Quick answer
Allegheny County's Medical Examiner recorded 432 accidental overdose deaths in 2024, and the county's own opioid reporting puts fentanyl in about 77% of them. Medication for opioid use disorder and naloxone are the treatments with the strongest evidence. Here is how to start in Pittsburgh. Helpline: (800) 653-9376.
Fentanyl is involved in roughly three out of four overdose deaths Allegheny County records, and it turns up in drugs people never meant to take an opioid with — cocaine, methamphetamine, counterfeit pills. The 2024 numbers finally moved in the right direction, but the treatment that drives survival has not changed: medication, fast, plus naloxone within reach. Here is what the county's own data show and how to get started.
What is the safest way to start fentanyl treatment in Pittsburgh?
It depends on where the person is right now. If someone is unresponsive or barely breathing, that is a 911 call and naloxone — not a search for an opening. If they are stable but using, same-week buprenorphine or methadone cuts overdose risk far more than waiting for a residential bed. If they have already detoxed and are stepping down, outpatient medication with counseling holds the gains. One call to a program that can screen this week is the next step in every case.
What Allegheny County's fentanyl data show
The Allegheny County Medical Examiner's 2024 annual report recorded 432 accidental overdose deaths — the lowest total since 2019 and down from 665 in 2023. Of those deaths, 346 involved multiple drugs and 86 a single drug. In the report's ranking of drugs appearing in combined accidental drug deaths, fentanyl ranked first at 303 appearances, followed by cocaine at 218 and methamphetamine at 127.
The county's Opioid Settlement Fund report adds texture to those totals: between January and August 2024, the Medical Examiner recorded 301 fatal overdoses against 466 in the same stretch of 2023, and fentanyl was involved in 77% of deaths in that window. The county also partnered with Biobot starting in March 2024 to test wastewater at its central plant for fentanyl, xylazine, cocaine, and methamphetamine — monitoring that showed fentanyl concentrations declining through the end of the year.
Statewide, the Pennsylvania Department of Health counted 3,341 overdose deaths in 2024, a 29.2% drop from 2023, with fentanyl contributing to 67% of fatal overdoses. County overdose reporting also notes that Black residents die at roughly twice the rate of white residents even though totals are highest among white individuals — risk is not evenly spread across Pittsburgh.
Medication is the first line of treatment
Fentanyl use disorder responds to the same medications as any opioid use disorder. NIDA lists three FDA-approved options:
- Methadone — a full opioid agonist, dispensed daily through a federally certified opioid treatment program.
- Buprenorphine — a partial agonist available as a daily tablet or film, a long-acting injection, or telehealth-supported prescribing.
- Naltrexone — blocks opioid receptors and can only be started after opioids have cleared the body.
People treated with methadone or buprenorphine are less likely to die or overdose again than people who receive no medication. A program that offers counseling but no medication is usually the wrong first call for someone using fentanyl.
Naloxone and harm reduction in Pittsburgh
- Prevention Point Pittsburgh — syringe services, naloxone distribution, and a mobile buprenorphine program funded in part through county opioid settlement dollars
- Pharmacy access — Pennsylvania's standing order lets anyone walk into a pharmacy and get naloxone without their own prescription
- Hospital bridge programs — UPMC and AHN emergency departments run warm-handoff pathways for overdose survivors, funded through county settlement investments
Carry two doses if you or anyone around you uses opioids — or cocaine or meth, because the supply is mixed. A fentanyl overdose can need more than one; give it, then call 911.
Treatment options around Pittsburgh
FindTreatment.gov data accessed October 2026 list 134 substance use treatment facilities within 30 miles of downtown Pittsburgh — 30 within 5 miles — including 17 federally certified opioid treatment programs, 47 facilities that prescribe buprenorphine, 48 that offer naltrexone, 17 with detoxification, and 100 delivering outpatient care. When you call, the questions that matter are: do you dispense or prescribe medication, and how soon can I start? Counts shift as programs open and close.
Allegheny County's Department of Human Services serves as the Single County Authority, coordinating publicly funded drug and alcohol services for county residents.
Paying for treatment
Pennsylvania's Medical Assistance covers opioid use disorder medications. Physical HealthChoices plans in Southwest Pennsylvania include AmeriHealth Caritas, Geisinger Health Plan, Jefferson Health Plans EverWell, Highmark Wholecare, and UPMC for You. The SAMHSA National Helpline, 1-800-662-4357, is a free, confidential starting point anywhere in the country, and PA Get Help Now at the same number helps navigate county-funded care.
How to start today
- If someone is overdosing — slow or stopped breathing, blue lips, unresponsive — call 911 and give naloxone. For a mental health or substance use crisis, call or text 988.
- Call or text (800) 653-9376 to speak with a treatment specialist, or use this form:
Calling is free; the referral service is paid for by treatment providers, and we check your benefits before you commit.
- Search findtreatment.gov with a Pittsburgh ZIP code such as 15222 and filter for opioid treatment programs or buprenorphine.
- Ask each program two things: whether they offer medication, and when the next opening is.
Fentanyl use disorder is treatable, and the medication that protects against overdose is available across Allegheny County. The first call is usually the hardest part.
Last updated: Tue Oct 20 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
How many fentanyl overdoses happen in Allegheny County?
The Allegheny County Medical Examiner's 2024 annual report recorded 432 accidental overdose deaths, down from 665 in 2023. The county's opioid settlement report counted 301 fatal overdoses between January and August 2024 — versus 466 in the same months of 2023 — and found fentanyl involved in 77% of deaths in that period. Fentanyl was the most frequently appearing drug among combined accidental drug deaths in 2024.
What medication treats fentanyl use disorder in Pittsburgh?
Three FDA-approved medications exist for opioid use disorder: methadone, dispensed daily through a federally certified opioid treatment program; buprenorphine, available by prescription or telehealth; and naltrexone, which is started only after opioids have cleared the body. NIDA reports that people on methadone or buprenorphine are less likely to die or overdose than people who receive no medication.
Where can I get naloxone in Pittsburgh?
Naloxone is available at Pennsylvania pharmacies without a separate prescription under the state's standing order, and Prevention Point Pittsburgh distributes naloxone through its syringe services and mobile programs. Because fentanyl can require more than one dose, carry at least two. In an overdose, give naloxone and call 911.
Is fentanyl also in cocaine and meth in Pittsburgh?
Yes — the county tests its wastewater for fentanyl, xylazine, cocaine, and methamphetamine precisely because the supply is mixed. County reporting notes that over half of opioid-involved overdose deaths have also contained a stimulant such as cocaine or methamphetamine. You cannot see, taste, or smell fentanyl, and it shows up in counterfeit pills as well as powders.
Who do I call in a crisis in Pittsburgh?
If someone is unresponsive or not breathing normally, call 911 and give naloxone if you have it. For a mental health or substance use crisis that is not a medical emergency, call or text 988. PA Get Help Now, 1-800-662-4357, helps people navigate county-funded treatment any time.