Updated on May 17, 2024
5 min read

Updated Overdose Statistics 2024: Trends in Drug-Related Deaths

The United States is affected by a rapidly changing overdose crisis. The surge of stimulants, fentanyl, and the impact of the COVID-19 pandemic has affected overdose trends.

Understanding the complexity behind overdoses is crucial for creating effective interventions and saving lives: 

  • Over 106,000 Americans died from drug overdoses in 2021, a staggering number that marks the highest annual total on record.
  • Synthetic opioids, primarily fentanyl, were involved in over 70,000 of those overdose deaths.
  • Black Americans saw a 44% increase in overdose deaths in just one year.
  • American Indian and Alaska Native (AIAN) people had the highest overdose death rates in both 2020 and 2021.

This article draws on the most recent and reliable data sources available. These include government agencies like the Centers for Disease Control (CDC), the National Institutes of Health (NIH), and peer-reviewed medical journals.

Trends in Overdose Deaths by Drug Type

In 2021, over 106,699 Americans died from drug overdoses, marking a 14% increase from 2020⁠—the highest annual total on record. Synthetic opioids, like fentanyl, were the main driving force for increasing overdose deaths in many areas.

Overdose deaths by drug type include:

  • Fentanyl: Synthetic opioids (mainly fentanyl) are growing at the fastest and deadliest pace, standing at 70,601 overdose deaths in 2021.
  • Heroin: Deaths involving heroin reached a peak in 2017 but have since trended downward, with 9,173 deaths in 2020.
  • Stimulants: Overdoses involving cocaine and methamphetamine continue to rise rapidly, reaching a combined total of 32,537 deaths in 2021.
  • Benzodiazepines: These medications are increasingly involved in overdoses, contributing to 12,499 deaths in 2021.
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Males accounted for 69% of drug-involved overdose deaths in 2021. The vast majority (77%) of preventable drug overdose deaths involve opioids, totaling 75,785 lives lost in 2020.

After opioids, stimulants like methamphetamine claimed the second highest number of lives through preventable overdose in 2021, reaching 31,607 deaths.

Demographic Disparities in Overdose Rates

The U.S. overdose crisis reveals deep disparities across different populations across race, age, gender, and other factors.

Racial and Ethnic Disparities

While overdose deaths rose for all groups, the increase was more severe within communities of color. For example, American Indian and Alaska Native (AIAN) and Black individuals had the highest overdose death rates in 2021. 

  • Black Americans saw a 44% increase in overdose deaths in just one year. 
  • American Indian and Alaska Native (AIAN) overdose death rates were the highest across all groups in both 2020 and 2021. 
  • Increases are also evident in specific states, such as a 42% rise in overdose deaths among Black individuals in Massachusetts from 2021 to 2022. 
  • Alcohol-induced deaths also spiked during the pandemic, with AIAN people experiencing a death rate six times higher than the next group.

Age and Gender

  • AIAN men aged 25 to 44 have some of the highest overdose death rates, on par with white men in the same age group. 
  • Overdose deaths among men remain consistently higher, though rates for specific substances, like opioids, are rising faster among women 

Socioeconomic and Geographic Factors

  • Areas with greater income inequality see more overdose deaths. 
  • Urban areas often have higher rates, but AIAN communities in both urban and rural settings are severely impacted. 
  • Within cities, overdose deaths can be highly concentrated in specific neighborhoods, highlighting local disparities 
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Geographic Patterns of Overdose Mortality

The overdose crisis isn't evenly distributed across the United States. Here's a look at the trends and geographic variations:

National Snapshot

The largest relative increase in synthetic opioid-related deaths from 2018 to 2019 occurred in the Western United States (67.9%). Meanwhile, the northeast region saw the largest relative increase in psychostimulant-related deaths in the same period (43.8%).

  • Some of the highest mortality rates are in counties near the Kentucky/West Virginia border, plus areas of New Mexico, Alabama, Indiana, Tennessee, and Virginia.
  • From 1980 to 2014, areas in Kentucky, West Virginia, Ohio, Indiana, and eastern Oklahoma saw the most dramatic increases in mortality, with some exceeding 5,000%.

Synthetic Opioids & Psychostimulants

When synthetic opioids are present, death rates for prescription opioids, heroin, cocaine, and psychostimulants all increase. Without synthetic opioid involvement, only psychostimulant and cocaine deaths show an increase.

  • From 2013 to 2019, deaths involving synthetic opioids (other than methadone) soared by 1,040% and were involved in nearly 88% of overdoses in 2021.
  • Deaths involving psychostimulants (like methamphetamine) rose by 317% from 2013 to 2019, both with and without the presence of synthetic opioids 

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Polysubstance Use and Overdose Risk

Polysubstance use involves using multiple drugs simultaneously or overlapping them. It’s a major factor that increases the risk of an overdose.

Combining substances can create unpredictable and often more dangerous effects. Here's what the data shows:

Overdose Deaths Involving Multiple Substances

  • A significant portion of the 106,699 drug overdose deaths in 2021 involved multiple substances
  • Deaths involving stimulants (cocaine and psychostimulants like methamphetamine) continue to rise, reaching 32,537 in 2021. 
  • Benzodiazepines, often combined with other drugs, were involved in 12,499 deaths in 2021, steadily increasing since 2015.

Impact of the COVID-19 Pandemic on Overdose Deaths

The COVID-19 pandemic worsened the already devastating drug overdose crisis.  Key statistics and findings illustrate the impact:

  • The pandemic worsened mental health, with 40% of adults reporting anxiety or depression symptoms in early 2021. 
  • Isolation, economic hardship, and health fears are linked to increased substance use and overdoses. 
  • From 2019 to 2020, overdose deaths rose 30%, with opioid overdoses surging by 45%. 

The COVID-19 pandemic amplified the overdose crisis, highlighting both the rise in overdose deaths and existing systemic inequities. It also showed the urgent need for better treatment access and harm reduction. 

It also increased the need for addressing the root causes that make communities vulnerable. This involves addressing mental health, substance use, and support services for the hardest-hit communities is essential.

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Response and Prevention Efforts

The fight against the overdose crisis needs powerful tools. Treatment programs that battle multiple addictions at once, lifeline tools like Naloxone, fentanyl test strips, and innovative strategies like Overdose Prevention Centers (OPCs) are key to saving lives and addressing the risks of polysubstance use.

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Updated on May 17, 2024
17 sources cited
Updated on May 17, 2024
  1. CDC. “Drug Overdose Deaths Rise, Disparities Widen.” Centers for Disease Control and Prevention, 2022. 
  2. Conway et al. “Impact of COVID-19 among people who use drugs: A qualitative study with harm reduction workers and people who use drugs.” Harm Reduction Journal, 2022.
  3. CDC. “Drug Overdose Deaths.” Centers for Disease Control and Prevention, 2024. 
  4. Drug Overdoses - Data Details.” - Injury Facts, 2023.
  5. Dwyer-Lindgren et al. “Trends and Patterns of Geographic Variation in Mortality From Substance Use Disorders and Intentional Injuries Among US Counties, 1980-2014.” JAMA, 2018.
  6. Knoebel, R. W., & Kim, S. J. “Impact of COVID-19 Pandemic, Social Vulnerability, and Opioid Overdoses in Chicago.” AJPM Focus, 2023.
  7. Massachusetts opioid-related overdose deaths rose 2.5 percent in 2022.” Mass.gov., 2022. 
  8. Mattson et al. “Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths — United States, 2013–2019.” Morbidity and Mortality Weekly Report, 2021.
  9. Mbabazi et al. “Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020.” Morbidity and Mortality Weekly Report, 2022.
  10. New York City Releases. “Overdose Data Showing Unprecedented Overdose Levels - NYC Health.” Nyc.gov. 2021. 
  11. NYU Web Communications.” Nyu.edu. 2022. 
  12. NIDA. “Drug Overdose Death Rates.” National Institute on Drug Abuse, 2023.
  13. CDC. “Products - Data Briefs - Number 457.” Centers for Disease Control and Prevention, 2024. 
  14.  Gramlich, J. “Recent surge in U.S. drug overdose deaths has hit Black men the hardest.” Pew Research Center, 2022. 
  15.  Doyle, S. “Opioid Overdose Crisis Compounded by Polysubstance Use.” Pewtrusts.org; The Pew Charitable Trusts, 2020.
  16.  Panchal et al. “The Implications of COVID-19 for Mental Health and Substance Use.” KFF, 2023.
  17. SubstanceUse Has Risen During COVID-19 Pandemic.” Senate.gov., 2022.

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