The Washington-based Trust for America's Health said in a report Monday that the state had 15.3 overdose deaths per 100,000 residents in 2010, most involving prescription drugs.
That's an increase of 89 percent from 1999, when there were 8.1 drug deaths per 100,000 people.
West Virginia led the nation in fatal overdoses with nearly 29 per 100,000 people.
The trust says Pennsylvania is among 28 states and the District of Columbia that received low scores on implementing strategies for curbing prescription-drug abuse the trust considers promising.
Pennsylvania lawmakers are considering an expansion of the state's prescription drug monitoring program, but the Pennsylvania Medical Society and civil libertarians have raised concerns about potential threats to patients' privacy.