"The United States is experiencing an epidemic of opioid overdose deaths from both prescription and illicit opioids such as fentanyl and heroin. In 2016, the number of opioid overdose deaths was five times higher than in 1999. There were more than 63,600 deaths attributed to opioids resulting in an average of 115 Americans dying every day. The first wave began with increased prescribing of opioids in the 1990s. The second wave began in 2010, with a rapid increase in overdose deaths involving heroin. Most recently, the third wave began in 2013 with significant increases in deaths caused by illicitly-manufactured fentanyl. This fentanyl can be found in combination with heroin, counterfeit pills, and cocaine."
United States. Indian Health Service: https://www.ihs.gov/