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D.C. opioid deaths skyrocket, with 96% of cases involving fentanyl

Opioid overdose deaths hit a record high in the District of Columbia in 2023, rising by more than 12% from 2022, according to a new report released by the city’s Office of the Chief Medical Examiner.

In 2023, 518 deaths were connected to the use of opioids at a 73% mortality rate versus 461 deaths in 2022 at a 68.6% mortality rate. All but five of the overdose deaths in 2023 were classified as accidental.

By comparison, the District saw 274 homicides last year.



The leading cause of fatalities was fentanyl, a synthetic opioid that has been the most prevalent substance causing overdoses since 2017. It is as much as 50 times stronger than heroin and 100 times stronger than morphine, according to the Centers for Disease Control and Prevention.

Fentanyl was connected to 504 overdose deaths in the District in 2023, 96% of the city’s total.

That percentage tracks with trends over the past five years. While fentanyl contributed to only 62% of deaths in 2016, it has been involved in more than 90% of D.C. opioid overdose fatalities every year since 2019.

The high rates of fentanyl deaths are partly caused by its contamination of other illicit drugs and its potency.

Fentanyl “has really taken over the drug supply. Increasingly, fentanyl is getting into cocaine, methamphetamine and other drugs sometimes deliberately and sometimes inadvertently,” Dr. Joshua Sharfstein, a professor at the Johns Hopkins Bloomberg School of Public Health, told WTOP-FM.

The demographic distribution of deaths was disproportionate, with 72% of deaths involving men, about 71% people ages 40 to 69 and 84% involving Black individuals.

Most of D.C.’s overdose deaths affected city residents, at 329. An additional 58 cases involved the homeless.

Opioid-related deaths were concentrated most heavily in the eastern half of the city. Ward 5 saw 50 deaths, with Ward 7 at 73 dead and Ward 8 at 80.

City officials also called attention to the slow growth in the use of xylazine, a nonopioid animal sedative that is being added to drugs, particularly opioids, to increase the effects of the drug. Fifteen opioid overdose deaths involved xylazine, also known as “tranq,” versus 11 in 2022.

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