What is fentanyl?

Pharmaceutical fentanyl is a synthetic opioid approved for treating severe pain, typically advanced cancer pain.1 It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.

However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl.2 It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.

Learn More: Fentanyl Data

Deaths involving illicitly manufactured fentanyl are on the rise

Rates of overdose deaths involving synthetic opioids other than methadone, which includes fentanyl and fentanyl analogs, increased over 22% from 2020 to 2021. The rate of overdose deaths involving synthetic opioids in 2021 was nearly 22 times the rate in 2013. Nearly 71,000 drug overdose deaths involved synthetic opioids other than methadone in 2021. The latest provisional drug overdose death counts suggest overdose deaths accelerated during the COVID-19 pandemic.

What can be done?

The increase in overdose deaths highlights the need to ensure people most at risk of overdose can access care, as well as the need to expand prevention and response activities. CDC issued a Health Alert Network Advisory to medical and public health professionals, first responders, harm reduction organizations, and other community partners recommending the following actions as appropriate based on local needs and characteristics:

  • Expand distribution and use of naloxone and overdose prevention education
  • Expand awareness about and access to and availability of treatment for substance use disorders
  • Intervene early with individuals at highest risk for overdose
  • Improve detection of overdose outbreaks to facilitate more effective response
Related Pages

Additional Resources


  1. Algren D, Monteilh C, Rubin C, et al. Fentanyl-associated fatalities among illicit drug users in Wayne County, Michigan (July 2005-May 2006).Journal Of Medical Toxicology: Official Journal of the American College Of Medical Toxicology [serial online]. March 2013; 9(1):106-115.
  2. Department of Justice, Drug Enforcement Administration, DEA Investigative Reporting, January 2015.
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