What is already known about this topic?
During 1999–2017, the rate of drug overdose deaths nationally approximately tripled; approximately 70,000 overdose deaths occurred nationally in 2017, with nearly 68% involving an opioid.
What is added by this report?
Using toxicology data, New York City identified fentanyl in 2% of drug overdose deaths during 2000–2012. By 2017, fentanyl was involved in 57% of all drug overdose deaths in New York City.
What are the implications for public health practice?
Universal fentanyl testing by local medical examiners and inclusion of drug-specific language on death certificates can aid surveillance and address the role of fentanyl in drug overdoses. Community-level educational outreach is indicated when an increase in fentanyl involvement is detected.