While America is prescribing fewer opioids than ever, a synthetic drug so potent it can kill with just two milligrams has stealthily ignited an unprecedented wave of tragedy, claiming over 80,000 lives in a single year.
Key Takeaways
- In 2021, there were 80,411 drug overdose deaths involving opioids in the United States
- Synthetic opioids other than methadone (primarily fentanyl) were involved in 71,238 overdose deaths in 2021
- Heroin was involved in 9,157 overdose deaths in 2021
- Opioid prescriptions per capita dropped 60% from 2012 to 2022, from 78.5 to 31.2 scripts per 100 people
- Opioid overdose deaths quadrupled from 1999 to 2021, rising from 8,280 to 80,411
- Fentanyl deaths increased 23-fold from 3,105 in 2013 to 71,238 in 2021
- In 2021, 2.7 million people aged 12+ had opioid use disorder in the past year
- Past-year opioid misuse affected 5.6 million people aged 12+ in 2021
- 9.2 million people misused prescription pain relievers in 2021
- Opioid overdose ED visits among males were 1.8 times higher than females in 2021
- Adults aged 35-44 had the highest opioid overdose death rate of 39.1 per 100,000 in 2021
- Black males aged 25-34 had 107.6 opioid deaths per 100,000 in 2021
- In 2021, opioid death rate in Northeast US was 28.4 per 100,000
- Midwest opioid death rate was 26.7 per 100,000 in 2021
- Southern states had 23.1 opioid deaths per 100k in 2021
The opioid crisis remains severe as fentanyl drives record high overdose deaths nationwide.
Demographic Statistics
- Opioid overdose ED visits among males were 1.8 times higher than females in 2021
- Adults aged 35-44 had the highest opioid overdose death rate of 39.1 per 100,000 in 2021
- Black males aged 25-34 had 107.6 opioid deaths per 100,000 in 2021
- Non-Hispanic Black females saw 75% increase in opioid deaths from 2020-2021
- Hispanic persons had opioid death rate of 17.9 per 100,000 in 2021
- Among adolescents 15-24, males had 3x higher opioid death rates than females
- Rural areas had 50% higher opioid death rates than urban in 2021 (25.5 vs 16.9 per 100k)
- Low-income (<$25k) adults had 2x opioid misuse rate of high-income
- Uninsured adults had 3.5x higher opioid overdose hospitalization rates
- LGBTQ+ youth report 2x higher prescription opioid misuse than straight peers
- Among incarcerated persons, 65% have history of opioid use disorder
- Native Hawaiian/Pacific Islander adults had 25.2 opioid deaths per 100k in 2021
- Females aged 25-34 saw 40% rise in opioid deaths 2020-2021
Demographic Statistics Interpretation
These numbers are not a crisis in the abstract, but a ruthless map of inequality, tracing with grim precision how poverty, race, geography, and systemic neglect can turn a national epidemic into a collection of personal catastrophes.
Geographic Variations
- In 2021, opioid death rate in Northeast US was 28.4 per 100,000
- Midwest opioid death rate was 26.7 per 100,000 in 2021
- Southern states had 23.1 opioid deaths per 100k in 2021
- Western US opioid rate was 22.5 per 100,000 in 2021
- Kentucky reported 50.2 opioid deaths per 100k in 2021
- New Mexico had 46.7 per 100k opioid deaths in 2021
- Louisiana's rate was 38.5 per 100,000 in 2021
- Tennessee had 37.2 opioid deaths per 100k in 2021
- In Los Angeles County, opioid deaths rose 105% from 2020 to 2022
- Baltimore City had 112 opioid deaths per 100k in 2021
- Philadelphia reported 58.9 per 100k opioid deaths in 2021
- San Francisco's opioid death rate was 45.2 per 100k in 2022
- In Canada, opioid deaths totaled 7,550 in 2022, mostly in British Columbia
- Mexico reported 15,000 opioid-related deaths in 2022
- In Australia, opioid overdose deaths were 2,200 in 2021, highest in Victoria
- UK opioid deaths reached 1,546 in 2022, concentrated in Scotland at 25.3 per million
Geographic Variations Interpretation
The grim reality of opioid statistics reveals that while geography may debate the numbers, it's clear we've all tragously lost the argument against this epidemic, with regional pockets of despair screaming louder than others.
Incidence and Prevalence
- In 2021, 2.7 million people aged 12+ had opioid use disorder in the past year
- Past-year opioid misuse affected 5.6 million people aged 12+ in 2021
- 9.2 million people misused prescription pain relievers in 2021
- Heroin use in past year was reported by 828,000 people aged 12+ in 2021
- Lifetime opioid misuse prevalence is 51.3% among US adults
- In 2022, 16 million people had prescription opioid use disorder globally
- Emergency department visits for opioid overdoses totaled 1.1 million in 2021
- Nonfatal opioid overdoses estimated at 3 million annually in US
- 40% of US adults reported prescription opioid exposure in past year per 2022 survey
- Opioid dependence or abuse diagnosed in 2 million ER visits in 2019
- Among high school students, 6% misused opioids in past year in 2021 YRBS
- In adults 18-25, past-month opioid misuse was 2.5% in 2021 NSDUH
- Among pregnant women, 7% reported opioid misuse in 2021
- Veterans have 40% higher opioid use disorder prevalence than civilians
- In Appalachia, 12% of adults reported opioid misuse in 2020
- Among US adults, 16% initiated opioid therapy in outpatient settings annually
- Past-year pain reliever misuse among AI/AN adults was 8.5% in 2021
Incidence and Prevalence Interpretation
Behind these staggering millions lies a nation hooked on a crisis, where a shocking half of us will dance with opioid temptation in our lifetime, a dance that too often ends in an emergency room or worse.
Mortality Rates
- In 2021, there were 80,411 drug overdose deaths involving opioids in the United States
- Synthetic opioids other than methadone (primarily fentanyl) were involved in 71,238 overdose deaths in 2021
- Heroin was involved in 9,157 overdose deaths in 2021
- Natural and semisynthetic opioids (like oxycodone and hydrocodone) were involved in 15,645 overdose deaths in 2021
- Methadone was involved in 4,860 overdose deaths in 2021
- From 1999 to 2021, nearly 645,000 people died from an opioid-involved drug overdose
- Opioid-involved overdose deaths rose from 49,860 in 2020 to 80,411 in 2021
- In 2021, the age-adjusted rate of opioid-involved overdose deaths was 24.5 per 100,000 population
- Provisional data show 109,680 drug overdose deaths in 2022, with opioids involved in over 75%
- Fentanyl and fentanyl analogs were implicated in 68% of all overdose deaths in 2021
- In 2020, opioid overdose death rates were highest among adults aged 25-44 years at 42.6 per 100,000
- Males had an opioid overdose death rate of 36.2 per 100,000 in 2021 compared to 14.5 for females
- Non-Hispanic White persons had 31.3 opioid deaths per 100,000 in 2021
- In 2021, opioid deaths increased 22% among Black persons to 35.7 per 100,000
- American Indian/Alaska Native persons had the highest rate at 52.4 per 100,000 in 2021
- In West Virginia, opioid overdose deaths reached 81.4 per 100,000 in 2021
- Ohio reported 45.7 opioid deaths per 100,000 in 2021
- District of Columbia had 48.6 per 100,000 opioid deaths in 2021
- Delaware's rate was 47.4 per 100,000 in 2021
- Pennsylvania had 42.8 opioid deaths per 100,000 in 2021
Mortality Rates Interpretation
So, while we were busy arguing about everything else, synthetic opioids, led by fentanyl, staged a hostile takeover of the American tragedy, driving overdose deaths to a grim new record and exposing devastating disparities that prove this crisis is an equal-opportunity destroyer with a viciously targeted aim.
Trends and Projections
- Opioid prescriptions per capita dropped 60% from 2012 to 2022, from 78.5 to 31.2 scripts per 100 people
- Opioid overdose deaths quadrupled from 1999 to 2021, rising from 8,280 to 80,411
- Fentanyl deaths increased 23-fold from 3,105 in 2013 to 71,238 in 2021
- From 2015-2021, opioid deaths rose 75% overall
- Provisional 2023 data shows a 3% decline in opioid deaths to about 76,000
- CDC projects up to 115,000 drug overdose deaths in 2022, mostly opioids
- Opioid misuse prevalence decreased from 4.1% in 2015 to 3.3% in 2021 among adults
- Emergency department visits for opioid overdoses fell 19% from 2021 to 2023 Q1
- Naloxone prescriptions increased 275% from 2019 to 2022
- Opioid use disorder treatment admissions dropped 10% from 2019 to 2021
- Provisional data for week 39 2023 shows 16,000 opioid deaths YTD
- CDC forecasts 107,941 total drug overdose deaths for 2022, 75% opioids
- Opioid death rates projected to decline 10% by 2025 with interventions
- From 2010-2020, opioid prescribing rates fell 44%
- Polysubstance overdoses involving opioids and stimulants rose 35% 2019-2021
- Buprenorphine prescriptions increased 66% from 2019 to 2022
- Opioid-involved EMS transports decreased 10% in 2023 Q1 vs 2022
- Global opioid consumption for medical use is only 19% of total needed
- US opioid market size for illicit fentanyl estimated at $150 billion annually
- Youth opioid misuse declined 50% from 2015-2021 per MTF survey
Trends and Projections Interpretation
We appear to be winning a doomed war on prescription pads while tragically losing the actual war against an illicit drug supply that has become exponentially more deadly.
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