Fentanyl Is Now the Leading Cause of Death for Adults Ages 18 to 45

Checking pulse

The findings are shocking. In 2020, fentanyl killed more young and middle-aged adults than car accidents, suicides, guns, heart attacks, cigarettes, alcohol and obesity. And it’s not that fentanyl slowly crept up to the number one cause of death. Fentanyl skyrocketed to that position. While other major causes of death took years to build up in numbers, fentanyl deaths soared to the number one cause of death in just a few years.

If the American people needed one final warning of just how serious this country’s opioid epidemic is, this is it. The fact that fentanyl is now the leading cause of death for a huge sector of the population tells us just how dangerous this drug is, just how important it is that addicts get help.

Fentanyl Is the Number #1 Killer for Young and Middle-Aged Americans

Fentanyl deaths

An article out of a local media station in Wichita, Kansas, broke the news. Based on an analysis by Families Against Fentanyl, fentanyl overdoses are now officially the leading cause of death for Americans 18 to 45. Not gunshot wounds. Not car accidents. Not suicide, obesity, heart attacks, strokes, diabetes, falls, homicides, or alcohol poisoning. But fentanyl—a pharmaceutical drug designed to treat severe, post-surgery pain or severe, chronic pain.

In rural states like Kansas, the effects of the fentanyl overdose epidemic have been painful, persistent, and unrelenting. Throughout 2019, Kansas saw 64 of its residents die from fentanyl overdoses. But in just one month in 2021, 240 residents died from fentanyl.

The gravity of that increase may take a moment to sink in. But it bears repeating. In just one month in 2021, more than three times the number of Kansas residents died from fentanyl than the total number of deaths recorded in the entire year of 2019.

That is what a fatal drug overdose epidemic looks like.

And to make matters worse, this is not just a problem for Kansas. Every state in the U.S. has been severely affected by fentanyl addiction and overdose deaths.

Putting the Crisis into Perspective

The fact that fentanyl is now the leading cause of death for Americans 18 to 45 is just one harsh truth in an extremely complex and multi-faceted health crisis. According to the CDC, there are several other factors and data points to consider, one being the fact that over 100,000 Americans died from drug overdoses in 2020. Other data points to consider include:

  • According to the same CDC reports, drug overdose deaths were higher in 2020 than ever before, at least since recording began. Skyrocketing drug deaths have paved the way to entirely new and unprecedented statistical figures, like the fact that almost 30% more Americans died from overdoses in 2020 than in 2019.
  • Not only did overdose deaths jump almost 30% in one year (2019 to 2020), but the total number of overdose deaths in 2020 was more than 200% higher than the overdose fatality numbers for 2016.
  • While overdose deaths used to be caused by a wide variety of drugs, the trend in recent years has been one of fentanyl causing more and more of the fatalities. Case in point, almost two-thirds of all overdose deaths in 2020 were caused by fentanyl (64%), a 49% increase over 2019’s fentanyl deaths.
  • The stark increase in deaths can be succinctly observed simply by analyzing total overdose deaths by year. In 2016, 56,517 Americans died from drug overdoses. In 2019, 78,056 Americans died from drug overdoses. In 2020, 100,306 Americans died from drug overdoses.
drug addicts
  • Just in the year 2020, United States law enforcement organizations busted enough drug trafficking operations and seized enough fentanyl to give every American a lethal dose.
  • Another critical factor is that overdose deaths involving psychostimulants like methamphetamine and cocaine are increasing (up 48% in one year), but this increase is almost solely the result of synthetic fentanyl being mixed into batches of meth and cocaine without the addicts’ knowledge.
  • In 2016, drug overdose emergencies killed about as many Americans as car accidents or gun violence did. But in 2020, drug overdoses killed more Americans than car accidents and gun violence combined.
  • Even though Covid-19 took headlines left and right in 2020, fentanyl was a more severe problem for adults. According to another news report, fentanyl overdoses killed about 79,000 U.S. adults under the age of 45, about 20,000 more deaths than adults under 45 who died from Covid-19.
“Even if Covid went away tomorrow, we’d still have a problem. What will have an impact is dramatic improvement to access to treatment.”

Some experts insist that 2020’s Covid-19 pandemic contributed to skyrocketing overdose deaths, and there is likely some truth to that. However, just solving the Covid-19 pandemic will not solve the addiction epidemic. Quoting Dr. Andrew Kolodny, medical director of opioid policy research at Brandeis University Heller School for Social Policy and Management, “Even if Covid went away tomorrow, we’d still have a problem. What will have an impact is dramatic improvement to access to treatment.” He then went on to say that, “These are deaths in people with a preventable, treatable condition. The United States continues to fail on both fronts, both on preventing opioid addiction and treating addiction.” And he’s right; now more than ever, the American people must focus on making qualified addiction treatment available to opioid addicts. To do anything but that is to consign tens of thousands of addicts to their deaths.

Fentanyl Is America’s Most Lethal Drug

Fentanyl is one of the most potent drugs known to man, and sadly it is now one of the most widespread. According to the National Institute on Drug Abuse, fentanyl is similar to morphine but 50 to 100 times more potent. Fentanyl is about ten times more potent than heroin.

Fentanyl was initially created only for use in very extreme and rare cases, such as for cancer patients who could not experience pain relief from other opioid drugs. Fentanyl was also used in post-surgery care and for pain patients in hospice care. Sadly, as was the case with so many other opioid pain relievers, overprescribing of fentanyl set in, patients became addicts, and the drug made its way into the hands of addicts who had no legitimate prescription for its use. The drug fell into the hands of black market traffickers, too, who figured out how to make illicit fentanyl in illegal drug labs.

Fast forward to the present day, and fentanyl is the leading cause of death for young and middle-aged adults, and it is responsible for almost two-thirds of all drug-related deaths. This is why addiction treatment is so crucial, why making sure that all addicts have access to treatment is so important.

Addiction Can Be Overcome Through Drug Rehab

Drug and alcohol addiction is a life or death crisis, but death can be averted through quality drug treatment. If you know someone who is exhibiting signs and symptoms of drug abuse, you must get them help as soon as possible. Drug addiction is a life or death crisis. Please do not wait until it is too late.


Reviewed by Claire Pinelli; ICAADC, ICCS, LADC, RAS, MCAP, LCDC



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.