By 2019, Pennsylvania's overall opioid overdose death rate was at 23.7 per 100,000 people – nearly five times the rate it had been in 2010. In 2020, the rate went up to 42.4 per 100,000 people. But different counties had different experiences. Some, like thinly populated Montour County in central eastern Pennsylvania, saw the death rate triple. But just south of there in more populous Dauphin County, the rate dropped by nearly half. The redder the county in the shaded map below, the more its opioid death rate increased. In greener counties, opioid death rates fell.