While the number of annual fentanyl deaths declined slightly from 2022 to 2023, it remains far too high. In 2023, fentanyl was responsible for roughly 70% of the deaths caused by drug overdoses. In the same year, it was the leading cause of death for all regions of the country and all age, race, and ethnic groups.
One gram of fentanyl, roughly the equivalent of a sugar packet, has the potential to kill 50 people. A 2024 DEA assessment found five out of 10 fentanyl-laced fake pills contained a potentially deadly dose of the drug.
Traffickers smuggle it across the border in hidden vehicle compartments, loads of produce, or duct taped to pedestrians or bus passengers.
The fentanyl trade, though, is more than a public health threat. It’s a national security risk, with sales of the drug funding Mexican cartels. In March 2025, the Trump administration named fentanyl and the gangs that traffic it as one of the top threats to the nation’s security in the Office of the Director of National Intelligence’s annual threat assessment.