A highly potent synthetic opioid, fentanyl is often mixed into other drugs sold on the street, including pills, heroin and even cocaine.

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Fentanyl is now the drug most frequently involved in overdose deaths in the U.S., according to a National Vital Statistics System report published Wednesday from the Centers for Disease Control and Prevention.

The report sheds a bright light on the changing nature of America's drug landscape — and the devastating number of overdose deaths that have occurred in the U.S. in recent years.

Back in 2011, oxycodone was the drug most commonly linked to overdose deaths. Starting in 2012 and lasting until 2015, heroin surpassed painkillers to become the drug most often involved. But then fentanyl, a synthetic opioid pain reliever 50 to 100 times more powerful than morphine, infiltrated the American drug supply — what the CDC calls "the third wave" of the opioid epidemic. By 2016, overdose deaths involving fentanyl had become more common than any other.

The authors of the report identified drug overdose deaths by looking at the text on death certificates for the years 2011 to 2016. In cases where a death involved more than one drug (e.g., both heroin and cocaine), they counted the death in all relevant drug categories. Alcohol, nicotine and other non-drug substances were not part of the analysis.

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