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Illicit fentanyl is distributed across the country and sold on the illegal drug market. Producing illicit fentanyl is not an exact science.

Two milligrams of fentanyl can be lethal. DEA analysis has found counterfeit pills ranging from .02 to 5.1 milligrams (more than twice the lethal dose) of fentanyl per tablet.

• 42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a lethal dose.
• Drug trafficking organizations typically distribute fentanyl by the kilogram.  One kilogram of fentanyl has the potential to kill 500,000 people.

Fentanyl is the primary driver of drug poisoning in the United States.

Comparison between 12 months-ending January 31, 2020, and the 12 months-ending January 31, 2021, during this period:

• Overdose deaths involving opioids rose 38.1%.
• Overdose deaths involving synthetic opioids rose 55.6% and appear to be the primary driver of the increase in total drug deaths.

It is often impossible to tell if a powder or pill contains fentanyl.

Fentanyl-involved unintentional drug poisoning deaths rose from 21,088 in 2010 to 47,600 in 2017 and remained steady in 2018 with 46,802 deaths. This was followed by a significant increase in 2019 to 49,860 overdose deaths.