Drug Overdose in the United States: The Numbers Behind the Crisis

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Drug overdose is an evolving public health crisis in the United States. Overdose deaths climbed dramatically over two decades — up about 520% from 1999 to 2023 — before falling nearly 3% from 2022 to 2023, the first yearly decline since 2018.

The need for treatment remains vast. In 2023, an estimated 54.2 million Americans aged 12 or older needed treatment for a substance use disorder in the past year, but only 12.8 million people with a substance use disorder received it. Reducing illegal drug use, the misuse of prescription opioids and other medicines, and overdose deaths has been a long-running challenge.

The toll in 2023

About 105,000 people died of a drug overdose — roughly 287 a day.
Nearly 80,000 (about 76%) involved an opioid, prescription or illegal.
Deaths involving more than one drug (polysubstance overdoses) have risen too.
People who have survived one opioid overdose are more likely to have another.
In 37 states and Washington, D.C., nearly 3 in 5 overdose deaths came with at least one missed chance to connect the person to care beforehand or to take life-saving action during the overdose.

Which drugs

Drug involved (2023)	Deaths	Share of all overdose deaths	Change in death rate, 2022–2023
Synthetic opioids other than methadone (mainly illegally made fentanyl and its analogs)	nearly 73,000	69%	down about 2%
Psychostimulants such as methamphetamine	nearly 35,000	33%	—
Cocaine	nearly 30,000	28%	—
Heroin	nearly 4,000	about 4%	down about 33%

Synthetic opioids accounted for nearly 92% of opioid overdose deaths. In 37 states and D.C., 47% of overdose deaths involved both opioids and stimulants.

Who is dying

Age: in both 2022 and 2023, the death rate was highest among adults aged 35–44. The lowest rate was among people 65 and older in 2022, but among people aged 15–24 in 2023.
Sex: in 2023 the age-adjusted rate for males (44.3 per 100,000) was higher than that for females (18.3).
Race and ethnicity: rates were highest among American Indian and Alaska Native people and lowest among Asian people in both years — and the gaps between groups are widening.

Group	Deaths per 100,000, 2022 → 2023	Change
Native Hawaiian or Other Pacific Islander	18.8 → 26.2	up 39%
Non-Hispanic Black	47.5 → 48.9	up nearly 3%
American Indian and Alaska Native	65.2 → 65.0	no significant change
Hispanic	22.7 → 22.8	no significant change
Asian	5.3 → 5.1	no significant change
Non-Hispanic White	35.6 → 33.1	down nearly 8%

What CDC is doing

CDC's response targets a shifting illegal drug supply, the continuing threat of illegally made fentanyl and other synthetic opioids, and rising deaths from stimulants and drug combinations.

Overdose Data to Action (OD2A). In 2023, CDC offered two funding opportunities to city, county, state and territorial health departments to try new approaches, widen prevention, connect people to life-saving care, and get current data out quickly.
Drug-Free Communities (DFC). CDC supports this program, the nation's leading effort to help communities prevent youth substance use. It funds local coalitions that draw on their communities' history, needs and strengths and plan prevention with an emphasis on change at the community level.
Data. CDC's Overdose Prevention Data Channel is its central source of up-to-date fatal and nonfatal overdose data, including provisional death estimates, for communities, policymakers, the media and health professionals.

Prevention works best when it is comprehensive, rooted in the community and based on evidence, tailored to local conditions and aimed at closing the gaps between groups. Not every overdose has to end in death — and everyone has a part to play in preventing them.