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Objectives. To contrast the geographic distribution of fentanyl-involved and non–fentanyl-involved fatal overdoses between 2014 and 2018 in Cook County, Illinois.

Methods. We conducted a spatial analysis using locations of fentanyl-involved fatal overdoses (n = 1433) compared with nonfentanyl opioid and polydrug fatal overdoses (n = 1838) collected through the Cook County Medical Examiner’s Office from 2014 to 2018. We also used logistic regression to test significant individual- and neighborhood-level covariates.

Results. Fentanyl overdoses geographically clustered more than nonfentanyl overdoses, and this difference was statistically significant. One area in particular showed significantly elevated risk for fentanyl overdoses (P < .05) located in 2 specific neighborhoods of Chicago. The odds of a fentanyl-involved overdose were significantly increased for men, Blacks, Latinos/as, and younger …