Is fentanyl use down since Trump became president
Executive summary
Fentanyl-related harms in the United States increased sharply after 2016 and through the pandemic era, and most national indicators show that fentanyl-driven overdose deaths and nonfatal overdoses were higher after Donald Trump took office than before—though some indicators flattened or dipped slightly in 2023; precise measurement of "use" versus "deaths" is limited by available surveillance data [1] [2] [3] [4].
1. The simplest answer: use as measured by deaths and emergency data rose after 2016, not down
Measured by overdose deaths and emergency-department and EMS encounter data—common proxies for population-level fentanyl use and harm—the trend is an escalation beginning around 2014–2016 that continued through 2021–2022, meaning fentanyl-linked fatalities were substantially higher during and after the Trump years than before them [1] [2] [4].
2. What the official numbers say about recent direction: a massive rise, then small declines in 2023 for deaths but continued high burden
CDC and NCHS provisional and finalized counts show that deaths involving synthetic opioids (primarily illicit fentanyl) climbed to unprecedented levels through 2021–2022, with total drug overdose deaths peaking over 107,000 in 2022 and slight declines to about 105,000 in 2023; deaths involving synthetic opioids decreased only modestly from 73,838 in 2022 to 72,776 in 2023, so the overall burden remains dramatically higher than in 2016–2017 [4] [3].
3. Nonfatal overdoses, seizures and local outbreaks corroborate expansion of fentanyl availability and harm
Emergency-department surveillance showed increases in suspected fentanyl-involved nonfatal overdoses through mid-2023 across most demographic groups, while law-enforcement seizure data and local health departments documented huge upticks in fentanyl supply—examples include 1,098% increases in fentanyl seizures in Eastern Washington and reported multi-hundred-percent rises in county-level fentanyl overdoses between 2017 and 2021—signals consistent with wider availability rather than declining use [5] [6] [7].
4. Measurement limits: "use" ≠ "deaths" and reporting delays complicate simple comparisons to 2017
Public-health sources and the CDC caution that surveillance primarily captures overdose deaths, ED visits, and seizures—not prevalence of nonfatal recreational use—and provisional data suffer reporting delays that can obscure near-term trends, so the evidence supports conclusions about rising harms and availability but cannot definitively quantify total numbers of people using fentanyl vs. before 2017 without additional prevalence surveys [8] [3] [9].
5. Competing interpretations, politics and implicit agendas in the reporting
Law-enforcement releases emphasize seizures and "drug threat" framing to justify interdiction efforts, while public-health sources emphasize treatment, harm reduction and social drivers—both use the same data to support different policies; some outlets highlight modest 2023 declines as proof of successful interventions, but those declines are small relative to the decade-long surge and do not show use returning to pre-2017 levels [10] [11] [4].
6. Bottom line and what remains unknown
Bottom line: fentanyl-related harms and indicators of availability increased markedly after 2016 and remained far above pre-2017 levels through at least 2023, so it is not accurate to say fentanyl use is "down since Trump became president" based on the available surveillance; however, national overdose deaths involving synthetic opioids showed only modest decreases in 2023, and direct measures of prevalence of nonfatal use are limited in the cited sources, leaving room for future adjustments as data are updated [1] [4] [3] [8].