Nebraska‘s Drug-Related Death Toll is underreported, obscuring the Scale of the Crisis
Lincoln, Nebraska – September 19, 2025 – Official state data significantly underestimates the number of Nebraskans dying from drug-related causes, a Flatwater Free Press investigation reveals. The discrepancy hinders effective public health responses and leaves the true cost of the opioid and methamphetamine crises largely unknown. While the state reported 243 drug overdose deaths in 2023, a more comprehensive analysis incorporating toxicology reports and medical examiner data suggests the actual figure is considerably higher – potentially exceeding 350.
This undercounting stems from a reliance on death certificates that often don’t reflect the full complexity of drug involvement. Current protocols prioritize listing the immediate cause of death, such as cardiac arrest, even when drug intoxication is a significant contributing factor. This practice masks the role of substances in fatalities, impacting funding allocations for prevention, treatment, and harm reduction programs. The lack of accurate data leaves communities vulnerable and prevents targeted interventions to address the escalating crisis, notably in rural areas were resources are already strained.
The investigation,led by reporter Natalia Alamdari,found that toxicology reports – which detail the presence of drugs in a person’s system at the time of death – are frequently not considered when determining the official cause of death. “We’re missing a huge piece of the puzzle,” saeid Dr. Jeremy Coffey, a forensic pathologist in Omaha. “If someone has fentanyl in their system and dies of a heart attack, the heart attack gets listed, not the fentanyl. But the fentanyl contributed.”
The problem isn’t unique to Nebraska. the Centers for Disease Control and Prevention (CDC) has acknowledged inconsistencies in overdose data reporting across states. However, advocates and public health officials argue Nebraska’s current system is particularly flawed.”We’re flying blind,” stated April Kunz, executive director of the Nebraska Harm Reduction coalition. “Without accurate numbers, we can’t effectively advocate for the resources our communities desperately need.”
State officials acknowledge the limitations of the current system and are exploring potential changes. The Nebraska Department of Health and Human Services is currently piloting a new data collection system that aims to incorporate toxicology reports more effectively. Implementation of the new system is expected by early 2026, but concerns remain about the backlog of historical data and the ongoing impact of underreporting in the interim. The Flatwater Free Press will continue to follow this developing story.
