One-third of U.S. adults now know someone who has died of a drug overdose, a number that researchers at the Johns Hopkins University say shows the devastating toll of potent opioids widely available across the country, and the urgency to do something about the crisis.

The nationally representative survey of 2,300 Americans found an estimated 82.7 million people know someone who fatally overdosed. One in five, or about close to 49 million, had a family member or close friend die.

The deaths crossed political party lines and spanned the country. They also had no socioeconomic boundaries, though were higher among those with annual household incomes under $30,000. About 40% of those lower-income respondents knew someone who died from overdose, while about one-quarter of higher-income respondents, those over $100,000, reported an overdose loss.

“This is important to all Americans, and no group regardless of political party affiliation or geographic location has gone unaffected,” said Alene Kennedy-Hendricks, the Hopkins researcher who led the survey.

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“What they think should be done about it might be different,” she said. “But the fact that this is a shared tragedy is important.”

The survey wasn’t able to show exactly where there were higher or lower percentages of people who have lost family or friends, but “it seems likely” Baltimore would have a higher rate, said Kennedy-Hendricks, an assistant professor in the Department of Health Policy and Management in the Hopkins’ Bloomberg School of Public Health.

A yearlong investigation by The Baltimore Banner and The New York Times found that Baltimore is an epicenter for overdoses, with nearly 6,000 deaths in the past six years. The city’s death rate from 2018 to 2022 was nearly double that of any other large city.

Researchers from Hopkins, along with those at Boston University School of Public Health, the University of Minnesota and the de Beaumont Foundation undertook the survey in 2023. The results are slated to be published Friday in the journal JAMA Health Forum.

Their aim was to show the reach of overdoses, which have been rising for decades across the country and have exceeded 100,000 annually in the past several years, according to data from the U.S. Centers for Disease Control and Prevention.

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There were about 108,000 overdose deaths in 2023, a slight dip from 2022, the CDC reported. Overdose deaths specifically involving opioids also went down, dropping from an estimated 84,181 in 2022 to 81,083 in 2023, according to the CDC

Maryland health figures show 2,509 people fatally overdosed in 2023, down slightly from 2,577 in 2022. The bulk were from the powerful synthetic opioid fentanyl, but cocaine-related deaths are also climbing.

The deaths nationally are overwhelmingly tied to fentanyl, which has mostly replaced other less potent opioids including heroin, a drug that had supplanted prescription opioids such as oxycodone. Fentanyl heavily suppresses breathing in small amounts, and users don’t always know what they are using.

The drugs commonly found on the street also are often adulterated with cheap additives, such as the large animal tranquilizer xylazine, which makes an overdose harder to reverse with the antidote medication naloxone.

The researchers found addiction was an important issue for 60% of respondents, even those reporting no overdose loss, which the researchers say is a message to policy and lawmakers to come up with better means of tackling the problem.

“This study contributes new evidence that the addiction crisis and the losses that come with it are common across Americans, but the burden is greater among those who are more economically precarious,” said Catherine Ettman, an assistant professor in the Bloomberg School’s Department of Health Policy and Management. “Addressing addiction can be a unifying theme in increasingly divided times.”