Are fentanyl overdose deaths rising in the US?
In 2023, fentanyl was responsible for about 199 deaths every day. Over a quarter of a million Americans have died from fentanyl overdoses since 2021.
In 2023, 72,776 people died from fentanyl overdoses nationwide, 1.4% fewer than the year before. Fentanyl deaths had previously increased every year from 2013 to 2022.
Fentanyl deaths reached a record high in 2022.
Synthetic opioid overdose deaths (mostly fentanyl), 1999–2024
It is important to note that this article uses provisional 2024 data that’s subject to change. The Centers for Disease Control and Prevention (CDC) notes that drug poisoning deaths may have a longer lag in reporting, making it likely that the provisional data is an undercount.
What is fentanyl and why is it so dangerous?
Fentanyl is a synthetic opioid up to 50 times stronger than heroin and 100 times stronger than morphine.
Like other opioids, fentanyl use can lead to dependency and addiction. Most illicit fentanyl is made in labs outside the country and smuggled across the US-Mexico border. Drug labs sometimes mix it with street drugs — heroin, cocaine, meth, or MDMA — to increase its effect, often without the user’s knowledge.
Early in the opioid epidemic (late 1990s to 2010), overdose deaths were largely driven by an increase in drug prescriptions. The Food and Drug Administration (FDA) approved pharmaceutical fentanyl as a pain reliever in 1998. It was typically prescribed to patients with severe or chronic pain. As prescriptions for these drugs fell, heroin, and eventually illicit fentanyl, became the main drivers of opioid overdose deaths.
How much fentanyl is a lethal dose?
How much fentanyl is a lethal dose?
Fentanyl is significantly stronger than other opioids — a two milligram dose can be lethal — and users are often unaware of how much fentanyl is in the illicit pills they’re taking, an especially dangerous combination. The DEA found that five out of 10 fentanyl-laced fake prescription pills contained a potentially lethal dose.
What can reverse a fentanyl overdose?
What can reverse a fentanyl overdose?
Many first responders and some civilians now carry naloxone (sold under the brand name Narcan), a drug that can rapidly reverse an opioid overdose. While there isn’t data available on the frequency of its use, the CDC does note that bystanders are present for 43% of overdose deaths and could potentially save lives by carrying and administering naloxone, which comes as a simple nasal spray.
When did fentanyl deaths begin to rise?
Fentanyl overdose deaths began rising in 2013, marking the beginning of what the CDC calls the third wave of the opioid epidemic. That year, 3,105 people died from a synthetic opioid overdose. Ten years later, there were 72,776 deaths involving fentanyl, an increase of 23 times over.
Since 2016, the number of fentanyl overdose deaths has surpassed overdose deaths on both prescription opioids and heroin.
Since 2016, fentanyl has taken more lives than heroin and prescription opioids combined.
Opioid overdose deaths, 1999–2024
Why did fentanyl deaths rise?
The increase in fentanyl overdose deaths may be attributable to a combination of factors: decline in opioid prescription rates and reformulations to drugs such as Oxycontin, both aimed at curbing abuse, and the illegal fentanyl laced with other street drugs.
From 2010 to 2023, the number of opioid prescriptions written per 100 people dropped from 81.2 to 37.5, a change of nearly 54. In West Virginia, where opioid prescription numbers peaked in 2009 at 146.9, per 100 people, they’ve since fallen by 68%.
But despite the waning availability of prescription opioids, total opioid overdose deaths more than tripled during the same period, with fentanyl overdoses involved in an increasingly large share of drug deaths.
In 2023, it was the underlying cause of 69% of drug overdose deaths, and it’s been a factor in over half of all drug overdose deaths since 2019.
Fentanyl was involved in 69% of drug overdose deaths in 2023.
Percent of overdose deaths with synthetic opioids (mostly fentanyl), 1999–2024
Which states have the most fentanyl deaths?
West Virginia had the highest rate of fentanyl overdose deaths in the US in 2023 — 69.2 deaths per 100,000 people, about 55% higher than second-highest Delaware’s 44.6. Washington, DC, had a rate of 50.5.
Nebraska had the lowest death rate in 2023, with 3.3 fentanyl overdoses per 100,000 residents.
West Virginia had the highest rate of fentanyl overdose deaths in 2023.
Synthetic opioid overdose deaths (mostly fentanyl) per 100,000 people by state of residence, 2023
California had the most total deaths from fentanyl in 2023 with 7,203, followed by New York (4,936) and Florida (4,593). None of these are among the states with the highest death rates, but more populous states tend to have more total deaths.
In addition to having the second-lowest fentanyl death rate in 2023, South Dakota also had the fewest total deaths: 42.
Explore data on fentanyl deaths
Synthetic opioid overdose deaths (mostly fentanyl) by state of residence, 2023
How do fentanyl death rates vary by race?
Fentanyl overdose rates varied by race: in 2023, Black Americans suffered 35.0 deaths per 100,000 people, a rate over 50% higher than the national average of 22.2 (age adjusted).
Black Americans represented 13.7% of the US population but 22.6% of fentanyl deaths.
Indigenous people had the second highest overdose rate, at 28.5 deaths per 100,000 people, with white Americans third at 21.9 per 100,000.
Asian Americans had rates below the national average, at 3.1 deaths per 100,000 people — 1.0% of fentanyl deaths for a group that makes up 6.5% of the population.
Black and Indigenous people experience higher fentanyl overdose death rates.
Rate of overdose deaths from synthetic opioids by race/ethnicity (per 100k people), 2023
Which age groups have higher overdose death rates?
In 2023, adults aged 35–44 accounted for 20,344 fentanyl overdoses, 28.0% of the fentanyl deaths that year, and were 13.5% of the US population.
The age group below them, adults 25–34 had 16,712 fentanyl overdoses, for 23.0% of total deaths, and were 13.6% of the population.
Together, these two age groups accounted for over half of all fentanyl deaths.
Since 2015, adults ages 24–44 have made up more than half of all fentanyl deaths.
Drug overdose deaths with synthetic opioids involved, by age group, 1999–2024
Where does this data come from?
The CDC tracks drug overdose data with the International Classification of Diseases, 10th Revision (ICD-10), which records fentanyl overdose deaths together with those caused by other synthetic opioids. Drug overdose deaths may involve multiple drugs, so a single death might be included in more than one ICD-10 category.
Resources for substance use disorders
If you or someone you know is experiencing substance use disorders, call the SAMHSA National Helpline, 1-800-662-HELP (4357), a free, confidential, 24/7, year-round treatment referral and information service for individuals and families facing mental health challenges and/or substance use disorders.
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