Drug Overdose Deaths with Illegally Made Fentanyls Detected Started to Decline in Late 2023

In 2023, nearly 7 in 10 overdose deaths were estimated to involve fentanyl, which is primarily illegally made. A new report based on data from CDC's State Unintentional Drug Overdose Reporting System (SUDORS) finds drug overdose deaths overall, and deaths with illegally made fentanyls (IMFs) started to decline in late 2023 across the U.S.

• These declines started earlier in the Northeast, Midwest, and South, where the percentages of deaths with IMFs detected were stable, compared to the West, where there was an increase in the percentage of overdose deaths with IMFs detected into 2024.
• Although still rare, there was a sharp increase in overdose deaths where carfentanil, a fentanyl analog 100 times more potent than fentanyl, was detected. Deaths with carfentanil were reported in 37 states during 2023 and the first half of 2024.
• Nearly all deaths with carfentanil also had IMF detected, suggesting the mixing of carfentanil into the fentanyl supply.

Even with the decline of drug overdose deaths involving IMFs, IMFs remain the leading driver of overdose deaths in the U.S. Sharp increases in carfentanil detection, while still rare, highlight a constantly changing illegal drug supply that could threaten progress in reducing overdose deaths. Overdose prevention efforts that address the widespread presence of IMFs and can rapidly adapt to more potent opioids (e.g., carfentanil) in the drug supply might result in lasting overdose death reductions across the entire U.S. Increasing access to naloxone and linking people to effective treatment for substance use disorders, can help prevent overdose deaths.

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