Chance an Overdose Death Involved Fentanyl (2023)

NCHS reported 73,297 drug overdose deaths involving Fentanyl in 2023, ranking it number 1 among the drugs most frequently mentioned in overdose death records. That equals 68.9% of the 106,352 U.S. drug overdose deaths in the report's 2023 table.

This is a conditional probability, not the probability that a random person dies from Fentanyl. The denominator is drug overdose deaths, and the numerator is overdose deaths in which Fentanyl was identified from death-certificate literal text. NCHS emphasizes that overdose deaths may involve multiple drugs, so these drug-specific percentages are not mutually exclusive and should not be added together.

The decision value is practical risk interpretation. Drug-specific overdose data helps separate the overall overdose crisis into substances and combinations that call for different responses: naloxone access, fentanyl test strips where legal and appropriate, medication-assisted treatment, careful prescribing, avoiding solitary use, safer storage, and faster emergency response. For Fentanyl, the report notes: Fentanyl ranked first in every year from 2017 through 2023 and was the most common concomitant drug found with other top drugs.

There are important limitations. The method relies on what medical certifiers wrote on death certificates, and NCHS says the reported numbers should be considered minimum counts because additional deaths may have involved the drug without it being captured in the literal text. Reporting improved over time, so trend comparisons require caution.