Most Common Drugs in U.S. Overdose Deaths: 2017–2023

CDC’s National Center for Health Statistics (NCHS) has released a new report titled “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017–2023.” This report provides a detailed look at drug overdose deaths across the country over a seven-year period.

This analysis focuses on the specific drugs involved in overdose deaths, using written documentation or “literal text” on the death certificates. This approach offers more detailed insights compared to the provisional monthly and annual final drug overdose death statistics released by NCHS.

Key Findings

• Changes in Overdose Deaths: From 2017 to 2022, the number of drug overdose deaths rose significantly, increasing by nearly 54%. In 2017, there were 70,715 deaths, which climbed to 108,790 in 2022. However, there was a slight decrease in 2023, with 106,352 deaths reported.

• Shifts in Drug Involvement: In 2023, the most common drugs involved in overdose deaths were fentanyl (first), methamphetamine (second), and cocaine (third). Heroin dropped from second place in 2017 to seventh in 2023. New drugs like xylazine and bromazepam have also appeared on the list since 2017.

Drugs Most Often Involved

• Fentanyl: This opioid was the leading cause of overdose deaths each year from 2017 to 2023. Deaths from fentanyl rose from 27,542 in 2017 to a peak of 73,944 in 2022, before slightly declining in 2023.
• Methamphetamine: Deaths involving methamphetamine increased, from 9,438 in 2017 to 34,167 in 2023, moving from the fourth most common drug to the second.
• Cocaine: Cocaine consistently ranked among the most common drugs, with deaths more than doubling from 15,050 in 2017 to 31,700 in 2023.
• Heroin: The number of deaths involving heroin decreased, dropping from the second most common drug in 2017 to the seventh in 2023.
• Xylazine: This drug first appeared among the list of 15 most commonly involved drugs in 2021 and rose to the fourth most common drug by 2023.

Intent of Death

In 2023, most unintentional overdose deaths involved fentanyl (71.9%), followed by methamphetamine (33.9%) and cocaine (31.0%). For suicides, in addition to fentanyl, diphenhydramine and oxycodone were commonly mentioned.

Background Information

The report uses literal text from death certificates collected by the National Vital Statistics System (NVSS) to provide national drug overdose death counts and rates. This includes opioids like fentanyl, oxycodone, and heroin, as well as stimulants like cocaine and methamphetamine, and other substances such as alprazolam, gabapentin, and xylazine.