Fact Check

Did Fentanyl Overdose Become Top Cause of Death for Adults Aged 18-45 in the US?

An extraordinary milestone went almost unnoticed in December 2021.

Published Dec 21, 2021

A Drug Enforcement Administration (DEA) chemist checks confiscated powder containing fentanyl at the DEA Northeast Regional Laboratory on October 8, 2019 in New York. - According to US government data, about 32,000 Americans died from opioid overdoses in 2018. That accounts for 46 percent of all fatal overdoses. Fentanyl, a powerful painkiller approved by the US Food and Drug Administration for a range of conditions, has been central to the American opioid crisis which began in the late 1990s. (Photo by Don EMMERT / AFP) (Photo by DON EMMERT/AFP via Getty Images) (DON EMMERT/AFP via Getty Images)
Image Via DON EMMERT/AFP via Getty Images
In 2020 and 2021, CDC data showed that fentanyl overdose was the single leading cause of death among 18-45 year-olds in the United States.

In December 2021, news outlets reported an alarming new milestone in the continued growth of the opioid fentanyl as a considerable danger in American society. On Dec. 17, for example, Fox News published an article with the headline "Fentanyl overdoses become No. 1 cause of death among US adults, ages 18-45."

That report stated that:

Fentanyl overdoses have surged to the leading cause of death for adults between the ages of 18 and 45, according to an analysis of U.S. government data.

Between 2020 and 2021, nearly 79,000 people between 18 and 45 years old — 37,208 in 2020 and 41,587 in 2021 — died of fentanyl overdoses, the data analysis from opioid awareness organization Families Against Fentanyl shows.

Over the previous two years, the U.S. did indeed see an alarming and rapid increase in the number and prevalence of fentanyl overdose deaths, and the claim that fentanyl poisoning was now the leading cause of death among 18-45 year-olds was indeed born out by official figures. We're issuing a rating of "True."

According to data collected by the U.S. Centers for Disease Control and Prevention (CDC), an estimated 64,268 fatal fentanyl overdoses took place in the U.S. between April 2020 and April 2021. That's a 50% increase on the number of deaths between 2019 and 2020, and nearly double the 32,754 deaths from April 2018 to April 2019 — a remarkable rise in such a short period of time.

Snopes replicated an analysis performed by the nonprofit group Families Against Fentanyl, using official CDC data from 2018 through to May 2021. The result of that analysis, which we have verified as accurate, is extraordinary. Among U.S. adults aged between 18 and 45 years old — broadly considered the "prime of life" — no single factor now kills more prolifically than a Fentanyl overdose: not even suicide, car crashes, a once-in-a-century pandemic like COVID-19, or all other drug overdoses combined.

Details about the methodology and datasets behind the analysis can be found on the website of Families Against Fentanyl. The 10 leading causes of death for 2021, 2020 and 2019 are shown in the table below:

The only slight caveat on that analysis is that the data for 2020 and 2021 are, as of yet, provisional. However, any future revisions to those figures are likely to be relatively minor, and will almost certainly not have a bearing on the new and startling preeminence of fentanyl as a killer of adults in the U.S.


Products - Vital Statistics Rapid Release - Provisional Drug Overdose Data. 7 Dec. 2021, https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.

Dan Mac Guill is a former writer for Snopes.

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