In 2023, around 72,776 people in the United States died from a drug overdose that involved fentanyl. This was the second-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, overdose deaths involving opioids in the United States totaled over ** thousand. The majority of opioid deaths involve fentanyl. This statistic shows the number of drug overdose deaths in the U.S. from 2020 to 2022, by involved drug type.

This data visualization presents county-level provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. County-level 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 (see Technical Notes). The provisional data presented on the dashboard below include reported 12 month-ending provisional counts of death due to drug overdose by the decedent’s county of residence and the month in which death occurred. Percentages of deaths with a cause of death pending further investigation and a note on historical completeness (e.g. if the percent completeness was under 90% after 6 months) are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical Notes). Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Technical Notes Nature and Sources of Data Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics (NCHS) as of a specified cutoff date. The cutoff date is generally the first Sunday of each month. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from the state vital registration offices through the Vital Statistics Cooperative Program (VSCP). The timeliness of provisional mortality surveillance data in the National Vital Statistics System (NVSS) database varies by cause of death and jurisdiction in which the death occurred. The lag time (i.e., the time between when the death occurred and when the data are available for analysis) is longer for drug overdose deaths compared with other causes of death due to the time often needed to investigate these deaths (1). Thus, provisional estimates of drug overdose deaths are reported 6 months after the date of death. Provisional death counts presented in this data visualization 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 2020 would include deaths occurring from July 1, 2019 through June 30, 2020. The 12 month-ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12 month-ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Cause of Death Classification and Definition of Drug Deaths Mortality statistics are compiled in accordance with the World Health Organizations (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regul

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.

National provisional drug overdose deaths by month and 2013 NCHS Urban–Rural Classification Scheme for Counties. Drug overdose deaths are identified using underlying cause-of-death codes from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined). Deaths are based on the county of residence in the United States. Death counts provided are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. Estimates for 2020 are based on provisional data. Estimates for 2018 and 2019 are based on final data. For more information on NCHS urban-rural classification, see: https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf

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.

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

A. SUMMARY This dataset includes data from the Office of the Chief Medical Examiner on the number of preliminary unintentional fatal drug overdoses per month.

B. HOW THE DATASET IS CREATED The Office of the Chief Medical Examiner releases a monthly report containing the previous month’s preliminary count of unintentional fatal drug overdoses. This dataset is manually updated based on that report.

The San Francisco Office of the Chief Medical Examiner (OCME) investigates any unknown cause of death for deaths that occur in San Francisco. OCME uses drug testing, death scene investigation, autopsy, medical record, and informant information to determine the cause of death. Preliminary determinations are generally based on drug testing and death scene investigations.

Preliminary deaths reported by the medical examiner consist of two categories: (a) cases that are still under investigation and involve suspected acute toxicity from opioids, cocaine, or methamphetamine; and (b) cases that have been finalized and were attributed to acute toxicity from any substance (including prescribed medication and over-the-counter medication).

C. UPDATE PROCESS This dataset is updated monthly following the release of the monthly accidental fatal drug overdose report from the Office of the Chief Medical Examiner. Department of Public Health staff manually copy data from the Office of the Chief Medical Examiner’s report to update this dataset.

D. HOW TO USE THIS DATASET This dataset is updated each month to include the most recent month’s preliminary accidental fatal drug overdose count. Counts from previous months are often also updated as it can take more than a month for the Office of the Chief Medical Examiner to finish reviewing cases.

E. RELATED DATASETS San Francisco Department of Public Health Substance Use Services Overdose-Related 911 Responses by Emergency Medical Services (EMS) Unintentional Drug Overdose Death Rate by Race/Ethnicity

In 2020, there were approximately 4.2 overdose deaths from heroin per 100,000 population in urban settings in the United States. In comparison, the overdose death rate from heroin in rural areas of the U.S. was 3.2 per 100,000 population. This statistic shows the death rate from drug overdose in the U.S. in 2020, by urbanicity and drug type

Actual and predicted rolling 12-month drug-overdose deaths per 100,000 persons over 2015-December 2021, divided into those related to synthetic opioids and other, and predicted overdose deaths in 2020 and through March 2021 for all overdoses and synthetic opioids overdoses using fourth order polynomial fitted to pre-pandemic data starting from either 2015 (2015 model) or 2017 (2017 model) through Feb. 2020.

We collect data and report statistics on opioid, stimulant, and other substance use and their impact on health and well-being.

It is projected that if the opioid overdose crisis stabilizes by the year 2020 there will be around ******* overdose deaths from prescription and illicit opioids from 2016 to 2025. If the crisis does not stabilize until the year 2025 it is predicted that overdose deaths due to illicit opioids will reach a total of over ****million from 2016 to 2025.

A. SUMMARY This dataset includes unintentional drug overdose death rates by race/ethnicity by year. This dataset is created using data from the California Electronic Death Registration System (CA-EDRS) via the Vital Records Business Intelligence System (VRBIS). Substance-related deaths are identified by reviewing the cause of death. Deaths caused by opioids, methamphetamine, and cocaine are included. Homicides and suicides are excluded. Ethnic and racial groups with fewer than 10 events are not tallied separately for privacy reasons but are included in the “all races” total.

Unintentional drug overdose death rates are calculated by dividing the total number of overdose deaths by race/ethnicity by the total population size for that demographic group and year and then multiplying by 100,000. The total population size is based on estimates from the US Census Bureau County Population Characteristics for San Francisco, 2022 Vintage by age, sex, race, and Hispanic origin.

These data differ from the data shared in the Preliminary Unintentional Drug Overdose Death by Year dataset since this dataset uses finalized counts of overdose deaths associated with cocaine, methamphetamine, and opioids only.

B. HOW THE DATASET IS CREATED This dataset is created by copying data from the Annual Substance Use Trends in San Francisco report from the San Francisco Department of Public Health Center on Substance Use and Health.

C. UPDATE PROCESS This dataset will be updated annually, typically at the end of the year.

D. HOW TO USE THIS DATASET N/A

E. RELATED DATASETS Overdose-Related 911 Responses by Emergency Medical Services Preliminary Unintentional Drug Overdose Deaths San Francisco Department of Public Health Substance Use Services

F. CHANGE LOG

• 12/16/2024 - Updated with 2023 data. Asian/Pacific Islander race/ethnicity group was changed to Asian.
• 12/16/2024 - Past year totals by race/ethnicity were revised after obtaining accurate race/ethnicity for some decedents that were previously marked as “unknown” race/ethnicity.

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.

Fatal overdose trends in Tennessee. Under "About this dataset" below, click "See more" to access downloadable supplemental materials (an infographic) for this report.

Drug-related mortality is a complex phenomenon, which accounts for a considerable percentage of deaths among young people in many European countries. The EMCDDA, in collaboration with national experts, has defined an epidemiological indicator with two components at present: deaths directly caused by illegal drugs (drug-induced deaths) and mortality rates among problem drug users. These two components can fulfil several public health objectives, notably as an indicator of the overall health impact of drug use and the components of this impact, identify particularly risky patterns of use, and potentially identify new risks.

There are around 50 statistical tables in this dataset. Each data table may be viewed as an HTML table or downloaded in spreadsheet (Excel format).

In 2020, there were around 40 overdose deaths among males per 100,000 population in urban settings, while the drug overdose death rate was slightly lower for males in rural areas with 34 deaths per 100,000 population. This statistic shows the death rate from drug overdose in the U.S. in 2020, by urbanicity and gender.

Analysis of ‘Accidental Drug Related Deaths 2012-2020’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/1b7f2866-87a3-43d7-ba26-1ad82a3f3424 on 12 February 2022.

--- Dataset description provided by original source is as follows ---

A listing of each accidental death associated with drug overdose in Connecticut from 2012 to 2020. A "Y" value under the different substance columns indicates that particular substance was detected.

Data are derived from an investigation by the Office of the Chief Medical Examiner which includes the toxicity report, death certificate, as well as a scene investigation.

The “Morphine (Not Heroin)” values are related to the differences between how Morphine and Heroin are metabolized and therefor detected in the toxicity results. Heroin metabolizes to 6-MAM which then metabolizes to morphine. 6-MAM is unique to heroin, and has a short half-life (as does heroin itself). Thus, in some heroin deaths, the toxicity results will not indicate whether the morphine is from heroin or prescription morphine. In these cases the Medical Examiner may be able to determine the cause based on the scene investigation (such as finding heroin needles). If they find prescription morphine at the scene it is certified as “Morphine (not heroin).” Therefor, the Cause of Death may indicate Morphine, but the Heroin or Morphine (Not Heroin) may not be indicated.

“Any Opioid” – If the Medical Examiner cannot conclude whether it’s RX Morphine or heroin based morphine in the toxicity results, that column may be checked

--- Original source retains full ownership of the source dataset ---

Descriptive statistics and results from adjusted and unadjusted longitudinal GEE models predicting overdose death rates from 2017–2020.

In 2020, the southern region of the U.S. had the highest number of drug overdose deaths involving illegally manufactured fentanyl and analogs, with 8,816 male and 3,488 female deaths. Males suffered more overdose drug deaths than females in all U.S. regions in that year. This statistic shows the number of drug overdose deaths that involved illicitly manufactured fentanyls in the U.S. in 2020, by region and gender.