Since 2020, fatal synthetic opioid-only overdose rates higher than polydrug overdose rates involving synthetic opioids

Declines seen across drug classes and for most states

Most individuals report that their first opioid exposure involved prescription opioids for themselves or others

Highest percentage of cocaine co-involvement seen in industries that are less physically strenuous

Opioid prescriptions in the emergency department linked to small increases in hospital admission and subsequent opioid prescription use

This trend may be driven by increases in heroin and synthetic opioids coinvolvement

Higher levels of smoking also tied to pain-related work limitations and worse self-reported health, mental health