The University of Michigan’s Poverty Solutions and Overdose Prevention Engagement Network (OPEN) began collaboration in 2023 to release a Michigan landscape map and white paper. These resources highlighted demographic information in connection to opioid use disorder, looking at data such as EMS response rates, annual income, and opioid-related hospitalizations.
The first iteration of this resource examined 2019 data, with a second iteration released last summer examining 2023 data. Now, a third iteration is available looking at 2024 data and shedding new light on four previously shown high-impact county clusters: the Bay County Cluster (Alcona, Iosco, Arenac, Bay, Saginaw, Genesee), the Marquette County Cluster (Baraga, Marquette, Dickinson, Delta, Menominee), the Wayne-Macomb-St. Clair County Cluster, and the Muskegon-Manistee County Cluster (Muskegon, Oceana, Mason, Manistee).
In 2022, Genesee and Iosco counties led Michigan in overall age-adjusted fatal opioid overdose rate. According to the new 2024 data, Genesee remained the second highest county, and Saginaw County jumped up to third. Encouragingly, Iosco County dropped out of the top 10 counties in this category.
Also notably, Genesee and Saginaw counties saw a sizable decline between 2023 and 2024 rates for fatal synthetic opioid overdose deaths per 100,000. Of the remaining counties in this cluster, only Bay County had enough fatal overdoses to calculate an overdose rate per 100,000. A significant socioeconomic change seen in this county cluster was that every county saw a decrease in its unemployment rate. Genesee county still led this cluster between 2023 and 2024, while Bay had the lowest rate.
Baraga county continues to see high rates of naloxone administration compared to other upper peninsula counties, with a rate of 144 per 100,000 this year. However, as of 2025, Chippewa county saw even higher rates than Baraga with a rate of 152 per 100,000.
Also in 2025, Chippewa and Luce counties were the highest rated counties in the entire state for the rate of EMS responses for probable opioid overdose per 100,000. Both counties saw an increase in this rate compared to 2024. No other counties in the Marquette cluster were in the top 15 of this metric.
On a positive note, the rate of unemployment for each county in the Marquette County Cluster decreased between 2024 and 2025.
In 2024, Wayne and Macomb counties alone accounted for 46% of the entire state’s fatal synthetic opioid overdoses, with 35% in Wayne County and 11% in Macomb. Importantly, Wayne and Macomb are two of the top three most populated Michigan counties, offering some explanation for the greater burden in cases. Another key factor is that in 2024, Wayne, Macomb, and St. Clair counties all saw this rate decrease compared to their 2023 rates, despite all still remaining in the top ten counties in Michigan for this category. It is also important to note that in 2024, the rest of the top ten counties in Michigan saw a decrease in this rate as well.
Wayne county dropped from the top-rated county for EMS responses to probable opioid overdoses in 2024 to third in 2025, while Macomb and St. Clair remained outside the top ten in this category.
Examining the rate of people experiencing a period of mental distress, Wayne and St. Clair counties each saw slight increases compared to 2023, while Macomb County had a decrease. Unemployment rates saw very little to no change between years, with the biggest difference in St. Clair County, down from 6.4% in 2023 to 5.7% in 2024.
Last year’s analysis discovered a new hotspot that included Muskegon, Oceana, Mason, and Manistee counties. Based on analysis of the rate of EMS responses for probable opioid overdoses, the Muskegon County rate decreased and dropped from second to fourth in the state, while Manistee County saw an increase and now sits at fifth in the state.
Additionally based on the new 2024 data, Manistee County was the top-rated county for prescription opioid and heroin treatment rates, and Muskegon was tied for fourth.
In this new hotspot, there was very little change in socioeconomic factors across all four counties, with each county only seeing a slight increase in respondents reporting mental or physical distress.
While there have been improvements across different factors across all four county clusters, the data still showcases that continued support is justified.
Both Poverty Solutions and OPEN hope that organizations will continue to use this data while engaging with their communities to advance the goal of improving health for all Michiganders.
