| % 2020 estimated Census population | Jan-Dec 2023 | Jan 2024 | |||
| Est. N = 8797 | Est. N = 358 | ||||
| Male | 49% | 5296 | 60% | 218 | 61% |
| Female | 51% | 3476 | 40% | 140 | 39% |
| Transgender | Not collected | 25 | <1% | 0 | 0% |
County Distribution of Suspected and Confirmed Fatal Overdoses
The following table shows the frequency distribution of deaths at the county level. The monthly total can be compared either to the percent of the census population on the far left or the percent of drug deaths in 2023. Caution must be exercised with these small numbers. They are likely to fluctuate randomly, without any significant statistical meaning.
The cumulative January – December 2023 percentages of deaths in most counties fall within plus or minus 0 to 2 percentage points of the 2020 census distribution. Penobscot County is 4 percentage points higher than the 2020 census proportion, Androscoggin County is 3 percentage points higher and Piscataquis County as well as Washington County are 2 percentage points higher than the 2020 census proportion. York County is 5 percentage points lower and Lincoln County and Sagadahoc County are 2 percentage points lower than the 2020 census proportion.
| % 2020 estimated Census population | Jan-Dec 2023 | Jan 2024 | |||
| Est. N = 608 | Est. N = 51 | ||||
| Androscoggin | 8% | 69 | 11% | 8 | 16% |
| Aroostook | 5% | 39 | 6% | 4 | 8% |
| Cumberland | 22% | 117 | 19% | 5 | 10% |
| Franklin | 2% | 6 | 1% | 1 | 2% |
| Hancock | 4% | 22 | 4% | 3 | 6% |
| Kennebec | 9% | 61 | 10% | 7 | 14% |
| Knox | 3% | 16 | 3% | 3 | 6% |
| Lincoln | 3% | 7 | 1% | 3 | 6% |
| Oxford | 4% | 25 | 4% | 4 | 8% |
| Penobscot | 11% | 91 | 15% | 2 | 4% |
| Piscataquis | 1% | 17 | 3% | 0 | 0% |
| Sagadahoc | 3% | 7 | 1% | 0 | 0% |
| Somerset | 4% | 29 | 5% | 2 | 4% |
| Waldo | 3% | 10 | 2% | 0 | 0% |
| Washington | 2% | 26 | 4% | 3 | 6% |
| York | 16% | 64 | 11% | 6 | 12% |
Race, ethnicity, and other demographic indicators of decedents
During 2023, out of 606 confirmed and suspected fatal overdoses for which race was reported, 553 (91%) of the victims were identified as White, 24 (4%) as Black or African American, and 12 (2%) as American Indian/Alaska Native. Out of the 590 fatal overdoses for whom ethnicity was reported, 583 (99%) were reported as not Hispanic, and 7 (1%) were identified as Hispanic.
Out of the 608 cases for which military background was reported in January – December 2023, 33 (5%) were identified as having a military background. Out of the 51 cases in January 2024 where military background was reported, 2 (4%) were identified as having a military background.
Of 608 total suspected and confirmed overdose cases in 2023, undomiciled or transient housing status was reported for 73 (12%) of the victims. The largest totals of undomiciled persons were found in Cumberland County (25, 34%), Penobscot County (16, 22%), Androscoggin County (11, 15%), and Kennebec County (7, 10%). In January 2024, 5 decedents (10%) were identified as undomiciled.
| Demographic Indicator | % of 2020 Census Population | Jan-Dec 2023 Est. Race N=608 Ethnicity N=592 | Jan 2024 Est. Race N=50 Ethnicity N=50 |
|---|---|---|---|
| Race and Ethnicity | |||
| White | 91% | 553 (91%) | 46 (92%) |
| Black or African American | 2% | 24 (4%) | 0 (0%) |
| American Indian/Alaska Native | 1% | 12 (2%) | 2 (4%) |
| Other race, 2+ races combined, non-hispanic | 7% | 11 (2%) | 2 (4%) |
| Not Hispanic | 98% | 583 (99%) | 50 (100%) |
| Hispanic | 2% | 7 (1%) | 0 (0%) |
| Military Background | 33 (5%) | 2 (4%) | |
| Undomiciled/Transient Housing Status | 73 (13%) | 5 (10%) |
Age and sex composition of decedents
The following table displays the age and sex composition of the January 2024 fatal overdose population, the 2023 year-to-date fatal overdose population, and the 2020 estimated census population. When comparing the January 2024 data with 2023 aswell as the census population proportion, caution must be exercised as the small number of cases in each month isvulnerable to random fluctuation that may not reflect a significant statistical trend. The cumulative proportion of males is slightly lower in January 2024 (71%) as in 2023 (73%). The age distribution for 2023 compared to the 2020 census poportion shows a disproportionately large impact of fatal overdoses in those aged 35-64. A 2 percentage point increase in those aged 25-34, a 2 percentage point decrease in those aged 18-24, and a 17 percentage point decrease in those 65 and older.
| % 2020 estimated Census population | Jan–Dec 2023 | Jan-2024 | |||
| Est. N = 723 | Est. N = 51 | ||||
| Male | 49% | 443 | 73% | 36 | 71% |
| < 18 | 18% | 3 | 0% | 0 | 0% |
| 18-24 | 7% | 28 | 5% | 1 | 2% |
| 25-34 | 12% | 84 | 14% | 5 | 10% |
| 35-44 | 12% | 199 | 33% | 21 | 41% |
| 45-54 | 12% | 136 | 22% | 13 | 25% |
| 55-64 | 16% | 120 | 20% | 9 | 18% |
| > 64 | 23% | 38 | 6% | 2 | 4% |
Basic incident patterns in fatal overdoses
The following table highlights some event characteristics among suspected and confirmed overdoses. Both EMS and police responded to most fatal overdoses (73%) in 2023. In 2023, law enforcement was more likely to respond to a scene alone (19%) than EMS (6%). The overwhelming majority (93%) of drug overdoses were ruled, or suspected of being, accidental manner of death. Of the 608 confirmed or suspected fatal overdoses in 2023, 206 (34%) had a history of prior overdose.
During 2023, 26% of fatal overdose cases had naloxone administered at the scene by EMS, bystanders, or law enforcement. This rate is higher than the 22% of fatal overdose cases in which naloxone was reportedly administered at the scene in 2020, and slightly higher than the proportion in 2022 (25%). Although most cases had bystanders present at the scene when first responders arrived, the details about who may have been present at the time of the overdose were usually unclear. However, bystanders, including family and friends, administered naloxone during 13% (82) of the fatal overdoses, often in addition to EMS and/or law enforcement. This is higher than 2022 (12%), 2021 (9%), and 2020 (4%).
Based on 483 suspected and confirmed drug death cases with EMS involvement during 2023, 266 (55%) of victims were already deceased when EMS arrived. In the remaining 217 (45%) cases, resuscitation was attempted either at the scene or in the ambulance during transport to the emergency room. Of those 217 who were still alive when EMS arrived, only 64 (29%) remained alive long enough to be transported but died during transport or at the emergency room and 151 (70%) did not survive to be transported and 1 had an unknown status. This is likely due to the high number of cases with fentanyl as a cause of death and individuals using alone. Fentanyl acts more quickly than other opioids and there is less time for victims to be found alive.
| Jan–Dec 2023 | Jan-2024 | |||
| Est. N = 608 | Est. N = 51 | |||
| EMS response alone | 37 | 6% | 2 | 4% |
| Law enforcement alone | 119 | 19% | 13 | 25% |
| EMS and law enforcement | 444 | 73% | 35 | 69% |
| Private transport to Emergency Dept. | 5 | 1% | 1 | 2% |
| Naloxone administration reported at the scene | 157 | 26% | 8 | 16% |
| Bystander only administered | 40 | 7% | 1 | 2% |
| Law enforcement only administered | 15 | 2% | 0 | 0% |
| EMS only administered | 43 | 7% | 5 | 10% |
| EMS and law enforcement administered | 10 | 2% | 0 | 0% |
| EMS and bystander administered | 30 | 5% | 0 | 0% |
| Law enforcement and bystander administered | 8 | 1% | 0 | 0% |
| EMS, bystander, and law enforcement administered | 4 | 1% | 0 | 0% |
| Naloxone administered by unspecified person | 4 | 1% | 0 | 0% |
| History of prior overdose | 206 | 34% | 22 | 43% |
Key drug categories and combinations causing overdose deaths
The following table displays the overall pattern of the most prominent drug categories in confirmed drug deaths. As expected, for those 593 confirmed cases in 2023, nonpharmaceutical fentanyl was the most frequent cause of death mentioned on the death certificate at 461 (78%).
Fentanyl is nearly always found in combination with multiple other drugs. Heroin involvement, declining rapidly inrecent years, was reported as a cause of death in 12 (2%) of 2023 deaths. Xylazine and nonpharmaceutical tramadol were identified as co-intoxicants with fentanyl for the first time in 2021. Among 593 confirmed deaths in 2023, there were 57 cases (10%) with xylazine listed in addition to fentanyl as a cause of death and 1 case without fentanyl listed as a cointoxicant, and 3 cases (1%) with tramadol listed along with fentanyl.
Stimulants continue to increase as a cause of death, usually in combination with other drugs, particularly fentanyl. Cocaine-involved fatalities constituted 220 (37%) of confirmed cases in 2023, an increase from 29% in 2022. Fentanyl is mentioned as a cause in combination with cocaine in 187 cases, 84% of 2023 cocaine cases. Methamphetamine was cited as a cause of death in 193 (33%) of the confirmed fatal overdoses in 2023, the one percentage point higher than in 2022;160 (83%) of the methamphetamine deaths also involved fentanyl as a co-intoxicant cause of death. Cocaine and methamphetamine are named together on 53 (9%) death certificates in 2023, in most of those cases (47, 89%) as co-intoxicants of fentanyl.
| Cause of death (alone or in combination with other drugs) Sample size for confirmed cases only | Jan–Dec 2023 | Jan-2024 | ||
| Est. N = 593 | Est. N = 29 | |||
| Fentanyl or fentanyl analogs | 461 | 78% | 18 | 62% |
| Heroin | 12 | 2% | 1 | 3% |
| Cocaine | 220 | 37% | 8 | 28% |
| Methamphetamine | 193 | 33% | 11 | 38% |
| Xylazine | 58 | 10% | ||
| Pharmaceutical opioids** | 109 | 18% | 0 | 0% |
| Fentanyl and heroin | 12 | 2% | 1 | 3% |
| Fentanyl and cocaine | 187 | 32% | 6 | 21% |
| Fentanyl and methamphetamine | 160 | 27% | 9 | 31% |
| Fentanyl and xylazine | 57 | 10% | 4 | 14% |
| Fentanyl and tramadol | 3 | 1% | 0 | 0% |