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.

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

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.

The graph illustrates the number of deaths from fentanyl in the United States from 1999 to 2022. The x-axis represents the years, spanning from '99 to '22, while the y-axis displays the annual number of fentanyl-related fatalities. Over this 24-year period, deaths rise dramatically from 730 in 1999 to a peak of 73,838 in 2022. Notable milestones include an increase to 1,742 deaths in 2005, a significant jump to 9,580 in 2015, and a sharp escalation to 70,601 deaths by 2021. The data reveals a consistent and severe upward trend in fentanyl-related deaths, particularly accelerating in the mid-2010s. This information is presented in a line graph format, effectively highlighting the dramatic increase in fatalities due to fentanyl across the United States over the specified years.

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 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

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

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

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

Prior dataset name - Estimated Accidental and Undetermined Drug Overdose Deaths CY 2012-Current County Health
View annual counts of Any Drug overdose deaths for 2012 forward, including provisional estimates of annual counts of overdose deaths for recent years, as noted with an asterisk and the month the data was pulled. NOTE: Finalized death records for overdose deaths are often delayed by 3-6 months. Counties labeled “no value” have data suppressed because the counts are between 1 and 9. Counts do not include suicides or homicides where someone intended to harm another person by poisoning.
Overdose Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are identified using underlying cause-of-death codes X40–X44, and Y10–Y14, and include the following:
- R99 when the Injury Description indicates an overdose death.
- X49 when literal COD is Mixed or Combined or Multiple Substance Toxicity, as these are likely drug overdoses
- X47 when substance indicated is difluoroethane, alone or in combination with other drugs
- X85 when it does not appear that someone intended to harm another person by poisoning
Source Office of Drug Surveillance and Misuse Prevention*
* These data were supplied by the Bureau of Health Statistics and Registries, Harrisburg, Pennsylvania. The Bureau of Health Statistics and Registries specifically disclaims responsibility for any analyses, interpretations or conclusions.
Any Drug Overdose Death - all drug overdose deaths, regardless of type of drug involved, excluding alcohol only deaths

In Los Angeles County, methamphetamine accounted for the highest share of overdose deaths among people experiencing homelessness (PEH) in the 12 months before and after the COVID-19 pandemic onset, contributing to approximately three-quarters of all overdose deaths in both years. Fentanyl ranked as the second leading cause of overdose death in both periods, but showed the largest increase in its contribution over the analyzed timeframe. This statistic depicts the percentage of deaths among people experiencing homelessness by overdose pre- and post-COVID-19 pandemic in Los Angeles County, by drug type.

Note: * Data are not complete and do not reflect the total number of deaths for the month.Source: Office of State Medical Examiners (OSME), Rhode Island Department of Health (RIDOH)

This dataset provides model-based provisional estimates of the weekly numbers of drug overdose, suicide, and transportation-related deaths using “nowcasting” methods to account for the normal lag between the occurrence and reporting of these deaths. Estimates less than 10 are suppressed. These early model-based provisional estimates were generated using a multi-stage hierarchical Bayesian modeling process to generate smoothed estimates of the weekly numbers of death, accounting for reporting lags. These estimates are based on several assumptions about how the reporting lags have changed in recent months across different jurisdictions, and the resulting estimates differ from other sources of provisional mortality data. For now, these estimates should be considered highly uncertain until further evaluations can be done to determine the validity of these assumptions about timeliness. The true patterns in reporting lags will not be known until data are finalized, typically 11–12 months after the end of the calendar year. Importantly, these estimates are not a replacement for monthly provisional drug overdose death counts, or quarterly provisional mortality estimates. For more detail about the nowcasting methods and models, see:

Rossen LM, Hedegaard H, Warner M, Ahmad FB, Sutton PD. Early provisional estimates of drug overdose, suicide, and transportation-related deaths: Nowcasting methods to account for reporting lags. Vital Statistics Rapid Release; no 11. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://doi.org/10.15620/ cdc:101132

This dataset tracks the updates made on the dataset "Provisional Drug Overdose Deaths by Urban/Rural Classification Scheme for 12 month-ending December 2018-December 2020" as a repository for previous versions of the data and metadata.

Analysis of ‘Early Model-based Provisional Estimates of Drug Overdose, Suicide, and Transportation-related Deaths’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/ff36ccc4-29ba-491f-9303-c97ff4492d84 on 28 January 2022.

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

This dataset provides model-based provisional estimates of the weekly numbers of drug overdose, suicide, and transportation-related deaths using “nowcasting” methods to account for the normal lag between the occurrence and reporting of these deaths. These early model-based provisional estimates were generated using a multi-stage hierarchical Bayesian modeling process to generate smoothed estimates of the weekly numbers of death, accounting for reporting lags. These estimates are based on several assumptions about how the reporting lags have changed in recent months across different jurisdictions, and the resulting estimates differ from other sources of provisional mortality data. For now, these estimates should be considered highly uncertain until further evaluations can be done to determine the validity of these assumptions about timeliness. The true patterns in reporting lags will not be known until data are finalized, typically 11–12 months after the end of the calendar year. Importantly, these estimates are not a replacement for monthly provisional drug overdose death counts, or quarterly provisional mortality estimates. For more detail about the nowcasting methods and models, see:

Rossen LM, Hedegaard H, Warner M, Ahmad FB, Sutton PD. Early provisional estimates of drug overdose, suicide, and transportation-related deaths: Nowcasting methods to account for reporting lags. Vital Statistics Rapid Release; no 11. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://doi.org/10.15620/ cdc:101132

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

As of August 2024, there were 548 non-fatal drug overdoses on supervised consumption sites (SCS), of which 148 were treated with naloxone in Canada. This statistic illustrates the monthly number of non-fatal drug overdoses treated with naloxone in supervised consumption sites (SCS) in Canada between March 2020 and August 2024.

In 2021, there were 298 drug overdose deaths were recorded in the Netherlands. The number of casualties was lowest in 2010, while 2021 represented the highest annual figure. In the last two years, a new record in drug deaths was reached.

 Opiates, cocaine and other dangerous drugs 

Many drug deaths in the Netherlands in 2021 were caused by opiates. Of the total 298 casualties in 2021, 150 died because of opiate use. By comparison, there were 72 cocaine deaths that year. This is also the highest number of cocaine-related deaths in the country in the past decade.

Cocaine use on the rise

 According to the Trimbos survey on drug use, cocaine use has increased in the Netherlands. Whereas in 1997, 2.6 percent of the respondents stated to have used cocaine at least once in their lives, by 2021 this had grown to 6.5 percent. Of the survey participants, 0.8 percent reported to have used cocaine in the past month, a slight change in comparison to earlier years as well.

The number of drug-related deaths in Sweden decreased in 2023 compared to the previous year, and amounted to around 9.4 deaths per hundred thousand inhabitants. Higher death figures were among men, at 11.55 deaths per hundred thousand inhabitants compared to 7.27 among women. Most deaths from opioids According to the Public Health Agency in Sweden (Folkhälsomyndigheten), the most common cause of death is overdosing, and in almost all cases from the use of opiates (types of opioids). Opioid users were the most common drug treatment entrants for specialized drug treatment care in Sweden in 2017. The gender distribution among these entrants consisted of 67 percent men and 33 percent women. Cannabis use is the most common drug use Opioids are the most common cause of drug-related deaths, but cannabis is the most commonly used drug. In a survey from 2018 on cannabis use, seven percent of women and 11 percent of men aged between 16 and 29 years stated that they had used cannabis within the last twelve months.

Accuracy: Data are from the "Weekly Update on Suspect Drug-Related Deaths in Ontario, by PHU Region" published weekly by the OCCO. Data are preliminary and subject to change.Suspect-drug related deaths include deaths where the preliminary investigation by the investigating coroner indicated: drugs were found at the scene, substance use equipment found at the scene, history of drug abuse, history of naloxone use, physical sign of drug use, positional asphyxia, unresponsive with snoring prior to death, or preliminary findings from autopsy indicate a suspected drug intoxication.Suspect-drug related deaths exclude deaths associated with trauma and medical assistance in dying cases. Investigations of suspect-drug related deaths may take several months, with identification of a number of death types, including: (1) opioid; (2) non-opioid acute drug toxicity, or (3) natural deaths (e.g., cardiac events), with different manners of death (natural, suicide, accident).When deaths initially thought to be drug related are determined to be natural deaths, this death is not removed from the preliminary suspected drug related death count to maintain comparable baseline data for the most recent months. Geographic regions are assigned based primarily on location of incident, however due to delays in data entry, may not yet be assigned for some recent deaths. Update Frequency: Weekly

Attributes:Week Starting on Monday – first date of the week, starting on Monday and ending on Sunday, when the death occurred. Number of suspected drug overdose deaths in Ottawa – number of suspected drug overdose deaths that occurred in Ottawa Contact: Ottawa Public Health Epidemiology Team

Monthly count of emergency department visits at Ottawa hospitals for patients diagnosed with an opioid overdose/poisoning

Accuracy: This data is specific to opioids and so counts will be lower than counts of suspected overdose related emergency department visits.

Opioid overdose visits include unscheduled emergency department visits where opioid poisoning was recorded as the main or other problem. Unconfirmed diagnoses are excluded.

Counts include all patients with an opioid overdose who are seen at Ottawa hospital emergency departments regardless of the patient's place of residence. Patients who reside outside of Ottawa and are seen at Ottawa hospitals are included.

Counts include all overdoses, regardless of the intent of the person who overdosed.

Cases include all ages and all levels of severity.

Counts are preliminary and may change over time as data is updated.

This data is not specific to the type of opioid (e.g. heroin or fentanyl) or the circumstances of it's use (therapeutic, recreational etc.).

Monthly counts of less than 5 will be suppressed for privacy purposes.

Source: National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health (CIHI)

Update Frequency: Monthly

Contact: Jason Haug