Updated on May 17, 2024
9 min read

Fentanyl Statistics 2024: Up-to-Date Facts on Abuse and Overdose

The United States is in the middle of a devastating opioid epidemic, and its deadliest driver is fentanyl. This synthetic opioid, far more potent than heroin, is fueling a tragic and alarming surge in overdose deaths.

Here's why the fentanyl crisis demands urgent action⁠—and why it's a critical issue today:

  • Drug overdose deaths have skyrocketed in recent years. In 2021 alone, over 107,000 Americans died of overdoses⁠—the highest total ever recorded. Fentanyl and other synthetic opioids are overwhelmingly responsible for this catastrophic loss of life.
  • Nearly 71,000 of those 2021 overdose deaths involved synthetic opioids, primarily fentanyl. This means fentanyl is now linked to roughly two-thirds of all fatal drug overdoses in the U.S.
  • No demographic is immune to fentanyl's devastation. Deaths are spiking among various racial groups, younger populations, and older adults. The crisis cuts across state lines, impacting rural and urban areas alike.

This article utilizes the most up-to-date statistics available to provide an accurate picture of the fentanyl crisis in 2024. For some statistics, the most up-to-date information will be cut off in 2021. We’ll update this article as more up-to-date information becomes available.

Quick Facts about Fentanyl

  • Fentanyl is a powerful synthetic opioid that is 50-100 times stronger than heroin or morphine.
  • In 2021, over 100,000 drug overdose deaths occurred in the US. Opioids like fentanyl were involved in most (over 75%) of these deaths.
  • Nearly 9 out of 10 opioid overdose deaths in 2021 involved synthetic opioids like fentanyl.
  • Every day, over 150 people die from overdoses involving synthetic opioids like fentanyl.
  • Since 2015, fentanyl has been involved in a growing number of overdose deaths. It was implicated in 20% of benzodiazepine-involved deaths in 2015, rising to 70% by 2021.
  • In 2022 alone, fentanyl caused about 200 deaths per day. Over a quarter million Americans have died from fentanyl overdoses since 2018.
  • Fentanyl overdoses more than doubled between 2019 and 2022, with over 73,000 deaths in 2022.
  • Fentanyl has been linked to over half of all drug overdose deaths since 2019. By 2022, it was involved in around 70% of overdose deaths.
  • In 2021, fentanyl accounted for over 67,000 preventable deaths, rising 26% from 2020.

The Rise of Fentanyl: Key Overdose Trends

The overdose crisis driven by fentanyl is a stark reality in the US. Here's what the numbers show:

  • Overdose deaths involving synthetic opioids (including fentanyl) increased by over 22% from 2020 to 2021.
  • In 2021, almost 71,000 overdose deaths involved synthetic opioids.
  • This rate is a shocking 22 times higher than the rate in 2013.
  • Since 1999, over 1 million people have died from drug overdoses.
Fentanyl addiction chart
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Fentanyl's Impact on Different Populations

Fentanyl's Impact on Black Americans

  • Between 2013 and 2020, fentanyl overdose rates for Black males increased by a shocking 6,980% and for Black females by 2,140%.
  • In 2020, the fentanyl overdose death rate for Black Americans was more than twice that of Hispanics and 27% higher than that of whites.
  • In the Midwest, 2020 crude rates for fentanyl overdoses were 60 deaths per 100,000 Black males compared to 25 per 100,000 white males. For Black females, the rate was 20 deaths per 100,000 compared to 10 among white females.
  • Illicit fentanyl has significantly driven increased overdose deaths in urban areas, disproportionately impacting Black communities.
  • In metropolitan areas, middle-aged Blacks (45–64 years) saw a doubling of opioid overdose deaths from approximately 20 to 42 per 100,000.
  • Black individuals aged 15–24 experienced the largest percentage increase (86%) in overdose deaths compared to other age/racial groups.
  • Black Americans often face challenges accessing buprenorphine, a medication for opioid use disorder, and are far less likely to receive a prescription than white patients.
  • In 2020, the overdose death rate among Black males 65 years and older was nearly seven times that of white males of the same age.

Fentanyl's Impact on Hispanic Americans

  • In California, fentanyl was involved in 40.2% of overdose deaths among Latinos in 2017, followed by heroin (31.2%) and cocaine (26.8%).
  • From 1999 to 2017, opioid-related death rates among Latinos nearly doubled, with large increases seen in deaths related to synthetic opioids.
  • In 2019, Latino overdose deaths linked to heroin and fentanyl increased by 1.3 and 2.2 times their 2018 rates, respectively.
  • The age-adjusted fentanyl-related death rate among Latinos more than doubled from 1.4 (2018) to 3.1 (2019).
  • Overdose deaths among Latinos have nearly tripled since 2011.
  • Between 2007 and 2019, fatal overdoses among Latinos from opioids mixed with cocaine rose 729%, and when mixed with methamphetamines, they rose a staggering 4,600%.
  • In Nevada, while drug overdose deaths increased by 54.5% from 2019 to 2020 across all races and ethnicities, the increase was a shocking 119.7% among Latinos.
  • In Cook County, the number of Latinos who died from an opiate overdose in 2020 was nearly twice the number of deaths recorded in 2019.

Fentanyl's Impact on Native Americans

  • The American Indian and Alaska Native (AI/AN) population had the highest drug overdose death rates in both 2020 and 2021, exceeding the rates of any other racial or ethnic group. These rates were 42.5 and 56.6 deaths per 100,000 persons, respectively.
  • Drug overdose deaths within the AI/AN population increased by a staggering 33% from 2020 to 2021.
  • In 2021, 1,358 non-Hispanic AI/AN people died by overdose – the highest recorded rate of any racial or ethnic group.
  • American Indian and Alaska Native residents in Washington state have the highest death rates from synthetic opioid overdoses; at least 203 individuals died between 2018 and 2022.
  • In King County, Washington, Indigenous residents died at more than nine times the rate of white residents in 2022.
  • Overdose deaths among Native Alaskans increased by over 40% during the pandemic (2019-2020).
  • In 2021, the overdose rate for Alaska Natives and American Indians was a devastating 77.7 per 100,000 people, vastly exceeding the rate of 28.8 for White Alaskans.

Fentanyl's Impact on Young and Older Americans

General Trends

  • 70% of all deaths involving benzodiazepines in 2021 also involved fentanyl, highlighting the increasing co-occurrence of these substances.
  • Opioid-involved overdose deaths skyrocketed from 21,089 in 2010 to 80,411 in 2021, with much of the increase driven by synthetic opioids like fentanyl.

Impact on Youth and Young Adults

  • In Washington state, by 2020, fentanyl-related deaths among those under 30 had doubled to eight per 100,000.
  • In Los Angeles County, most fentanyl overdose deaths occurred in adults aged 40-64 (46%) and 26-39 (39%), with young adults aged 18-25 accounting for 11%.
  • Nationally, 71% of preventable opioid deaths occur among those aged 25 to 54. However, overdose deaths among individuals 55 and older are rising rapidly.

Impact on Older Adults

  • Older adults aged 65+ made up 5% of fentanyl overdose deaths in Los Angeles County.
  • In 2022, fentanyl overdose death rates per 100,000 were:
    • Adults aged 26-39: 36.5
    • Adults aged 40-64: 26.4
    • Young adults aged 18-25: 19.4
    • Older Adults 65+: 5.9
    • Youth 17 and under: 0.5

Nationwide Impact

  • Drug poisonings are a leading cause of death for Americans ages 18-45, with nearly 70% of these deaths in 2022 caused by fentanyl and other synthetic opioids.
  • Drug overdose death rates in 2021 exceeded 2020 rates for all age groups 25 and over.

It’s evident from these statistics that while fentanyl's reach is devastatingly widespread Systemic inequities mean that some populations are bearing a heavier burden than others.

Understanding the disproportionate impact of fentanyl is crucial for developing targeted, effective interventions and prevention strategies. 

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Fentanyl and Other Drugs Statistics

Polysubstance use, involving the combination of fentanyl with other drugs, has become a significant concern due to the increased risk of overdose and death. Here are key statistics highlighting the extent of this issue:

General Polysubstance Use

  • Nearly half of all drug overdose deaths in 2019 involved multiple drugs.
  • 71% of all drug overdose deaths involved fentanyl. The majority (76%) of these deaths included multiple substances.

Specific Drug Combinations

  • Opioids were involved in approximately 9 out of 10 cases of polysubstance deaths in 2021. 
  • Of those combinations, 41.1% involved methadone, 39.1% heroin, 9.9% buprenorphine, and 13.5% an illicit opioid other than methadone or buprenorphine. 
  • Combinations involving cocaine rose from less than one-third of cases in 2011 (30.8%) to over half in 2021 (57.8%).
  • A study revealed these latent classes of polysubstance overdose deaths:
    • Fentanyl/heroin/cocaine (64%)
    • Fentanyl/alcohol (18%)
    • Prescription drugs including opioids, benzodiazepines, and antidepressants (18%).

Geographic and Demographic Patterns

  • In Maryland, overdose deaths were concentrated in two counties (Baltimore City and County), with significant differences in polysubstance use patterns across demographics and locations.
  • The presence of xylazine, a veterinary tranquilizer, in drug samples that contained opioids increased significantly between 2020-2021, with the South experiencing the largest increase.

Impact of Polysubstance Use

  • Polysubstance use, particularly when fentanyl is involved, dramatically increases the risk of overdose and death due to fentanyl's potency.
  • Combining opioids with other depressants (alcohol, benzodiazepines) can cause severe respiratory depression, further increasing fatal overdose risk.

Fentanyl's Influence During the Pandemic

The COVID-19 pandemic has exacerbated the opioid overdose crisis in the United States, with fentanyl playing a major role in the increase in overdose deaths. Here are some key statistics and findings regarding fentanyl during the pandemic:

  • Overdose Deaths: The number of people who died from a drug overdose in 2021 was over six times the number in 1999. The number of drug overdose deaths increased more than 16% from 2020 to 2021, with over 75% of the nearly 107,000 drug overdose deaths in 2021 involving an opioid
  • Synthetic Opioids: Synthetic opioid-involved death rates (excluding methadone) increased by over 22% from 2020 to 2021. Nearly 71,000 drug overdose deaths involved synthetic opioids other than methadone in 2021
  • Third Wave of Opioid Overdose Deaths: The third wave of the opioid overdose epidemic began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl
  • Harm Reduction Services: Access to harm reduction services, including naloxone and fentanyl test strips, was highlighted as a source of hope and community resiliency during the pandemic

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Treatment and Recovery: Options and Success Rates

Despite the devastating impact of the opioid crisis, it's important to remember that recovery is possible. Millions of Americans have successfully overcome both opioid and alcohol use problems. 

While the paths to recovery can differ, understanding patterns of treatment, support services, and the duration of substance use offers valuable insights for helping others on their recovery journey.

  • Nearly 1.2 million people in the U.S. have resolved an opioid use problem, including an estimated 259,260 (1%) in the past year and 489,465 (2.2%) in the last 1-5 years.
  • In comparison, approximately 11.4 million people have resolved an alcohol use problem, with an estimated 1.6 million (7%) in the past year and 2.6 million (12%) in the last 1-5 years.
  • Individuals in mid-recovery (1-5 years) from opioids reported significantly higher rates of treatment utilization, recovery support services, mutual-help group attendance, and medication use compared to those in mid-recovery from alcohol.
  • Those with primary opioid problems used for an average of 8-9 years before achieving recovery, compared to 22-23 years for those with primary alcohol problems.
  • Use of medications for opioid use disorder (e.g. buprenorphine, methadone) was more common among those in mid-recovery from opioids compared to alcohol.

Fentanyl Statistics by State

Here are some fentanyl statistics by state:

States with the Highest Rates of Fentanyl Overdose Deaths

  • West Virginia had the highest rate at 60.8 deaths per 100,000 people in 2022.
  • The District of Columbia also had a high rate of 46.3 per 100,000 people.

States with the Lowest Rates of Fentanyl Overdose Deaths

  • South Dakota had the lowest rate of fentanyl overdose deaths among states in 2022 at 4.2 deaths per 100,000 residents.

Total Fentanyl Deaths by State

  • California had the most total fentanyl overdose deaths in 2022, with 6,453.
  • Florida and New York followed with 5,083 and 4,950 total deaths, respectively.

Summary

These alarming statistics highlight the urgent need for change. We must address the factors contributing to the fentanyl crisis on multiple fronts. 

This includes expanding access to treatment, harm reduction strategies, and interventions tailored to the hardest-hit states.

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Updated on May 17, 2024
27 sources cited
Updated on May 17, 2024
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