The Western and Midwestern U.S. Hard Hit by Fentanyl Overdoses

Midwest and West Drug Problem map

No one who uses drugs is ever safe. The spread of fentanyl across America and the fact that highly lethal fentanyl is now in the drug supply for non-opioid drugs (like meth and cocaine) has proven that there is always a severe risk when one uses drugs.

Drug addiction is a serious risk even in rural parts of the Midwest, West, Southwest, and Pacific Northwest. Overdose death is a critical issue in these regions. And even in advanced, prosperous, and populous metro areas along the west coast and in many western urban centers, addiction and overdose risk is always just a few blocks away.

And if any drug has shown the American people that substance abuse can ruin one’s life and lead to an early death, it is fentanyl.

The Fentanyl Crisis Expands, Leaving Overdose Deaths in its Wake

For much of the earlier years of the opioid epidemic (the late-1990s and early-2000s), this drug crisis mostly revolved around prescription opioids. When medical professionals and patients began to realize that prescription painkillers were addictive, doctors pulled back on their prescribing, effectively reducing the number of prescription opioids in the hands of the American public.

To continue their drug-consuming habits, those already addicted to opioid painkillers shifted to heroin and fentanyl, seeking alternatives to the once-easy-to-get pills. And while heroin deaths did climb somewhat as a result, fentanyl deaths skyrocketed. The East Coast and much of the Appalachian region were hardest hit between 2010 and 2016, and many experts believed the problem would stay in those regions.

Not so.

According to recent reporting by the Centers for Disease Control and Prevention and various news outlets, the fentanyl crisis (which includes synthetic, fentanyl-like drugs made in clandestine labs) has exploded across the United States.

According to the CDC, between May of 2020 and April of 2021, nearly two-thirds (64%) of the more than 100,000 overdose deaths reported for that period were tied to illicit fentanyl or its synthetic counterparts. The fentanyl crisis started east of the Mississippi, and it appeared the crisis would stay in the isolated pockets of economic devastation and hardship that were themselves perfect storms for isolated micro addiction epidemics. But sadly, recent data shows fentanyl addiction has spread everywhere. Quoting the CDC, “[Deaths] increased sharply in Midwestern states (33.1%), Southern (64.7%) and Western (93.9%) jurisdictions.” These increases were noted as occurring after the southeast, northeast, and Appalachia had already been devastated by fentanyl addiction.


Furthermore, the recent surge in fentanyl deaths is largely a problem for young people, particularly young men. About 73% of the deaths attributed to fentanyl are among men, and about 20% of the deaths involve Americans under the age of 25.

Another factor to consider is that the methods of use of the drug have changed, particularly in western states where fentanyl is a relatively new drug of choice. Traditionally, opioid drugs are most lethal when they are consumed intravenously. This has not been the case in western states, where 57% of Americans who die from fentanyl overdoses died from simply smoking, snorting, or swallowing the drug.

Yet another factor to consider is that fentanyl-related deaths have now moved beyond just the abuse of opioid drugs alone. According to the CDC, four in every ten fentanyl deaths now involve a stimulant drug such as cocaine or methamphetamine. Often, addicts will use cocaine or meth, thinking they are using just cocaine or meth. Not knowing that their drug supply has been tainted with fentanyl, the addicts overdose and die. This saddening trend began in the western states, but now the misuse of fentanyl-laced cocaine and fentanyl-laced meth has made its way east.

Finally, and this is very recent, but reports also indicate that another reason why so many addicts died from fentanyl in the last year is that some drug traffickers have made illicit fentanyl and modified the drug into a pill form that looks like oxycodone, alprazolam, or other prescription drugs. While this has allowed traffickers to expand into other markets of illicit drug use (by marketing to addicts who normally use prescription drugs), this practice has also left a trail of dead addicts in its wake.

When all of the above risk factors are added together, one can understand how the nation came to a point where over 100,000 Americans died from drug overdoses in one year. While there is no doubt that the pandemic and socioeconomic factors contributed to 2020’s highest-ever overdose deaths, the spread of fentanyl into western states undoubtedly also played a central role in the surge in overdose deaths.

Why is Fentanyl So Dangerous?

The nationwide spread of fentanyl and the stark danger of the drug are abundantly clear. But why is fentanyl so dangerous? Fentanyl is a highly potent opioid drug, intended only for treating severe pain following surgery or for special-case patients who suffer with severe, chronic pain. Fentanyl is about 100 times more potent than morphine and anywhere from ten to fifty times more potent than heroin.

Fentanyl lethal dose
Image Courtesy of

Legitimate, pharmaceutical-grade fentanyl by itself is dangerous merely because of how potent it is. But another risk factor is the added danger posed by illicit fentanyl and other, fentanyl-like substances. Quoting the Drug Enforcement Administration, in its explanation of illicitly manufactured fentanyl, “Producing illicit fentanyl is not an exact science. Two milligrams of fentanyl can be lethal depending on a person’s body size, tolerance, and past usage. DEA analysis has found counterfeit pills ranging from .02 to 5.1 milligrams (more than twice the lethal dose) of fentanyl per tablet.” When clandestine drug labs manufacture illicit fentanyl, it is even more dangerous and lethal than pharmaceutical-grade fentanyl. Also according to the DEA, about 42% of seized and tested fentanyl contains at least two milligrams of fentanyl, a lethal dose for most humans.

“Producing illicit fentanyl is not an exact science. Two milligrams of fentanyl can be lethal depending on a person’s body size, tolerance, and past usage. DEA analysis has found counterfeit pills ranging from .02 to 5.1 milligrams (more than twice the lethal dose)
of fentanyl per tablet.”

As times goes by, this highly potent and very lethal drug continues to claim more lives, garnering a higher percentage of total overdose deaths with each passing year. According to the National Institute on Drug Abuse, fentanyl accounted for 14% of overdose deaths in 2010. But by 2016, the drug accounted for almost 50% of all overdose deaths. The drug now accounts for over 63% of overdose deaths in the more recent figures.

Addiction Treatment; Saving Lives from Fentanyl Addiction

With fentanyl alone claiming more than half of all lives lost to drug overdoses each year, the use of this drug should be seen for what it is, i.e., life-threatening. For those currently addicted to fentanyl, it is of the utmost importance that they get into drug treatment centers as soon as possible.

Fentanyl addiction is a daily gamble with one’s life. If you know someone who is using fentanyl, please get in touch with a qualified residential drug treatment center today. Don’t let your loved one become just another statistic.




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.