The report examines drug overdose deaths in the United States from 2017 to 2018, focusing on the involvement of opioids. In 2017, approximately two-thirds of the 70,237 drug overdose deaths involved opioids, with synthetic opioids being a significant driver of increases in overdose deaths. By 2018, the total number of drug overdose deaths decreased by 4.1%, but the rate of opioid-involved deaths decreased by only 2%. Prescription opioid-involved deaths decreased by 13.5%, heroin-involved deaths by 4.1%, while synthetic opioid-involved deaths increased by 10%. The report highlights the need for comprehensive surveillance, prevention measures, and continued efforts to reduce opioid-involved deaths, particularly those involving synthetic opioids. It also emphasizes the importance of addressing social determinants of health and the changing nature of drug use, including the resurgence of methamphetamine use and the mixing of opioids with other substances.The report examines drug overdose deaths in the United States from 2017 to 2018, focusing on the involvement of opioids. In 2017, approximately two-thirds of the 70,237 drug overdose deaths involved opioids, with synthetic opioids being a significant driver of increases in overdose deaths. By 2018, the total number of drug overdose deaths decreased by 4.1%, but the rate of opioid-involved deaths decreased by only 2%. Prescription opioid-involved deaths decreased by 13.5%, heroin-involved deaths by 4.1%, while synthetic opioid-involved deaths increased by 10%. The report highlights the need for comprehensive surveillance, prevention measures, and continued efforts to reduce opioid-involved deaths, particularly those involving synthetic opioids. It also emphasizes the importance of addressing social determinants of health and the changing nature of drug use, including the resurgence of methamphetamine use and the mixing of opioids with other substances.