Overview
Drug overdose deaths have risen
steeply throughout the United States. Data from the Centers for Disease Control
and Prevention (CDC) indicates that overdose deaths remain historically high
and are continuing their upward trajectory. CDC estimates that there were over
110,000 overdose deaths in 2022, up from approximately 109,000 in 2021. Illicit
fentanyl is at the forefront of this public health crisis. Of these drug-related
overdose deaths, the majority involved this lethal substance. Fentanyl has
become one of the single largest threats Americans have ever encountered.
Highlighting the severity of this national threat, fentanyl has become the
leading cause of death for Americans ages 18-45, claiming more lives than
suicide, COVID-19, or automobile accidents in this age group.
CDC has a continuously updated
dashboard that can be accessed for current information on drug overdose deaths
at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
CDC also has an online dashboard to
track non-fatal drug overdoses that can be accessed at https://www.cdc.gov/drugoverdose/nonfatal/dose/surveillance/dashboard/index.html.
The chart below, from CDC’s Drug Overdose Dashboard, shows the rise in overdose deaths that began to surge around the time of the COVID-19 pandemic in 2020.

Fentanyl
Production and Trafficking
The majority of the fentanyl in the
United States is mass-produced by transnational criminal organizations
operating in Mexico using China-sourced precursor chemicals. The two cartels
thought to be primarily involved in the production and trafficking of fentanyl
into the United States are the Sinaloa Cartel and Cartel Jalisco Nueva
Generación (CJNG). Fentanyl is primarily entering the United States via the
southern border, seized by law enforcement as kilogram bricks of fentanyl
powder and in bulk quantities of counterfeit pills.
Fentanyl in the Drug Supply
Fentanyl has changed the drug threat
environment to such an extent that the use of almost any illicit drug could
potentially expose an individual to this deadly substance. At the retail level,
drug dealers sell fentanyl powder and fentanyl-laced pills and also mix
fentanyl with a variety of drug types such as heroin, cocaine, and
methamphetamine. Sometimes drugs sold as heroin, cocaine, or methamphetamine are found to contain just fentanyl or fentanyl mixed with xylazine (an animal tranquilizer).
Fentanyl-Xylazine
Drug Mixtures
- In April of
2023, fentanyl mixed with xylazine was declared by the Office of National Drug
Control Policy (ONDCP) as a national emerging drug threat. Because xylazine
does not respond to life-saving Narcan since it’s not an opioid,
fentanyl-xylazine mixtures are contributing to the rise in deaths nationally.
- In July of 2023,
ONDCP released a National Response Plan to reduce the currently rising threat
from fentanyl-xylazine drug mixtures in the United States.
Click below to read the White House’s press release:
National Response Plan to Address the Emerging Threat of Fentanyl Combined with
Xylazine.

White
House Press Release on Emerging Drug Threat from Fentanyl-Xylazine Mixtures
https://www.whitehouse.gov/briefing-room/statements-releases/2023/07/11/fact-sheet-in-continued-fight-against-overdose-epidemic-the-white-house-releases-national-response-plan-to-address-the-emerging-threat-of-fentanyl-combined-with-xylazine/.
Click below to read the National Response Plan.
Fentanyl Adulterated or Associated
with Xylazine Response Plan
https://www.whitehouse.gov/wp-content/uploads/2023/07/FENTANYL-ADULTERATED-OR-ASSOCIATED-WITH-XYLAZINE-EMERGING-THREAT-RESPONSE-PLAN-Report-July-2023.pdf