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Fentanyl: The Deadliest Drug The U.S. Has Ever Seen

In just a few years, illicit fentanyl has pushed U.S. drug fatalities to a record, reaching into every corner and demographic group. U.S. drug overdose deaths have surged more than 400 percent in the past two decades to more than 108,000 in 2021, the result of an addiction crisis set off by the overuse of prescription opioids. Today, illicit drugs are deadlier than ever, largely because of the pervasiveness of fentanyl. Deaths attributed to a drug class that includes prescription opioids such as oxycodone pills, once the major factor in the crisis, plateaued in recent years, due in part to tighter regulations on prescriptions, says the Wall Street Journal. Deaths in which heroin was a factor rose sharply after 2010, as prescription pill abusers looked for other drugs. The deaths were one-fourth of total overdose deaths in 2016, but the portion soon declined as illicit synthetic opioids, mainly fentanyl, became more available and total deaths skyrocketed. In 2014, synthetic opioids, largely illicit fentanyl, took off. Traffickers flooded the nation with a bootleg version of the more-powerful drug, which is relatively easy and inexpensive to make. The drug, which can quickly cause fatal overdoses, caused deaths to rise steeply. The rise of fentanyl had an effect on other drugs, as stimulants and opioids became an increasingly toxic combination.


Cocaine, often used with opioids, added to the death toll. It was found in nearly 25,000 overdose deaths in 2021, up around 430 percent from a decade earlier. Fentanyl also inflated deaths from another drug class made up mainly of the synthetic stimulant methamphetamine. Around two-thirds of overdose victims who died after using meth last year also had opioids, especially fentanyl, in their systems. Now, fentanyl, either on its own or mixed with other drugs, has spread to every corner of the illegal drug market. Two-thirds of total drug overdose victims last year had synthetic opioids in their systems, making fentanyl the most deadly illegal drug the U.S. has ever seen. By 2021, deaths from the fentanyl and meth drug classes had surged., affecting rural, suburban and urban communities in nearly every state. Early on, fentanyl deaths were more concentrated in rural areas, and fentanyl hit the white population hard. As the drug spread, the demographics of victims have changed. From 2010 to 2013, when overall deaths were still relatively low, rural areas and small towns had higher rates of synthetic opioid overdoses than most urban areas. When fentanyl use exploded, suburban areas took the lead in death rates for a time, until cities overtook all other areas. As synthetic opioids fueled overall drug deaths, fatalities among Blacks in 2020 surpassed those of whites for the first time in two decades. Experts say the COVID-19 pandemic exposed gaps in access to treatment and other services. Native populations, while small in total numbers, have the highest overdose death rate.

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A daily report co-sponsored by Arizona State University, Criminal Justice Journalists, and the National Criminal Justice Association

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