While drug-related deaths are much more common among adults than children, it is likely that millions of children in the United States have been directly or indirectly affected by the epidemic.

According to a Population Reference Bureau report, between 2000 and 2016, the number of children under age 20 living in counties with high drug overdose death rates—defined as 20 or more deaths per 100,000 population—rose from less than 250,000 to nearly 22.6 million, almost a 100-fold increase. The percentage of children living in high-rate counties also increased significantly during this period, from less than 1 percent of children in 2000 to 28 percent in 2016.

A 2019 map from the National Center for Health Statistics (Center for Disease Control and Prevention) shows crude death rates by county from 2003-2017 for drug poisoning death rates beginning in 1999.

Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent).