CDC’s Injury Center looks at deaths and nonfatal overdoses for four categories of opioids:
Natural opioids (including morphine and codeine) and semi-synthetic opioids (drugs like oxycodone, hydrocodone, hydromorphone, and oxymorphone)
Methadone, a synthetic opioid
Synthetic opioids other than methadone (drugs like tramadol and fentanyl)
Heroin, an illicit (illegally made) opioid synthesized from morphine that can be a white or brown powder, or a black sticky substance.
Nearly 500,000 people died from overdoses involving any opioid, including prescription and illicit opioids, from 1999-2019.1
This rise in opioid overdose deaths can be outlined in three distinct waves.
The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.2
The second wave began in 2010, with rapid increases in overdose deaths involving heroin.3
The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl.4,5,6 The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.7
Many opioid-involved overdose deaths also include other drugs.8,9