Trends in Suspected Fentanyl-Involved Nonfatal Overdose Emergency Department Visits, by Age Group, Sex, and Race and Ethnicity — United States, October 2020–March 2024

Fatal overdoses involving synthetic opioids such as fentanyl increased sharply during the past decade. Recent data indicate declines in deaths with illegally manufactured fentanyls detected beginning in mid-2023. However, timely data on nonfatal overdoses involving fentanyl are limited. Emergency department (ED) data from CDC's National Syndromic Surveillance Program during October 2020-March 2024 were analyzed. Quarterly trends in rates of suspected nonfatal overdose of unintentional or undetermined intent involving fentanyl or fentanyl analogs (fentanyl-involved nonfatal overdoses) (i.e., the number of ED visits for fentanyl-involved nonfatal overdose per 10,000 total ED visits) were analyzed overall and by age group, sex, and race and ethnicity. During quarter (Q) 4 (October-December) 2020 to Q3 (July-September) 2023, rates of fentanyl-involved nonfatal overdose ED visits increased 8.7% per quarter, from 1.4 to 3.5 per 10,000 ED visits, then declined 11.0% per quarter, to 2.9 per 10,000 ED visits, from Q3 2023 to Q1 (January-March) 2024. Trends increased among a majority of demographic groups through mid-2023, with the highest rates and the largest increases among non-Hispanic American Indian or Alaska Native persons (e.g., 11.9 per 10,000 ED visits in Q3 2023, and an average quarterly increase of 9.0%, respectively). Providers in EDs have an important role in preventing fentanyl-involved nonfatal overdoses. Buprenorphine, a medication used to treat opioid use disorder that can be initiated in an ED, might benefit persons who use EDs as a main source of medical care. In addition, comprehensive services, including screening and treatment of co-occurring mental health conditions, as well as evidence-based prevention, treatment, and recovery support services, might be initiated in EDs because these might be particularly important in communities at high risk for fentanyl overdoses.