Opioid Epidemic Persists: 105,000 Overdose Deaths in the U.S. in 2023
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Much of the recent crisis has been driven by the spread of synthetic opioids—especially illicit fentanyl and its analogues—which are incredibly potent and often mixed into other drugs without users’ knowledge. According to the CDC, the rate of overdose deaths involving synthetic opioids other than methadone (primarily fentanyl) decreased by around 2% from 2022 to 2023. The number of heroin-involved deaths saw a much steeper drop, falling approximately 33%, and deaths involving prescription opioids declined by about 12%. Despite these reductions, synthetic opioids remain by far the greatest contributor to overdose fatalities.
The pandemic worsened the crisis, with the National Institute on Drug Abuse observing that factors like social isolation, stress, and reduced access to treatment in 2020 and 2021 caused spikes in opioid-related deaths, especially in hard-hit states such as New York. The Office of the State Comptroller in New York reports that in 2021, 85% of overdose deaths in the state involved opioids, and that between 2019 and 2021, opioid overdose deaths there rose by roughly 68%. Deaths increased among all racial and ethnic groups, with particularly sharp rises for Black and Hispanic individuals, highlighting the epidemic's uneven impact across communities.
Beyond the United States, Health Canada’s September 2025 update reveals that the opioid crisis continues to take a heavy toll in Canada as well. Between January and March of 2025 alone, there were more than 1,300 apparent opioid toxicity deaths, with the vast majority involving fentanyl or its analogs. In 2025, about 62% of opioid toxicity deaths also involved stimulant drugs, such as methamphetamine or cocaine, complicating both treatment
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