Characteristics associated with low availability of treatment facilities and high rates of opioid overdose mortality were analyzed using a cross-sectional analysis design that combined county-level data from January 1, 2017, to December 31, 2021. Data for 3,130 counties in 50 states and Washington D.C. from several sources were accessed through PolicyMap, including American Community Survey (ACS), the Centers for Disease Control and Prevention (CDC), the United States Bureau of Labor Statistics (BLS), and the Substance Abuse and Mental Health Services Administration (SAMSHA).