Deaths caused by drug overdose in the United States have reached unprecedented levels, driven largely by fentanyl—a synthetic opioid 50 times stronger than heroin and 100 times stronger than morphine.
According to CDC data, just over 105,000 overdose deaths were recorded in 2023, marking the third consecutive year above the 100,000 mark. Synthetic opioids—mainly fentanyl—were responsible for 70,000 deaths, or about 68% of the total. To put this in perspective, more Americans now die each year from fentanyl and similar drugs than the 58,220 US casualties of the Vietnam War over a decade.
Most fentanyl-related deaths stem from illicitly manufactured fentanyl, not prescription drugs. Much of it traces back to precursor chemicals produced in China, which were shipped to Mexico and subsequently trafficked across the US border. This supply chain made fentanyl a central issue in the recent Trump–Xi summit, where US President Donald Trump agreed to halve certain tariffs in exchange for China's commitment to curb precursor exports.
Washington views the fentanyl epidemic as a national security threat, citing its vast death toll, links to transnational crime networks, and potential to destabilise communities. For its part, China denies responsibility, pointing to its 2019 ban on fentanyl-class substances and blaming US demand and overprescription for fuelling the crisis.
