By The United States Sentencing Commission
More than 780,000 Americans died from a drug overdose in the last ten years. Overdose deaths have increased more than 300 percent from the level two decades ago. The number of such deaths has continued to increase in recent years, with the Centers for Disease Control reporting that 91,799 people died of drug overdoses in 2020, 106,699 in 2021, 107,941 in 2022, and 105,007 in 2023. Provisional data shows a recent decline in overdose deaths beginning in late 2023 and continuing into 2024. Overdoses remain one of the leading causes of deaths in adults in the United States. While fentanyl and fentanyl analogues, methamphetamine, cocaine, and heroin are the drugs most often involved in these deaths, synthetic opioids like fentanyl— which is up to 50 times more potent than heroin—contribute to nearly 70 percent of overdose deaths. In this report, the Commission examines all overdoses identified in drug trafficking cases reported to the Commission for fiscal years 2019 to 2023. One or more deaths occurred in more than three-quarters of these cases, while no deaths occurred in the remaining cases. The Commission is able to collect information about the overdoses reported in these cases through the sentencing documents the courts provide to the Commission in every case.8 Using that information, this report provides an analysis of the 1,340 individuals sentenced for a federal drug trafficking offense involving an overdose in fiscal years 2019 to 2023. In it, the Commission analyzes the demographic characteristics of these individuals, the offense conduct that occurred in the case, and how the courts sentenced these individuals—including the application of sentencing guideline provisions that provide for heightened base offense levels when the offense of conviction established that death or serious bodily injury resulting from an overdose occurred, or departures from the guideline range for death or physical injury, or how often courts varied from the guideline range for a similar reason. Additionally, in this report, the Commission provides the results of a special data collection project to explore the outcome of each overdose, the type of drug involved in the overdose, the victim’s knowledge of the drug they were taking, and the sentenced individual’s conduct during the offense.
Washington, DC, USSC, 2025. 52p.
