It’s more than homicide and suicide combined. Drug use itself hasn’t risen, but the deadliness has. The overdose rate is highest in Black and Indigenous Americans, and has risen mostly quickly in youth.

It is found in counterfeit pills that purport to be oxy, Percocet, and Xanax, and more. It has even been found in cocaine and meth. Heroin has been almost completely replaced by it. Whether fentanyl is used intentionally or accidentally, the risk for overdose is much higher.

Opioid overdose is 100% reversible. Carrying Narcan, not using alone, and trying to avoid mixing opioids with either alcohol or benzodiazepines are proven ways of reducing deaths. Fentanyl test strips can identify when there’s fentanyl somewhere it shouldn’t be, such as pills and powders, which can prevent an overdose before it occurs.