Cartel reduces fentanyl production

Ohio overdose deaths fall 30%+ on early 2024


Overdose death continues to fall in Ohio at an historic pace. In the span of just a few months, Ohio overdose deaths have dropped from about 400 per month to an average of about 300 per month — and maybe even lower than that in 2024.

Based on preliminary mortality data, Harm Reduction Ohio projects less than 275 Ohio residents died from accidental drug overdoses in January 2024. If accurate, that would be the fewest overdose deaths reported in January in Ohio since the 246 overdose deaths recorded in January 2015.

In almost the snap of a finger, overdose deaths have fallen 25% to 35% in Ohio, meaning about 1,400 fewer deaths a year, even though death rates are still high by historical standards.

Numbers in red reflect months after El Chapo cartel family ended fentanyl production.

What caused the sudden change?

Fentanyl supply from Mexico shrinks

Read our detailed report from last month

Harm Reduction Ohio reported last month that the decision by an important branch of the Sinaloa caret to stop making and smuggling fentanyl appears to be the cause of sudden decline in Ohio overdose deaths. The El Chapo branch of the complex, multi-part Sinaloa Cartel shut down its fentanyl business in June 2023 and, in September 2023, overdose deaths began to plummet in Ohio.

In May, Harm Reduction Ohio estimated Ohio’s overdose death count in 2023 would be approximately 4,505, down from 4,915 in 2022. Nearly the entire decline occurred in the final four months of 2023. However, overdose death appears to be declining even faster than estimated. Harm Reduction Ohio now projects a final overdose death count of about 4,665, below last month’s forecast of 4,505.

What does it mean for 2024?


The drop in overdose death has continued to gain speed in early 2024. Harm Reduction Ohio now estimates about 265 to 275 Ohio residents died from drug overdoses in January of this year, the lowest number in any month since 2015, a time when fentanyl’s emergence in Ohio was just starting. Harm Reduction Ohio further estimates 260 to 280 overdose deaths in February of 2024 and 290 to 320 in March. The more recent monthly estimates have wider ranges and greater uncertainty because mortality data is less complete.

Big picture: Overdose death in Ohio is falling faster and more dramatically than anybody predicted. Why El Chapo’s branch of the Sinaloa Cartel left the fentanyl business is not well understood. The most common theory is the change is tactical, part of a negotiating strategy to improve relations with the Mexican and U.S. governments. Falling fentanyl prices also likely plays a role; the fentanyl business is much less profitable than it used to be.

Regardless of the cause of the reduction in the fentanyl supply,  the results in Ohio are clear: a reduction in fentanyl’s presence in Ohio’s drug supply when measured by lab tests done on drug seizures at state crime labs. (Details on decline here.)

The future of fentanyl volume

Joaquín “El Chapo” Guzmán

It’s unclear whether the reduction in fentanyl smuggling will last. El Chapo’s branch of the cartel is strongest around the city of Culiacán (pop. 800,000), the capital of the largely rural state of Sinaloa (pop. 3,000,000).  El Chapo’s operation was believed to be the country’s biggest fentanyl smuggler, but it still controlled less than half the market. Other branches of the Sinaloa Cartel could replace the volume or El Chapo’s branch could re-enter the fentanyl business that it pioneered. A rise in fentanyl prices rise could incentivize all cartel branches in expand production and exports.

Four sons of El Chapo Joaquín Guzman now control the family business and reveal little publicly about their business strategy. El Chapo himself is now in federal prison in the United States. The four controlling sons are called Los Chapitos, or “little Chapos.” One of the sons was captured in January 2023 and extradited to the United States in September 2023.

The role of harm reduction

Overdose reduction efforts — such as treatment and naloxone distribution — are likely to have played a relatively minor reduction in the sharp decline in overdose deaths. Studies show about 90% of increases and decreases in Ohio overdose death levels can be explained by increases and decreases in the level of fentanyl and its analogs in the Ohio drug supply. In other words, if you know what’s in Ohio’s drug supply, you can know within a 20% range about how about many people will die.

Overdose Death: By the numbers

The following chart estimates overdose deaths by month since 2015. The numbers for 2015 through 2022 are final and actual deaths counts. The numbers for 2023 and 2024 are estimates based on Harm Reduction Ohio’s analysis of preliminary mortality data. Final death counts for 2023 will be published in the fall of 2024.






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