The report examines the trends in drug overdose deaths in the United States from 2013 to 2017, focusing on the increasing involvement of synthetic opioids, particularly illicitly manufactured fentanyl (IMF). In 2016, 66.4% of drug overdose deaths involved opioids, with a 21.4% increase from 2015. From 2013 to 2017, overdose death rates increased in 35 out of 50 states and DC, and significant increases in death rates involving synthetic opioids occurred in 15 out of 20 states. In 2017, among 70,237 drug overdose deaths, 47,600 (67.8%) involved opioids, with increases across all demographic groups. Synthetic opioids contributed to a 45.2% increase in overdose death rates from 2016 to 2017. The report highlights the need for more timely and comprehensive surveillance data to inform prevention and response strategies, emphasizing the urgency of intensified measures to curb deaths involving prescription and illicit opioids, especially IMF.The report examines the trends in drug overdose deaths in the United States from 2013 to 2017, focusing on the increasing involvement of synthetic opioids, particularly illicitly manufactured fentanyl (IMF). In 2016, 66.4% of drug overdose deaths involved opioids, with a 21.4% increase from 2015. From 2013 to 2017, overdose death rates increased in 35 out of 50 states and DC, and significant increases in death rates involving synthetic opioids occurred in 15 out of 20 states. In 2017, among 70,237 drug overdose deaths, 47,600 (67.8%) involved opioids, with increases across all demographic groups. Synthetic opioids contributed to a 45.2% increase in overdose death rates from 2016 to 2017. The report highlights the need for more timely and comprehensive surveillance data to inform prevention and response strategies, emphasizing the urgency of intensified measures to curb deaths involving prescription and illicit opioids, especially IMF.