Taking a Longer View: The Real Story of Our Overdose Losses

Doctor depressed

When news media or government agencies talk about the number of people lost to drug overdoses, their charts typically reach back perhaps 20 years. So reports from, for example, 2019 generally show the overdose statistics as far back as 1999. But what happens if we go back further than that? What happens if we take a longer view of this tragic and disruptive phenomenon?

When I went looking for this longer-range statistic, it was surprisingly hard to find. But I was determined to get a longer-range view of this situation that has taken so many lives. I felt that we could honor the memories of those who lost everything by taking a hard look at our current situation and resolving to overcome it.

I finally dug up a chart buried in the National Center for Health Statistics website that covered the years between 1980 and 2008. Take the statistics from that chart and add them to more recent numbers and we get a longer view of the devastation wrought by drugs. Here’s what that looks like.

U.S. Drug Overdose Deaths 1980 to 2020
U.S. Drug Overdose Deaths 1980 to 2020

There’s another important way to look at this information and that is by reviewing the rate of overdose losses. Because, of course, the population of the United States has increased significantly since 1980. So here’s another chart showing the increase in the rate of loss. In other words, how many lives were lost per 100,000 population at any particular time?

Fentanyl deaths 1999 to 2019
Fentanyl deaths 1999 to 2019

You can see that this chart rises from 2.7 deaths per 100,000 people to an estimated 28.2 per 100.000, a massive increase. This chart reveals that even taking into account the increase in the American population, overdose deaths are on a steep climb.

Possible Observations

Sure, the understanding we get from a 20-year chart makes things look pretty bad. But looking at 40 years of data is downright sobering. Here are some of the observations that could be made based on this information.

  1. According to the Centers for Disease Control and Prevention (CDC), we lost 93,331 lives in the twelve months ending December 2020. That is MORE than the total number of lives lost in the twelve-year period from 1980 through 1991. 
  2. If we had truly been paying attention throughout this time period, we would have seen that the numbers were going up steadily. Year after year, we lost an increasing number of people over a 41-year period except for 1990 and 2018. As long as these numbers were increasing, it would only be reasonable to guess that they would keep going up unless something remarkable and significant changed. The same thing is true looking forward from today.
  3. We can also conclude that the actions we were taking to address this situation have not been working. Isn’t it true that if we continued, year after year, addressing drug abuse and overdose deaths in exactly the same way, we should have noticed that our approach was unsuccessful and replaced it with a different one?
  4. In 1981, we were losing 2.1 lives per 100,000 population. By 2020, we were losing an estimated 28.2 lives per 100,000—more than ten times the rate of loss.
  5. Overdose deaths increased an astonishing 22,000 between 2019 and 2020. Many officials, including the CDC, concluded that measures taken to quell the spread of COVID-19 increased our losses due to overdoses. Isolation, loneliness, drug consumption alone at home and closed rehab centers may all have contributed to this increase.
  6. Some years, the numbers only increased a few hundred. Other than the 2020 increase, the biggest single jump was between 2015 and 2016—when fentanyl arrived in American drug supplies in a big way, but many people using drugs didn’t know it yet. The next year was almost as bad, but then it seems efforts were marshaled to save lives from overdose. In 2018, overdose deaths dropped, meaning that at least 3,000 lives were saved that year, probably more.

If our current rate of loss is more than ten times the rate a few decades ago, there must be many times more drugs coming across our borders. And more drug dealers and traffickers—perhaps not ten times more because each person or group may be dealing with a larger volume.

The Big Numbers

So in this 41-year period, how many Americans did we lose?

One million, one hundred fourteen thousand, nine hundred eighty-three.

Yes, we’ve passed a million overdose deaths just since 1980. That’s more than the number of people that live in Austin, Texas.

Fentanyl’s Role in These Catastrophic Losses

This chart from the CDC shows how the number of deaths from synthetic opioids has grown over the last several years.

This statistic excludes the synthetic opioid methadone but includes a few tramadol deaths in with the tens of thousands of deaths from fentanyl.

Fentanyl isn’t just one drug. There’s pure fentanyl and then there are nearly 200 analog (chemically similar) drugs that have fentanyl in their name. These analog drugs have names like acetylfentanyl, furanylfentanyl and carfentanil. The CDC acknowledges this increase in the following statement:

“Overdose deaths involving synthetic opioids were nearly 12X higher in 2019 than in 2013.”

In the following chart, you can see the number of individuals we lost each year due to fentanyl and its analogs.

Rate of overdose deaths per 100,000 people.
Rate of overdose deaths per 100,000 people.

The Drug Enforcement Administration warns us that fentanyl is being added to heroin, methamphetamine and cocaine and it’s being pressed into all kinds of counterfeit pills. The police department of Portland, Oregon noted that not one sample of Xanax they seized from drug dealers in their city contained any Xanax. Instead, the pills contained fentanyl or another synthetic drug.

In August of 2019, the Drug Enforcement Agency announced that in less than eight months of 2019 in Arizona alone, they had seized 1,138,288 counterfeit pills containing fentanyl. In all of 2018, they had only seized 380,000 pills. Generally speaking, fentanyl is everywhere. And because of its enormous potency, it is a highly dangerous and unpredictable drug to consume.

We must honor those million-plus Americans we have lost to drug overdoses. We can do this by working together relentlessly to reduce these numbers. This incredible threat stalking our streets makes finding a rehab program for anyone you care about who is using drugs an urgent necessity. Even if they don’t use opioids, fentanyl can be in nearly any supply of illicit drugs or pills. You can further help by supporting rehabilitation and prevention in your community. Or spread the word about this catastrophic loss of life in your community, now that you know about it. Your help is appreciated.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP, LCDC


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.