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The Statistics on Opioid Overdose Deaths in 2019

According to the National Institute on Drug Abuse (NIDA), more than 130 people in the United States die of an opioid overdose every day.
The misuse and abuse of opioids represent a national crisis in 2019. The Centers for Disease Control and Prevention (CDC) estimates that the total economic burden associated with the abuse of prescription opioids in the United States is over $78 billion per year.

Some Preliminary Figures

Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) and other sources reveals the following:

  • About 21 to 29 percent of people who are prescribed opioids for chronic pain wind up misusing the drugs.
  • Misuse is not the same thing as drug abuse. Misuse can be taking the drug occasionally in a way that is contrary to its intended purpose; however, a small number of people who occasionally misuse the drug may go on to abuse it on a regular basis.
  • Of all the people who are prescribed opioid medications, 8 to 12 percent develop an opioid use disorder.
  • An estimated 4 to 6 percent of people who misuse prescription opioid medications will progress to abusing heroin.
  • Over 80 percent of heroin users initially misused or abused prescription opioids.

What Went Wrong with Opioids?

Although opioid medications had been around for many years, in the 1990s, pharmaceutical companies began to aggressively market them.
Many pharmaceutical companies reassured people in the medical profession that their patients would not become addicted to prescription opioid pain relievers and provided incentives to physicians to prescribe these drugs.
In addition, some of the results from research pharmaceutical companies had been doing were not revealed to the medical community. This included information on the potential addictive nature of oxycodone products.
The increase in the prescription of these medications resulted in greater availability for potential drug abusers. Opioid overdose rates increased along with the growing number of prescriptions. 

Overdose Mortality Data

At the time of this writing, the most complete available data on deaths due to opioid overdoses is for 2017.
The full data for 2019 will not be available until late 2020. The data for 2018 will be available in late 2019.
The figures in this article are based on the 2017 results that have been published by the CDC.

Overall Opioid Overdose Deaths

According to the CDC, the overall mortality rate from drug overdoses in 2017 was 70,237. Of this figure, nearly 68 percent involved an opioid overdose (47,600).
The change in opioid overdose deaths from 2016 to 2017 represented a 12 percent increase; however, preliminary data for 2018 suggests an overall drop in the number of drug overdose deaths in the U.S.
The mortality rate associated with an opioid overdose varies significantly, depending on the opioid.

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Synthetic Opioids

These types of opioids are man-made substances that mimic the actions of the naturally occurring opioids that are processed from the opium in the poppy plant, like morphine. Synthetic drugs include familiar drugs like methadone, tramadol, and fentanyl. They also include illicitly made fentanyl and other illicitly manufactured opioids that may be available.
Fentanyl is a particular opioid of interest. It is estimated to be 50 times more potent than heroin and nearly 100 times more potent than morphine.
The pharmaceutical form of fentanyl is prescribed to manage severe pain, especially pain in those who have become tolerant to other opioids. It can be used to treat cancer pain or even end-of-life chronic pain.
Nonpharmaceutical fentanyl is manufactured illegally. It may be mixed with drugs like heroin and cocaine, and users may take it without knowing what they are using. It is this form of the drug that is of particular interest regarding opioid overdose deaths because of its potency.

Drug Overdose Deaths Related to Synthetic Opioids

Overdose deaths that involved a synthetic opioid other than methadone accounted for more than half of all opioid overdose deaths in the U.S. in 2017. According to the data:

  • There were 28,000 recorded deaths involving an overdose of a synthetic opioid (not methadone).
  • Men ages 25 to 44 had the largest increase in overdose deaths related to synthetic opioids.
  • The highest death rates from synthetic opioids occurred in West Virginia, Ohio, and New Hampshire.
  • There were increases in synthetic opioid overdose deaths in 23 states.
  • Data indicates that increases in synthetic opioid deaths are primarily driven by illegally manufactured fentanyl.

The data allows us to speculate that the large number of overdose deaths associated with fentanyl may have occurred in individuals who had been taking the drug mixed with some other drug like heroin or cocaine. In many cases, the user probably did not know how much fentanyl was actually in the drug they were taking (if they knew at all).

CDC data illustrates a sharp rise in the number of overdose deaths associated with synthetic opioids across many states and across the country in general. This rise is most likely attributable to illicit fentanyl or other synthetic analogs of fentanyl, like carfentanil, which is estimated to be 10,000 times more potent than morphine.

Oxycodone prescription with American flag in the background

More Data on Fentanyl and Fentanyl Analogs

The data collected by the CDC indicates that even people who use only nonopioid substances experience a greater risk of overdosing if they are exposed to substances that are mixed with opioids. The addition of fentanyl may be a significant factor in overdose-related deaths for many different types of drugs.

For instance, a research study covering 10 states showed that:

  • Nearly 57 percent of the people who died from an overdose tested positive for fentanyl or a fentanyl analog.
  • Over half of the people who died from opioid overdose tested positive for fentanyl.
  • Missouri and states in the northeastern U.S. had the highest rate of overdose deaths that involved fentanyl, followed by states in the midwestern and southern U.S.


According to the available data:

  • In 2017, more than 15,000 people died from drug overdose that involved heroin.
  • Heroin-related overdose deaths remained stable from 2016 to 2017, but there was a substantial increase in heroin overdose deaths from 2010 to 2016.
  • Men between the ages of 25 and 44 have the highest rate of death due to heroin overdose, at 14.8 per 100,000 individuals.

SAMHSA reported that in 2017, almost 500,000 people over the age of 12 reported using heroin at least once. The risk factors for heroin use are:

  • Misusing prescription opioids in the past.
  • Abusing any drug.
  • Having some form of mental illness.

Prescription Opioids

Prescription painkillers are used in the treatment of different types of pain. These medications include morphine, codeine, hydrocodone, oxycodone, and related products. They are efficient pain relievers, but they do carry a significant risk of abuse.
The available data indicates that in 2017:

  • A little more than 35 percent of all opioid overdose deaths involved the use of a prescription opioid (about 16,600 deaths).
  • The most common prescription opioids associated with overdose deaths were methadone, oxycodone (OxyContin), and hydrocodone (Vicodin).
  • Overdose deaths as a result of prescription opioids were highest among Caucasians and Native Americans.
  • Prescription opioid overdose mortalities occurred at a rate of 6.1 men per 100,000 people and 4.2 women per 100,000 people.
  • There was a sharp increase in prescription opioid overdoses for people over the age of 65.
  • States with the highest mortality rates due to prescription opioid overdose were West Virginia, Maryland, Kentucky, and Utah.

What Actions Are Being Taken?

The United States Department of Health and Human Services (HHS) has partnered with other organizations in an effort to:

  • Promote the distribution and use of drugs that reverse the effects of an opioid overdose, such as naloxone.
  • Expand public health surveillance services to better understand issues with opioid abuse.
  • Improve the availability of recovery and treatment services for everyone.
  • Fund research on pain and addiction.
  • Develop more productive ways to engage in pain management strategies for physicians and others.

The National Institutes of Health (NIH) provides workshops, conventions, and other resources to develop safer strategies to manage chronic pain. The goal is to develop new technologies to assist in the treatment of opioid use disorders, and to invest resources in prevention, particularly the prevention of opioid overdoses.

Recognizing an Overdose

You are at risk for an opioid overdose if:

  • You take more opioids than your prescription dictates.
  • You take opioids illicitly.
  • You combine opioid medications with other drugs like alcohol.
  • You have certain medical conditions, such as problems with liver or kidney functioning.
  • You are older, especially over 65, because your metabolism is different.

Signs that someone has overdosed on opioids include:

  • Extremely small pupils (pinpoint pupils).
  • Breathing that is very slow (repressed or restricted breeding).
  • Lethargy or unconsciousness.
  • Limp muscles.
  • Skin that feels cold and clammy to the touch.
  • Bluish lips or fingernails.
  • Vomiting.

If an opioid overdose is suspected:

  • Immediately call emergency medical services (911).
  • Stay with the person.
  • Unless you have been trained to do so, do not give the person any food, liquid, or other substances.
  • Try to keep the person awake and breathing.
  • Lie the person on their side. This can prevent them from choking on their own vomit.
  • Administer naloxone, which blocks the effects of opioids, if you have been trained to do so.

Other treatments may be attempted by medical personnel. They may intubate the person if they have stopped breathing, administer fluids, and give medications to address specific symptoms that may be present, such as reduced heart rate or decreased blood pressure.

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