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 2023, Germany was responsible for over 16 percent of the world's total fentanyl consumption. This drug can be used as an analgesic and is about 100 times more potent than morphine. This statistic displays the distribution of the global fentanyl consumption by region.

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.

West Virginia is currently the state with the highest drug overdose death rate in the United States, with 82 deaths per 100,000 population in 2023. 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 2023, around ****** 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 *** 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 has 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.

In 2023, there were around ** overdose deaths involving fentanyl among non-Hispanic American Indian and Alaska natives in the United States per 100,000 population, making it the most affected ethnicity among every other in the analyzed period.

From 1999 to 2023, the number of drug overdose deaths among U.S. females increased from ***** in 1999 to ****** in 2023. 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.

Network of 46 papers and 57 citation links related to "Co-occurring Illicit Fentanyl Use and Psychiatric Disorders in Emergency Department Patients".

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.

Marijuana is by far the most used illicit drug in the United States, with over 64 million people using this drug in 2024. The second most used drug at that time was cocaine, followed by methamphetamine and ecstasy. The United States has had a complicated history with drugs, from fighting a “War on Drugs” starting in the 1970s, to seeing the legalisation of marijuana in many states, and experiencing an ongoing nationwide opioid overdose epidemic. Recreational marijuana Although marijuana is still illegal under federal law, 21 states have legalized the recreational use of marijuana. This legalization has opened a new and thriving market in these states. It is estimated that sales of legal cannabis will reach around 25 billion U.S. dollars by the year 2025. Although support for the legalization of marijuana has not always been strong, now around 68 percent of U.S. adults believe it should be made legal. The opioid epidemic The opioid epidemic describes a rise in overdose deaths in the U.S. due to prescription opioids, heroin, and illegally manufactured synthetic opioids such as fentanyl. The epidemic stems from misleading information from pharmaceutical companies concerning the dangers of opioids such as oxycontin, overprescribing of opioids from physicians, and an influx of easily accessible heroin and highly potent synthetic opioids. In 2022, there were around 81,806 deaths from opioid overdose in the United States.

This data contains 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 (see Technical notes) 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 (see Technical notes). Starting in June 2018, this monthly data release will include both reported and predicted provisional counts.

The provisional data include: (a) the reported and predicted provisional counts of deaths due to drug overdose occurring nationally and in each jurisdiction; (b) the percentage changes in provisional drug overdose deaths for the current 12 month-ending period compared with the 12-month period ending in the same month of the previous year, by jurisdiction; and (c) the reported and predicted provisional counts of drug overdose deaths involving specific drugs or drug classes occurring nationally and in selected jurisdictions. The reported and predicted provisional counts represent the numbers of deaths due to drug overdose occurring in the 12-month periods ending in the month indicated. These counts include all seasons of the year and are insensitive to variations by seasonality. Deaths are reported by the jurisdiction in which the death occurred.

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 (see Technical notes). 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 (see Technical notes). Provisional data will be updated on a monthly 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 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. 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 (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 2017 would include deaths occurring from July 1, 2016, through June 30, 2017. The 12-month ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. Counts for the 12-month period ending in the same month of the previous year are shown for comparison. 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. Methods to adjust provisional counts have been developed to provide predicted provisional counts of drug overdose deaths, accounting for delayed reporting (see Percentage of records pending investigation and Adjustments for delayed reporting).

Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period. Therefore, they should not be considered comparable with final data and are subject to change.

Cause-of-death classification and definition of drug deaths Mortality statistics are compiled in accordance with World Health Organization (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 regulations on use of the classification. Causes of death for data presented in this report were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual (2).

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). Drug overdose deaths involving selected drug categories are identified by specific multiple cause-of-death codes. Drug categories presented include: heroin (T40.1); natural opioid analgesics, including morphine and codeine, and semisynthetic opioids, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone (T40.2); methadone, a synthetic opioid (T40.3); synthetic opioid analgesics other than methadone, including drugs such as fentanyl and tramadol (T40.4); cocaine (T40.5); and psychostimulants with abuse potential, which includes methamphetamine (T43.6). Opioid overdose deaths are identified by the presence of any of the following MCOD codes: opium (T40.0); heroin (T40.1); natural opioid analgesics (T40.2); methadone (T40.3); synthetic opioid analgesics other than methadone (T40.4); or other and unspecified narcotics (T40.6). This latter category includes drug overdose deaths where ‘opioid’ is reported without more specific information to assign a more specific ICD–10 code (T40.0–T40.4) (3,4). Among deaths with an underlying cause of drug overdose, the percentage with at least one drug or drug class specified is defined as that with at least one ICD–10 multiple cause-of-death code in the range T36–T50.8.

Drug overdose deaths may involve multiple drugs; therefore, a single death might be included in more than one category when describing the number of drug overdose deaths involving specific drugs. For example, a death that involved both heroin and fentanyl would be included in both the number of drug overdose deaths involving heroin and the number of drug overdose deaths involving synthetic opioids other than methadone.

Selection of specific states and other jurisdictions to report Provisional counts are presented by the jurisdiction in which the death occurred (i.e., the reporting jurisdiction). Data quality and timeliness for drug overdose deaths vary by reporting jurisdiction. Provisional counts are presented for reporting jurisdictions based on measures of data quality: the percentage of records where the manner of death is listed as “pending investigation,” the overall completeness of the data, and the percentage of drug overdose death records with specific drugs or drug classes recorded. These criteria are defined below.

Percentage of records pending investigation

Drug overdose deaths often require lengthy investigations, and death certificates may be initially filed with a manner of death “pending investigation” and/or with a preliminary or unknown cause of death. When the percentage of records reported as “pending investigation” is high for a given jurisdiction, the number of drug overdose deaths is likely to be underestimated. For jurisdictions reporting fewer than 1% of records as “pending investigation”, the provisional number of drug overdose deaths occurring in the fourth quarter of 2015 was approximately 5% lower than the final count of drug overdose deaths occurring in that same time period. For jurisdictions reporting greater than 1% of records as “pending investigation” the provisional counts of drug overdose deaths may underestimate the final count of drug overdose deaths by as much as 30%. Thus, jurisdictions are included in Table 2 if 1% or fewer of their records in NVSS are reported as “pending investigation,” following a 6-month lag for the 12-month ending periods included in the dashboard. Values for records pending investigation are updated with each monthly release and reflect the most current data available.

Percent completeness

NCHS receives monthly counts of the estimated number of deaths from each jurisdictional vital registration offices (referred to as “control counts”). This number represents the best estimate of how many deaths occurred in a given jurisdiction in each month. Death records in the NVSS

In 2023, Estonia had the highest incidence of drug-induced deaths in Europe at *** per million population. This was followed by Latvia at *** deaths per million population, and ** deaths per million in Norway. On the other hand, in Romania, there were only * drug-induced deaths per million population in 2023. Number of drug-induced deaths There were nearly *** thousand drug-related deaths reported in the EU in 2022. There was a steady increase in the number of deaths in the EU from only *** thousand cases in 2013. When combined with Turkey and Norway, the number of drug-induced deaths in 2022 nearly reached ***** thousand. This was the highest number of drug-related deaths recorded in the given period. Drug deaths by gender and age In 2022, 77 percent of drug-induced deaths reported in the EU were attributed to men. Half of the deaths that occurred among men were among those aged between 25 and 44 years. Similarly, the largest share of female deaths due to drug use was also reported in the same age group.

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.

In 2023, around ** kilograms of fentanyl were consumed in Japan for medical reasons, the lowest amount of the past decade. Consumption decreased steadily over the last ten years, starting at around ***** kilograms in 2014.Fentanyl is used in Japan as medical narcotic for people suffering from great physical pain, such as late-stage cancer patients.

It is estimated that around *** percent of the global population uses illicit drugs. Use of illicit drugs varies by country and region as countries enact their own laws regarding such substances. Access to illicit drugs also differs by country and region and culture plays a role in how acceptable drug use is. Global drug use Worldwide, cannabis is by far the most used illicit drug, followed by opioids and amphetamines. It is estimated that around *** million people worldwide consume illegal drugs and **** million could be considered addicts or problem drug users. Drug addiction and abuse can negatively impact relationships, increases the risk of a number of diseases, and can ultimately lead to death. Opioid epidemic in the U.S. The United States has a long and complicated history with illegal drugs, once going so far as to fight a “War on Drugs”. Today, the U.S. is experiencing what has been called an opioid epidemic. This has been characterized by an increase in overdose deaths from prescription opioids, heroin and, more recently, illegally manufactured synthetic opioids, such as fentanyl. In 2021, there were ****** opioid overdose deaths in the United States.

Fentanyl is a synthetic opioid used particularly in the treatment of pain in cancer patients. It is most commonly administered using a patch directly applied to the skin. It is believed to be 100 times more potent than morphine. It is often sold as a heroin-like substance to recreational opioid users. As of 2017, the price of 1 kg of pure fentanyl for a drug trafficking organization (DTO) was about 4,150 U.S. dollars. Comparatively, heroin sold to DTOs for about 6,000 U.S. dollars. The revenue generated from 1 kg of fentanyl by a DTO is estimated to equal about 1.6 million U.S. dollars.

The U.S. opioid epidemic

The U.S. is currently experiencing an opioid use epidemic like it has never seen before. The United States is responsible for the greatest share of fentanyl consumption globally. The total number of heroin users in the U.S. has increased over the last several years. Opioids are obtained through both illegal and legal methods in the United States as drugs like hydrocodone, oxycodone and morphine are commonly distributed by doctors.

Fighting the epidemic

A recent survey among law enforcement personnel found that a large percentage of those working in the Mid-Atlantic, New England and New York/New Jersey area said that heroin was highly available in their regions. However, despite law enforcement’s awareness of the opioid epidemic there are still several barriers that prevent successful reductions in opioid use. A recent survey found that a majority of adults believed that the overprescribing of opioids and lack of access to treatment are significant barriers in the fight against the opioid epidemic.

During 2024, there were a total of 7,146 deaths from opioid overdose in Canada, 2,231 of which occurred in the province of Ontario. This statistic shows the number of deaths from opioid overdose in Canada in 2024, by province. Opioid Use and Misuse Opioids are commonly prescribed as both short-term and long-term pain management strategies. Unfortunately, opioids are sometimes used problematically, including taking increased amounts, tampering with the route of administration, or using with the goal to improve mood, all of which can lead to addiction, overdose, and even death. In 2023, there were around 6,462 hospitalizations in Canada due to opioid poisoning. Opioid Crisis in Canada Among Canadian adults, the majority view the opioid issues of the country as a serious problem or a crisis. Moreover, many opioid deaths also involve the use of a stimulant, which adds to the polysubstance nature of the opioid crisis. Efforts against the opioid crisis in Canada are multi-faceted. One way is focused on reducing possible harm from using illicit opioid sources such as heroin or other street opioids through the use of opioid agonist treatment methods including methadone and naloxone.

In 2024, it was estimated that around *** thousand people in the United States used crack in the past month. Crack cocaine is the solid form of cocaine, and it is typically smoked to give an instant but short euphoric high. Crack is highly addictive and a rise in its use in the 1980s and early 1990s was associated with an increase in crime and violence in parts of the United States as well as stricter drug policies and an increase in incarceration rates. How many people have used crack? It is estimated that as of 2023, around *** million people in the United States had used crack in their lifetime. However, the use of cocaine, the powder form of crack that is usually snorted but can also be injected, is much more common than crack. It is estimated that over ** million people have used cocaine in their lifetime, making it the second most-used illicit drug in the United States. Marijuana is by far the most used illicit drug in the United States. Opioids: The newest drug epidemic Although the United States experienced a crack epidemic in the 1980s and early 1990s, crack is no longer the most feared drug in the country. Opioids now account for the vast majority of drug overdose deaths in the U.S. with the country currently experiencing what has been called an opioid epidemic. In 2021, there were just over ****** deaths due to opioid overdose in the United States, the highest number ever recorded. Although the origins of the opioid epidemic lie in misrepresentation and over prescription of opioids by pharmaceutical companies and physicians, illegally manufactured fentanyl, an extremely potent synthetic opioid, now accounts for most opioid overdose deaths.

This statistic displays the total number of drug deaths in the Netherlands in 2022, by type. In that year, there were *** drug-related deaths in the Netherlands. Over half of these deaths were caused by opioids. Cocaine was responsible for another ** deaths. Rising drug-induced deaths across Europe From 2010 to 2023, the annual number of drug deaths in the Netherlands increased by over three times, rising from ** to *** deaths per year. The Netherlands is not alone in grappling with drug-related deaths. Across the European Union, there has been a notable increase in drug-induced fatalities over the past decade. In 2022, nearly *** thousand people died from illicit drug overdoses in EU countries, with this number rising to almost ***** thousand when including Norway and Turkey. Demographics and risk factors The majority of drug-induced deaths in Europe occur among individuals aged 25 to 44 years, with men being disproportionately affected. In 2023, ** percent of male drug deaths and ** percent of female drug deaths fell within this age group. Notably, opioids play a significant role in drug-related fatalities across Europe, with countries like Denmark, Austria, and Latvia reporting that over ** percent of their drug-related deaths involved opioids.

In 2023, there were ***** deaths in Germany that were caused by the consumption of drugs. *** of those deaths were the effects of long-term damage done by drug use. The second most common cause of death was from heroin or morphine in combination with other drugs.

In 2024, there were a total of 7,146 deaths in Canada due to opioid overdose, with around 28 percent of deaths occurring among those aged 30 to 39 years. This statistic shows the distribution of deaths from opioid overdose in Canada from 2016 to 2024, by age.