Nearly half of opioid-related overdose deaths involve fentanyl


An analysis of opioid-related overdose deaths found that synthetic opioids, such as illicit fentanyl, have surpassed prescription opioids as the most common drug involved in overdose deaths in the U.S. A research letter published in the Journal of the American Medical Association (JAMA) concluded that nearly half of opioid-related deaths in 2016 involved fentanyl.

Fentanyl Crystal and Pills
Image courtesy of DEA
Fentanyl Crystal and Pills

The report analyzed 2010-2016 mortality data from the National Vital Statistics System which includes information on all deaths in the U.S., based on death certificates submitted by medical examiners and coroners. Results showed that among the 42,249 opioid-related overdose deaths in 2016, 19,413 (45.9%) involved fentanyl; 17,087 (40.4%) involved prescription opioids; and 15,469 (36.6%) involved heroin.* This was a significant increase from 2010, when only 3,007 (14.3%) of opioid-related deaths involved fentanyl. In 2016, fentanyl was also frequently involved in overdose deaths involving non-opioids drugs; 40.3% of cocaine-involved overdose deaths; 31.0% of benzodiazepine-involved overdose deaths; and 20.8% of antidepressant-related deaths involved synthetic opioids.

The authors caution that lack of awareness about the potency of fentanyl, along with its variability, availability and increasing contamination of the illicit drug supply, poses substantial risks to people who use drugs. They emphasize the need for widespread public health education and training of clinicians and first responders about fentanyl risks, suggest they be equipped with multiple doses of naloxone to reverse overdose, and call for expanded access to medication-assisted treatment for opioid addiction.

For a copy of the paper, go to — "Changes in Synthetic Opioid Involvement in Drug Overdose Deaths in the United States, 2010-2016" — published in JAMA. It was authored by scientists from the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.

To view videos by the NIDA co-authors, go to: Dr. Compton Discusses: Half of Opioid-Related Overdose Deaths Involve Fentanyl and Dr. Emily Einstein Discusses How Overdose Deaths are Counted.

To view the blog post by NIDA Director Dr. Nora Volkow, go to: The True, Deadly Scope of America’s Fentanyl Problem.

The National Institute on Drug Abuse is part of the National Institutes of Health, within the U.S. Department of Health and Human Services (HHS). The Substance Abuse and Mental Health Services Administration is also part of HHS.

*Some deaths involved multiple drugs.

More information on opioids and fentanyl, including an Infographic and additional videos, can be found on the Opioids and Fentanyl webpages.

For more information, contact the NIDA press office at or 301-443-6245. Follow NIDA on Twitter and Facebook. The NIDA website is

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About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit

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