Deaths due to drug overdose have topped a million for the first time since the Centers for Disease Control and Prevention began collecting data on the problem more than two decades ago.
A study released Thursday by the National Center for Health Statistics, a division of the CDC, found that 932,364 people died in the U.S. from fatal overdoses from 1999 through 2020.
Separate preliminary data from the CDC shows another 100,000 drug deaths expected in 2021.
Unlike the COVID-19 pandemic, which hit elderly Americans hardest, researchers found drug deaths have risen fastest among the young and middle-aged adults struggling with addiction.
"Among adults aged 35–44, the age group with the highest rates, drug overdose deaths increased 33% from 2019 to 2020," the report found. Men are also more vulnerable than women, it said.
The opioid epidemic began in the late 1990s when the pharmaceutical and health care industries started marketing and prescribing highly addictive painkillers far more aggressively.
In recent years, most overdose deaths have involved illicit fentanyl, a powerful synthetic opioid, as well as cocaine and methamphetamines.
After public health officials made some early progress in reducing drug deaths, researchers found overdoses began rising again after 2013 with a sharp increase in fatalities during the first year of the pandemic.
Young people ages 15-24 saw the biggest year-to-year increase of fatal overdoses with deaths up 49% in 2020.
The Biden administration has scrambled in recent months to try to slow the rate of drug deaths, in part by making medical treatment more widely available for people with addiction.
Last month, the first safe consumption site in the U.S., where people can use street drugs under medical supervision, opened in New York City.
Despite the growing death rate, public health "harm reduction" strategies for people with addiction have faced resistance and legal challenges around the country.