Drug Overdose Deaths in the United States, 2003–2023

This report presents rates of drug overdose deaths from the National Vital Statistics System by demographic group and by the type of drugs involved (specifically, opioids and stimulants), with a focus on changes from 2022 to 2023.

Data were analyzed using National Vital Statistics System multiple cause-of-death mortality files for 2003 through 2023, drug poisoning (overdose) deaths were defined as having an International Classification of Diseases, 10th Revision (ICD-10) underlying cause-of-death code of X40-X44 (unintentional), X60-X64 (suicide), X85 (homicide), or Y10-Y14 (undetermined intent). The type of drug(s) involved was indicated by ICD-10 multiple cause-of-death codes: T40.1 (heroin), T40.2 (natural and semisynthetic opioids), T40.3 (methadone), T40.4 (synthetic opioids other than methadone), T40.5 (cocaine), and T43.6 (psychostimulants with abuse potential). Age-adjusted death rates were calculated using the direct method and the 2000 U.S. standard population. Pairwise comparisons of were conducted using the z test with an alpha level of 0.05, and trends were assessed using the Joinpoint Regression Program (5.0.2).

The age-adjusted rate of drug overdose deaths decreased from 32.6 deaths per 100,000 standard population in 2022, to 31.3 in 2023. Rates decreased between 2022 and 2023 for people ages 15-54 and increased for adults 55 and older. From 2022 to 2023, rates decreased for White non-Hispanic people, while rates for other race and Hispanic groups generally stayed the same or increased. From 2022 to 2023, rates declined for deaths involving synthetic opioids other than methadone, heroin, and natural and semisynthetic opioids, remained statistically unchanged for methadone, and increased by 4.9% for cocaine (from 8.2 to 8.6) and by 1.9% for psychostimulants with abuse potential (from 10.4 to 10.6).