In 2022, around 73,838 people in the United States died from a drug overdose that involved fentanyl. This was the highest number of fentanyl overdose deaths ever recorded in the United States, and a significant increase from the number of deaths reported in 2019. Fentanyl overdoses are now the driving force behind the opioid epidemic, accounting for the majority of overdose deaths in the United States. What is fentanyl? Fentanyl is an extremely potent synthetic opioid similar to morphine, but more powerful. It is a prescription drug but is also manufactured illegally and is sometimes mixed with other illicit drugs such as heroin and cocaine, often without the user’s knowledge. The potency of fentanyl makes it very addictive and puts users at a high risk for overdose. Illegally manufactured fentanyl has become more prevalent in the United States in recent years, leading to a huge increase in drug overdose deaths. In 2022, the rate of drug overdose death involving fentanyl was 22.7 per 100,000 population, compared to a rate of just one per 100,000 population in the year 2013. Fentanyl overdoses by gender and race/ethnicity As of 2022, the rate of drug overdose deaths involving fentanyl in the United States is over two times higher among men than women. Rates of overdose death involving fentanyl were low for both men and women until around the year 2014 when they began to quickly increase, especially for men. In 2022, there were around 19,880 drug overdose deaths among women that involved fentanyl compared to 53,958 such deaths among men. At that time, the rate of fentanyl overdose deaths was highest among non-Hispanic American Indian or Alaska Natives and lowest among non-Hispanic Asians. However, from the years 2014 to 2018, non-Hispanic whites had the highest fentanyl overdose death rates.

In 2022, there were around 22.7 overdose deaths in the United States involving fentanyl per 100,000 population. The death rate involving fentanyl presented an exponential increase since 2014. This statistic presents the rate of drug overdose deaths involving fentanyl in the U.S. from 1999 to 2022.

Data on drug overdose death rates, by drug type and selected population characteristics. Please refer to the PDF or Excel version of this table in the HUS 2019 Data Finder (https://www.cdc.gov/nchs/hus/contents2019.htm) for critical information about measures, definitions, and changes over time. SOURCE: NCHS, National Vital Statistics System, numerator data from annual public-use Mortality Files; denominator data from U.S. Census Bureau national population estimates; and Murphy SL, Xu JQ, Kochanek KD, Arias E, Tejada-Vera B. Deaths: Final data for 2018. National Vital Statistics Reports; vol 69 no 13. Hyattsville, MD: National Center for Health Statistics.2021. Available from: https://www.cdc.gov/nchs/products/nvsr.htm. For more information on the National Vital Statistics System, see the corresponding Appendix entry at https://www.cdc.gov/nchs/data/hus/hus19-appendix-508.pdf.

In 2022, there were around 25 overdose deaths involving fentanyl among non-Hispanic whites in the United States per 100,000 population. This statistic presents the rate of drug overdose deaths involving fentanyl in the U.S. from 1999 to 2022, by race/ethnicity.

This statistic shows the death rate of top ten U.S. states for fentanyl overdose deaths during calendar year 2016. According to the data, the drug overdose death rate for fentanyl was highest in New Hampshire with 30.3 deaths per 100,000 persons.

This data presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts. Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts. Reporting of the specific drugs and drug classes involved in drug overdose deaths varies by jurisdiction, and comparisons of death rates involving specific drugs across selected jurisdictions should not be made. Provisional data presented will be updated on a monthly basis as additional records are received. For more information please visit: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

In 2022, there were an estimated 73,838 overdose deaths in the U.S. involving fentanyl, around 53,958 of which occurred among males. This statistic presents the number of overdose deaths from fentanyl in the U.S. from 1999 to 2022, by gender.

West Virginia is currently the state with the highest drug overdose death rate in the United States, with 91 deaths per 100,000 population in 2022. Although West Virginia had the highest drug overdose death rate at that time, California was the state where the most people died from drug overdose. In 2022, around 10,952 people in California died from a drug overdose. The main perpetrator Opioids account for the majority of all drug overdose deaths in the United States. Opioids include illegal drugs such as heroin, legal prescription drugs like oxycodone, and illicitly manufactured synthetic drugs like fentanyl. The abuse of opioids has increased in recent years, leading to an increased number of drug overdose deaths. The death rate from heroin overdose hit an all-time high of 4.9 per 100,000 population in 2016 and 2017, but has decreased in recent years. Now, illicitly manufactured synthetic opioids such as fentanyl account for the majority of opioid overdose deaths in the United States. Opioid epidemic The sharp rise in overdose deaths from opioids have led many to declare the United States is currently experiencing an opioid epidemic or opioid crisis. The causes of this epidemic are complicated but involve a combination of a rise in dispensed prescriptions, irresponsible marketing from pharmaceutical companies, a lack of physician-patient communication, increased social acceptance of prescription drugs, and an increased supply of cheap and potent heroin on the streets.

This indicator includes unintentional overdoses, homicides, and suicides from drug overdose. Death rate has been age-adjusted to the 2000 U.S. standard population. ICD-10 codes used to identify drug overdose related deaths are X40-X44, X60-X64, X85, and Y10-Y14.Drug overdose deaths have increased dramatically in the US over the past two decades. The first wave of deaths in the 1990s largely involved prescription opioids and was a consequence of increased prescribing of these drugs by medical providers. In the second wave that began in 2010, there was a rapid increase in the number of deaths involving heroin and, in the current wave that started in 2013, there has been a rise in the number of overdose deaths involving synthetic opioids, particularly illicitly manufactured fentanyl, which can be found in combination with heroin, counterfeit pills, cocaine, and other drugs. In Los Angeles County in recent years, the vast majority of all drug overdose deaths have involved fentanyl. Important inequities have been noted by sociodemographic characteristics, with low-income and Black individuals found to have the highest overdose death rates. Cities and communities can take an active role in preventing overdose deaths by promoting primary prevention and supporting evidence-based harm reduction and treatment strategies.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

This data presents counts of provisional drug overdose deaths by selected drugs and U.S. Department of Health and Human Services (HHS) public health regions, based on provisional mortality data from the National Vital Statistics System. This data is limited to drug overdose deaths with an underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision (ICD-10) code numbers X40-X44 (unintentional), X60-X64 (suicide), X85 (homicide), or Y10-Y14 (undetermined intent). Specific drugs were identified using methods for searching literal text from death certificates. The provisional data are based on a current flow of mortality data and include reported 12 month-ending provisional counts of drug overdose deaths by jurisdiction of occurrence and specified drug. Provisional drug overdose death counts presented on this page are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2022 would include deaths occurring from July 1, 2021, through June 30, 2022. Evaluation of trends over time should compare estimates from year to year (June 2021 and June 2022), rather than month to month, to avoid overlapping time periods. It is important to note that the data represent counts of deaths, and not mortality ratios or rates, which are the standard measure used to compare groups, and therefore should not be used to determine populations at disproportionate risk of drug overdose death.

In 2022, there were around 33 overdose deaths involving fentanyl among men in the United States per 100,000 population. Since 2014, fentanyl-related death rates have increased exponentially for both genders. However, the rate for men was more than double that for women. This statistic presents the rate of drug overdose deaths involving fentanyl in the U.S. from 1999 to 2022, by gender.

In 2022, the death rate from opioid poisoning in the United States was around 36.6 per 100,000 population among Black, non-Hispanics. This was a significant increase compared to the death rate reported in 1999. This statistic shows the death rate from drug poisonings involving opioids in the U.S. from 1999 to 2022, by race/ethnicity.

From 1999 to 2022, the number of drug overdose deaths among U.S. females increased from 5,591 in 1999 to 32,127 in 2022. Globally, drug use is a general problem. As of 2021, there were an estimated 296 million global drug consumers and 39.5 million drug addicts.

Opioid use in the United States

Among many demographics, drug overdose deaths continue to rise in the United States. Opioids are the most commonly reported substance in drug-related deaths. The number of drug-related deaths in the U.S. due to opioids has dramatically increased since the early 2000s. In 2017, then-President Donald Trump declared a national emergency over the opioid crisis in the United States. Since then, there have been joint efforts among various governmental departments to address the opioid crisis through education and outreach.

Substance use treatment

Substance abuse treatment is vital in reducing the number of drug overdose deaths in the United States. As of 2020, the state of California had the largest number of substance abuse treatment facilities . However, many states in the U.S. have less than 100 substance abuse treatment facilities.

ObjectiveU.S. drug-related overdose deaths and Emergency Department (ED) visits rose in 2020 and again in 2021. Many academic studies and the news media attributed this rise primarily to increased drug use resulting from the societal disruptions related to the coronavirus (COVID-19) pandemic. A competing explanation is that higher overdose deaths and ED visits may have reflected a continuation of pre-pandemic trends in synthetic-opioid deaths, which began to rise in mid-2019. We assess the evidence on whether increases in overdose deaths and ED visits are likely to be related primarily to the COVID-19 pandemic, increased synthetic-opioid use, or some of both.MethodsWe use national data from the Centers for Disease Control and Prevention (CDC) on rolling 12-month drug-related deaths (2015–2021); CDC data on monthly ED visits (2019-September 2020) for EDs in 42 states; and ED visit data for 181 EDs in 24 states staffed by a national ED physician staffing group (January 2016-June 2022). We study drug overdose deaths per 100,000 persons during the pandemic period, and ED visits for drug overdoses, in both cases compared to predicted levels based on pre-pandemic trends.ResultsMortality. National overdose mortality increased from 21/100,000 in 2019 to 26/100,000 in 2020 and 30/100,000 in 2021. The rise in mortality began in mid-to-late half of 2019, and the 2020 increase is well-predicted by models that extrapolate pre-pandemic trends for rolling 12-month mortality to the pandemic period. Placebo analyses (which assume the pandemic started earlier or later than March 2020) do not provide evidence for a change in trend in or soon after March 2020. State-level analyses of actual mortality, relative to mortality predicted based on pre-pandemic trends, show no consistent pattern. The state-level results support state heterogeneity in overdose mortality trends, and do not support the pandemic being a major driver of overdose mortality.ED visits. ED overdose visits rose during our sample period, reflecting a worsening opioid epidemic, but rose at similar rates during the pre-pandemic and pandemic periods.ConclusionThe reasons for rising overdose mortality in 2020 and 2021 cannot be definitely determined. We lack a control group and thus cannot assess causation. However, the observed increases can be largely explained by a continuation of pre-pandemic trends toward rising synthetic-opioid deaths, principally fentanyl, that began in mid-to-late 2019. We do not find evidence supporting the pandemic as a major driver of rising mortality. Policymakers need to directly address the synthetic opioid epidemic, and not expect a respite as the pandemic recedes.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

Source: Office of State Medical Examiners (OSME), Rhode Island Department of Health (RIDOH)Note: Counts may not add to annual totals due to missing case information. Percentages may not add to 100 due to rounding. Percentages are displayed as decimals. Prescription medications include prescription opioids such as oxycodone, hydrocodone, and benzodiazepines. Illicit drugs include substances such as heroin, illicit fentanyl, and cocaine.

Mississippi saw a 55 percent increase in drug overdose deaths from 2019 to 2020. Opioids - such as prescription pain relievers, heroin, and illegally manufactured synthetic opioids such as fentanyl - are the main driver of overdose deaths. This statistic shows the percent change in drug overdose deaths in the U.S. from 2019 to 2020, by state.

Model-based estimates for the proportion of non-COVID-19 excess deaths attributable to opioids.