According to an October 2019 report from the US Centers for Disease Control and Prevention’s National Center for Health Statistics, fentanyl is now the drug most commonly identified in fatal overdoses. In 2017 fentanyl was associated with 38.9% of all drug overdoses, an increase from its 2016 number of 29%. This is only the second year that the CDC has analyzed fatal overdoses in this way.
In 2017 heroin was behind 22.8% of fatal overdoses, cocaine 21.3%, and methamphetamine 13.3%. Although on a national level fentanyl is the deadliest drug, in certain parts of the country methamphetamine is responsible for more deaths. This includes many of the rural flyover states such as Oklahoma, Colorado, Montana, North Dakota, and Utah, but also includes California, Arizona, Washington and Oregon. Although these numbers are unsurprising in some ways, understanding the popularity and comparatively increased availability of methamphetamine in less populated states, there could be a different explanation for this statistic in the west coast states.
East of the Mississippi, powdered heroin is most common, while on the west coast black tar heroin is the most common form of heroin. It is very difficult to cut black tar heroin with fentanyl, which could be the reason why some of these states are seeing a reduced number of fentanyl overdose deaths.