In the District of Columbia, Pennsylvania, and Florida the rate of opioid-related deaths at least doubled every two years between 1999 and 2016; the annual percent change (APC) was 41% or higher in 2016. Opioids include natural opioids, synthetic opioids, and heroin. Eight states—Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire, and Ohio—had opioid-related mortality rates that were at least doubling every three years, with an APC of 26% or higher. Nationwide, the opioid-related mortality APC from 1999 through 2016 was 18.5%. Across the states, the opioid-related mortality APC decreased only in Montana . . .