North Carolina had significant 61.9% substance death increase all-ages 2009-2018 vs 1999-2008 - - - - 9,818 more substance deaths in recent 10 year span 2009-2018 vs 1999-2008 = 25,682 - 15,864 = 9,818. North Carolina had 25,682 substance deaths in recent 10 years, 2009-2018. North Carolina substance death rate increased significantly 7.4 points comparing recent 10 year substance death rate to prior 10, 2009-2018 vs 1999-2008 death rates = 25.933 - 18.541 = 7.392 substance death rate point increase in recent 10 year period. North Carolina had 41,546 tragic, sad, un-necessary mind-altering substance deaths recent 20 years, 1999-2018."