Overdose Deaths by the Numbers

ByAngelique Cruz
Edited byAliha Strange

Updated: February 11, 2024

ByAngelique Cruz
Edited byAliha Strange

Updated: February 11, 2024

Advertising & Editorial Disclosure

The drug crisis has stolen precious lives for many years. As of 2020, there have been over 932,000 fatalities associated with drugs in the U.S. Numbers from the Centers for Disease Control (CDC) show that overdose deaths have been increasing through the years. In 2020 alone, drug overdose deaths totaled 91,799. Almost 75% involved opioids. Out of the opioid-related deaths, over 82% were synthetic, excluding methadone. From 2018 to 2019, only two states saw a decrease (Arkansas and Michigan). From 2019 to 2020, 12 states had stable rates, but the remaining 38, plus the District of Columbia, showed an increase.

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Total Number of Overdose Deaths

Drug overdose has wreaked havoc on Americans across the country for years. The crisis has gotten to the point where several thousand Americans die each year from drug overdosing. The graph below details the numbers.

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It's worth noting that each year reported numbers have fallen below the predictions. However, overdose deaths, in general, have been increasing since 2017. The only exception is 2018, when figures (reported and predicted) went down by around 4.2%.

The most significant increase occurred between 2019 and 2020. Overdose deaths rose about 30%, from 71,130 to 92,478. Numbers continued to increase in 2021. Although it uses provisional data, 2021 numbers show that overdose deaths are almost 17% higher than the previous year.

Fentanyl contaminates more illicit and counterfeit prescription drugs, putting more people at risk of overdosing. The possibility of dying from taking one pill is higher if it's laced with fentanyl.

Overdose Deaths by Drug Type

Drug use has been present in the U.S. for several decades, and overdose deaths are an ongoing concern. However, some drugs result in more fatalities than others. The graph below explores this further.

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Overdose deaths connected to fentanyl contributed the most for both years, comprising around half of the total fatalities. The contributions of the other drugs were as follows:

  • Psychostimulants (Meth): 23.12% (21.18% in 2020)
  • Cocaine: 17.26% (17.17% in 2020)
  • Natural/Semisynthetic (Prescription): 9.50% (11.82% in 2020)

The general trend shows that overdose deaths increased from 2020 to 2021. The sole exception is those involving natural or semisynthetic ones (prescription drugs) — fatalities decreased slightly from 13,722 to 13,503.

Although there were 13,404 additional overdose deaths involving fentanyl in 2021, the most considerable difference was from the use (or misuse) of psychostimulants (meth). The number of fatalities increased by almost 34% from 2020.

Overdose Deaths by Age Bracket

Poisoning, which includes overdosing, is the leading cause of preventable home death and injuries across all ages.

MoneyGeek analyzed overdose statistics in several ways — one of which was age. The bar graph below shows when overdose deaths were more likely to occur and how many involved opioids.

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Although the number of overdose deaths varies between age groups, it's worth noting that every age group struggles with this disease. Counts were highest in the following groups (descending order):

  • 35 to 44: 22,710
  • 25 to 34: 21,784
  • 45 to 54: 18,919
  • 55 to 64: 15,819

The other age groups have 4-digit counts or fewer overdose deaths.

In 2020, most preventable drug overdoses (77%) involved opioids. Unfortunately, most of them (18,239) occurred between the ages of 25 and 34.

Opioid deaths also comprise more than 80% of all fatalities from overdoses in the following age groups:

  • 15 to 24: 84.37%
  • 25 to 34: 83.73%
  • 1 to 4: 82.86%

Opioid deaths affected the 85 and older age group the least, with less than 30%.

Overdose Deaths by Sex

Besides age, the number of overdose and opioid deaths differs between sexes. In 2020, more overdose and opioid deaths involved more males than females. The graph below breaks this down.

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The number of overdoses, including opioid-related deaths, among males was more than twice as much as in females.

However, the contribution rate of opioids in these is high for both sexes. Over 76% of male overdose deaths involved opioids. In comparison, overdose fatalities in females were at 71%.

Overdose Deaths by Race and Ethnicity

Another angle to consider when analyzing opioid overdose statistics is the difference between races and ethnicities. According to Kaiser Family Foundation (KFF) data, over half of deaths involve white non-hispanics. The pie chart below provides more information.

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Almost 70% of opioid deaths in 2020 involved white non-Hispanics. It's more than double the number of opioid fatalities from the other ethnicities in their data.

Black non-Hispanics and Hispanics comprised about 28% of all recorded opioid deaths in 2020. The former contributed 17% of fatalities, while the latter approximately 11%

KFF couldn't determine the ethnicity of a small portion of the population (2.1%).

Overdose Deaths per State

Does the number of overdose deaths vary in different areas? Yes, they do. The heat map below shows the fatality count from overdosing per state. Darker colors represent states with higher incidents, while lighter shades show fewer occurrences.

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Among all states, California had the most opioid deaths in 2020 at almost 9,000. Other high-count states were as follows:

  • Florida: 7,231
  • Ohio: 5,204
  • Pennsylvania: 5,168
  • New York: 4,965

In comparison, Wyoming and South Dakota had the fewest, at 99 and 83, respectively.

Knowing overdose statistics is one thing, but seeing how it relates to an area's population is another. That's where the death rate comes in. For example, although California has the most opioid deaths at 8,908, its death rate is only 13.7 per 100,000 population.

West Virginia, with only 1,129 recorded incidents in 2020, has the highest death rate at 70. The states with the lowest mortality rates are Hawaii and Nebraska, both with a 5.3 per 100,000 population.

The Drug Overdose Epidemic: An Overview

Most understand the dangers of drug use, but not everyone knows how extensive the problem is. It has become so widespread that it’s considered an epidemic.

Between 2016 and 2018, the government enacted three federal laws to address it:

Unfortunately, drug overdose deaths increased by 30% from 2019 to 2020. Those specifically involving opioids went up by 38%. Using provisional data, the CDC estimates opioid deaths increased by over 10,700.

The Opioid Epidemic

Opioids are not the sole substance behind overdose deaths in the U.S., but they are the most significant contributor to the overdose crisis. Since 1999, over 564,000 people have died from an opioid overdose. That's almost 61% of all recorded overdose deaths.

The nature of opioids is that it causes the body to release endorphins, which diminish pain while increasing pleasure. They are generally safe to use when taken for short periods (which usually happens when physicians prescribe them as a form of pain relief). Its effects produce a temporary sense of well-being, and some users want to repeat or prolong the experience. This continuous craving (and giving in to it) leads to addiction.

The Opioid Waves

The opioid crisis has been present since the ‘90s and has had devastating effects. These include premature death, shorter life expectancy and more cases of some medical conditions like hepatitis C and HIV.

Over the years, there have been three opioid waves connected to specific drugs. The sections below detail this further.

Wave
Primary Drug/Opioid
Wave Duration
Epidemic Description

1

Prescription
Opioids

1996–2010

In the early ‘90s, doctors prescribed opioids sparingly — usually
only as pain management for people with a terminal illness like
cancer, who were severely injured or had surgery.

However, things changed in 1996. The purpose of prescribed
opioids expanded, and doctors began prescribing them to
patients suffering from chronic conditions.

2

Heroin

2010–2013

The increase in heroin-related overdoses triggered the second
opioid wave in 2010. Procuring opioids became more
challenging, with actions taken to curb their prescription. As a
result, people began turning to heroin, a semisynthetic opioid
created from opium poppies.

There is no accepted medicinal use for heroin, making it illegal
in the U.S. However, it's widely available, making it easy to
obtain.

3

Fentanyl

2013–Present

After several years, the drug of choice shifted from heroin to
fentanyl. It's a synthetic drug similar to morphine but 50 to 100
times more potent. Some doctors prescribe it to opioid-resistant
patients, making regular painkillers less effective.

In 2013, deaths from fentanyl started increasing, triggering the
third opioid wave. The challenge is that the market for it is still
changing. You'll also find it in combination with other drugs, such
as cocaine and heroin.

Opioids Linked to Overdosing

The opioid waves were due to rising overdose deaths associated with three specific drugs — prescribed opioids, heroin and fentanyl. The section below details its harmful effects and the extent of the damage these have done.

Primary Drug/Opioid
Description
Harmful Effects

Prescription
Opioids

Besides methadone, oxycodone and hydrocodone,
other drugs associated with opioid deaths are
benzodiazepines. Studies showed that prolonged use
of prescribed opioids often leads to addiction, as is
the case for one in four patients.

  • Drowsiness
  • Confusion
  • Nausea
  • Constipation
  • Euphoria
  • Slowed breathing

Heroin

Heroin is highly addictive, and most people use it
with alcohol or other drugs. This practice makes
overdoses more likely. Although some people smoke
or snort heroin, injection is the most common
method. Unfortunately, using potentially unclean
needles increases the risk of developing viral and
bacterial infections.

Overdose deaths involving heroin jumped a
whopping 286% between 2002 and 2013.

  • Euphoria
  • Dry mouth
  • Upset stomach
    and vomiting
  • Itching
  • A fuzzy brain
  • Collapsed veins
  • Insomnia
  • Infections of the
    heart lining and
    valves
  • Liver and kidney
    disease

Fentanyl

While it's a prescribed opioid, fentanyl is sometimes
illicitly manufactured. The former comes in the form
of a shot, tablets or a patch.

Illicitly made, it's usually in powder form. Distributors
drop it in eye drops or nasal sprays or shape it into
pills resembling authentic prescribed opioids.

Overdose deaths due to synthetic opioids (including
fentanyl) in 2020 were 18 times higher than when the
third wave began
in 2013.

  • Extreme happiness
  • Drowsiness
  • Nausea
  • Confusion
  • Constipation
  • Sedation
  • Tolerance
  • Addiction
  • Respiratory
    depression
    and arrest
  • Unconsciousness
  • Coma
  • Death

Overdose Deaths FAQs

Substance abuse is a mental health issue that can lead to overdose. Coverage for mental health care is one healthy step in the right direction.

MoneyGeek answered several commonly asked questions to provide more information on overdose and opioid deaths.

How many overdose deaths occurred in the U.S. in 2020?
How significant were opioids in overdose deaths in 2020?
What happened during the opium waves?
Do the number of opioid deaths vary between age, race and gender?
Which states had the most overdose deaths in 2020?
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Related Content

Overdose deaths are intertwined with mental health, life insurance and health insurance. Learn more on these topics through the online references we've provided.

About Angelique Cruz


Angelique Cruz headshot

Angelique Cruz has been researching personal finance for three years, with expertise in macroeconomics, financial statistics and behavioral finance. After a decade-long stint as a management consultant creating professional and personal development programs, she now specializes in writing informative content around personal, auto and home loans. Angelique has a degree in psychology from the Ateneo de Manila University.


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