South Central Pennsylvania has had more criminal cases against suspects accused of selling drugs tied to fatal overdoses over the past five years than anywhere else in Pennsylvania, according to data from the Administrative Office of Pennsylvania Courts.
The state court administrative agency conducted an analysis of drug-delivery-resulting-in-death (DDRD) offenses filed between the start of 2021 and the end of 2025. For each of the state’s 67 counties, the organization counted the number of cases each year in which a person was charged with DDRD or related lesser counts of conspiracy, criminal conspiracy engaging, solicitation or attempt.
A drug delivery resulting in death charge is “issued to a person who intentionally administers, dispenses, delivers, gives, prescribes, sells or distributes any controlled substance, and another person died as a result of using the substance,” according to the state court administrator.
Dozens of cases in Franklin, neighboring counties
Several counties with some of the highest tallies over the five-year span are in the south central region, including eighth-ranked Franklin County with 23 (3.36% of all of the county’s criminal cases in that time frame), according to the data.
A short drive north on Interstate 81 or U.S. 11, Cumberland County ranks third on the list with 40 cases (5.85%). Heading east on U.S. 30, York County ranked fourth with 38 cases (5.56%).
On the eastern edge of South Central Pennsylvania, Lancaster County holds the top spot statewide with 44 cases (6.43%). On the other side of the region, Blair County had 28 cases (4%).
Elsewhere, Monroe and Bucks counties in Eastern Pennsylvania and Mercer and Westmoreland counties on the Commonwealth’s west side also had among the most cases. About half of the counties in the state has cases in the single digits.
Cases dropping across Pennsylvania
Overall, there were 684 drug-delivery-resulting-in-death cases from 2021 to 2025, according to the data. The number of cases dropped each year, from 178 in 2021 to 89 in 2025.
The court administrative agency said that charges have fallen by 22% and convictions have decreased by 72% from 2024 to 2026.
Similarly, fatal overdoses driven by the fentanyl epidemic have been on the decline. In December, a representative of Franklin County Drug and Alcohol reported that the county was on track for its lowest number of fatal overdoses in over a decade.
The opioid epidemic and the introduction of super potent fentanyl in the mid-2010s caused overdoses and deaths to skyrocket. Franklin County’s record high was 46 overdose deaths in 2016, while 2025 wrapped up with seven.
