Drop in deaths tied to one cartel ending fentanyl production

Fentanyl in Ohio’s drug supply falls significantly


Overdose deaths in Ohio declined sharply and unexpectedly in the last four months of 2023.

Based on nearly complete mortality data, Harm Reduction Ohio estimates overdose deaths decreased in 2023 as follows:

  • September: 319 overdose deaths, down 18.7% from September 2022.
  • October: 326 overdose deaths, down 27.2%.
  • November: 307 overdose deaths, down 25.8%.
  • December: 332 overdose deaths, down 24.8%.

The large drop in overdose deaths appears to have continued, and perhaps even accelerated, in the first few months of 2024, although it’s too early to say for sure.

The sudden decline is especially remarkable because overdose deaths had increased in the first half of 2023, running near historically high levels that sometimes exceeded 400 deaths per month.

Harm Reduction Ohio estimates approximately 4,500 Ohio residents died from drug overdoses in 2024. This would be the lowest number of overdose deaths since the COVID pandemic arrived in 2020.

However, the annual death toll of 4,500 in 2023 masks the size and suddenness of this major drop in overdose deaths.

Consider: Ohio suffered an average of 401 overdose deaths per month from January through August of 2023, essentially the same pace of death as in 2022. However, in the last four months of the year, overdose deaths plummeted by 24.2% to an average of 321 per month.

The decline of deaths involving fentanyl has been especially dramatic, larger than declines involving other drugs.


Cartel “Los Chapitos” Branch Stops Fentanyl Production

The primary cause of the decline in overdose deaths appears to be a decision by a key branch of the Sinaloa cartel in Mexico to stop producing fentanyl.

The sons of cartel leader Joaquín Guzmán (“El Chapo”) imposed and enforced a prohibition on fentanyl production starting in June 2023. The cartel killed more than 50 local fentanyl cooks to enforce its decision.

The El Chapo branch of the Sinaloa cartel was an early adopter of using fentanyl as a substitute for heroin and was believed to be Mexico’s largest fentanyl producer before its sudden exit from the business.

The reason for the cartel branch getting out of the fentanyl business, at least temporarily, is not clear. However, journalists and analysts believe it is likely part of a negotiating strategy with the Mexican and U.S. governments. Additionally, the price of fentanyl has fallen so low that it is not as profitable as it once was.

Joaquín Guzmán (“El Chapo”) and his family have controlled the Sinaloa cartel’s original home turf since 1988. It is a brutal branch of a cartel that now has many branches and factions.

Guzmán was extradited to the United States in 2017 and now, at age 67, is held in a supermax prison in Colorado. Guzmán’s four sons now operate the family business and are called “Los Chapitos,” or “the little Chapos.”

Ovidio Guzman Lopez on flight to U.S. Credit: @derekmaltz_sr on X

In January 2023, the Mexican military captured one of the brothers, Ovidio Guzmán López, to hold him for extradition to the United States.

Los Chapitos issued a public letter in May 2023 denying involvement with fentanyl. “We have never produced, manufactured, or marketed fentanyl or any of its derivatives,” the letter said.

In June 2023, Los Chapitos ordered an immediate halt to all fentanyl production and trafficking. More than 50 people who did not stop were murdered, reported InSight Crime. Some victims were handcuffed, shot, and left next to stacks of fentanyl.

In September 2023, the captured brother was extradited to the United States. In October, banners were tied to bridges in Culiacán that confirmed the prohibition on fentanyl production. The banners’ messages ended: “You have been warned. Respectfully, Chapitos.”

Fentanyl is still being produced beyond the Los Chapitos stronghold in Culiacán. Some news reports say some Culiacán area producers have moved north, closer to the U.S. border, to keep their businesses going.

Regardless, Ohio drug seizure data – as well as overdose death data – show fentanyl’s presence in Ohio has declined significantly concurrent with the Los Chapitos’ exit from the business.

Fentanyl Presence in Ohio Declines

The Los Chapitos’ decision to stop fentanyl production can be seen in the drugs seized and tested by law enforcement in Ohio.

The next chart shows how fentanyl’s presence in Ohio drugs changed from before COVID-19 to the first quarter of 2024. In the quarter of 2020 when fentanyl was found in 29.4% of Ohio drugs, overdose deaths in Ohio hit historic levels, including a record 574 deaths in May 2020.

In recent months, fentanyl’s presence (alone and mixed with other drugs) tumbled from 27.7% of all drugs in the fourth quarter of 2022 to 25.5% of all drugs in the fourth quarter of 2023, the lowest level since before COVID-19.

In these charts, fentanyl’s presence in Ohio’s drug supply is measured by what substances were found in drugs tested at Ohio Bureau of Criminal Investigation (BCI) crime labs. The labs test more than 50,000 drugs annually from samples submitted by Ohio law enforcement agencies. (Fentanyl analogs such as acetyl fentanyl are counted as fentanyl in this chart.)

Changes in fentanyl’s presence in drug seizures closely follow changes in overdose deaths. In a nutshell, more fentanyl equals more deaths; less fentanyl equals fewer deaths.

Fentanyl’s presence declined significantly in the second half of 2023, especially in the last quarter. Drugs that contain “fentanyl alone” are most highly correlated with changes in overdose deaths. “Fentanyl alone” means drugs that the crime lab found contained just fentanyl – without heroin, cocaine, meth, or benzodiazepines in the mixture.

The chart shows that fentanyl by itself (i.e., with no other drugs) accounted for 13.2% of drugs tested in the fourth quarter of 2022. A year later, that number had fallen to 9.8% in the fourth quarter of 2023, and then fell again to 7.8% in the first quarter of 2024.

This sharp decline likely mirrors a drop in overdose deaths in early 2024. A connection between the decline in fentanyl’s presence in Ohio and overdose deaths cannot be confirmed until the summer when mortality data is more complete.

 Sources and Methodology 

Mortality Estimates: Harm Reduction Ohio’s overdose death estimates for 2023 are based on Ohio Department of Health mortality data. The state updates all deaths in Ohio several times a week in an online mortality database. The final mortality data, including overdose death counts, are finalized in the autumn of the following year. As of now, 98.9% of deaths have been added to the 2023 mortality data. Harm Reduction Ohio estimates the final overdose death counts by computing an average of incomplete reporting for each month, based on the average pace of reporting in the previous four years. As of May 21, 2024, the mortality data includes 4,434 confirmed overdose deaths of Ohio residents in 2023. Harm Reduction Ohio’s methodology estimates a final death toll of 4,505. Because of the sharp decline in overdose deaths near year-end (when data is most incomplete), the number of overdose deaths in 2023 has a reasonable chance of being below 4,500.

Sinaloa cartel: This section summarizes reporting done by journalists in Mexico and published by Reuters, the Wall Street Journal, USA TODAY,  ABC News and InSight CrimeInSightCrime, a think tank and journalistic organization, has been especially detailed (and incredibly brave) in its coverage of Mexican cartels.

Fentanyl in Ohio Drugs: Harm Reduction Ohio analyzed drug seizures tested in the Ohio Bureau of Criminal Investigation (BCI) crime labs. BCI crime labs conduct more than 50,000 gas chromatography–mass spectrometry (GC-MS) tests every year on drug samples submitted by more than 500 law enforcement agencies in all 88 Ohio counties. The GC-MS lab tests identify the presence of controlled drugs found in each sample but do not calculate the weight or purity of the controlled substances found. For example, a lab test would determine that cocaine and fentanyl were found in a substance, but not how much cocaine or fentanyl was in the tested sample. Harm Reduction Ohio requests data updates from BCI quarterly and, for this story, a monthly update to have more complete data to analyze the relationship of fentanyl’s presence to the decline in overdose deaths. The BCI drug seizure dataset now includes about 400,000 GC-MS tests done on drugs seized in Ohio since 2013.

Detailed Data

For an in-depth look at Ohio’s unexpected decline in overdose death, Harm Reduction Ohio provides detailed data on the change in:

Click for detailed data

Click for detailed data


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