2018 surveillance report slides clearance final 8.31.18 ... · these slides contain selected data...
TRANSCRIPT
Surveillance ReportHighlights from the 2018 Annual Surveillance
Report of Drug-Related Risks and Outcomes —
United States
Background
� These slides contain selected data from the second annual surveillance
report summarizing the latest information at the national level for
prescribing patterns, drug use, and nonfatal and fatal overdose related
to the current drug overdose epidemic.
� Intended to serve as a resource for persons charged with addressing this
ongoing national crisis.
� Suggested citation when using resources from this presentation:
Centers for Disease Control and Prevention. 2018 Annual
Surveillance Report of Drug-Related Risks and Outcomes —
United States. Surveillance Special Report. Centers for Disease
Control and Prevention, U.S. Department of Health and Human
Services. Published August 31, 2018. Accessed [date] from
www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-
surveillance-report.pdf
Data Sources
Outcome Data Source Year(s)
Opioid prescribing practices IQVIA™ 2006–2017
Drug use, misuse, substance use disorder,
and treatment
National Survey on Drug Use and Health
(NSDUH)a 2016
Nonfatal overdose hospitalizations and
emergency department visits
Healthcare Cost and Utilization Project
(HCUP)b 2015
Drug overdose mortalityNational Vital Statistics System (NVSS),
Mortality Componentc 1999–2016
aA product of the Substance Abuse and Mental Health Services Administration (SAMHSA).bA product of the Agency for Healthcare Research and Quality (AHRQ).cMaintained by the National Center for Health Statistics, CDC.
Opioid Prescribing Practices
Opioid prescriptions (Rx) Number Rateb
All opioids 191,146,822 58.5
LA/ER opioidsc 17,442,895 5.3
Days of supply per Rx
< 30 days 110,759,830 33.9
≥ 30 days 80,386,991 24.6
Average opioid Rx per patient 3.4
Average days of supply per Rx 18.3
Source: IQVIA™ Transactional Data Warehouse.
Abbreviation: Rx, prescription.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol, and Butrans® and
Belbuca® (buprenorphine), were identified using the National Drug Code. bRate per 100 persons.cLA/ER represents opioids that are long acting (LA) or extended release (ER).
Total number and rate of opioid prescriptionsa (Rx) dispensed per 100 persons annually —
United States, 2017
Opioid Prescribing Practices
Total number and rate of morphine milligram equivalents (MME) dispensed per 100 persons
annually — United States, 2017
Morphine milligram equivalents (MME) Number Ratea
Total MME 166,941,732,435
MME per capita 511.1
Average MME per Rx 873.4
Average daily MME per Rx 45.3
Daily dosage per Rx
< 50 MME 142,842,185 43.7
≥ 50 but < 90 MME 32,079,439 9.8
≥ 90 MME (high dose) 16,225,198 5.0
Source: IQVIA™ Transactional Data Warehouse.
Abbreviation: MME, morphine milligram equivalents; Rx, prescription.aRate per 100 persons.
Opioid Prescribing Practices
Percent of persons who had at least one prescription filled for an opioida by sex —
United States, 2017
Source: IQVIA™ Total Patient Tracker, 2017 Enhanced.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol, and Butrans®
and Belbuca® (buprenorphine), were identified using the National Drug Code.
14.8
19.9
0.0
5.0
10.0
15.0
20.0
25.0
Male Female
Percent
Opioid Prescribing Practices
Opioid Prescribing Practices
Percent of persons who had at least one prescription filled for an opioida by age group —
United States, 2017
Source: IQVIA™ Total Patient Tracker, 2017 Enhanced.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol and
Butrans® and Belbuca® (buprenorphine), were identified using the National Drug Code.
1.7
10.4
13.0
17.3
20.5
23.1
26.3 26.8
17.4
0.0
5.0
10.0
15.0
20.0
25.0
30.0
0–14 15–19 20–24 25–34 35–44 45–54 55–64 ≥ 65 All ages
Percent
Age Group (years)
Opioid Prescribing Practices
Annual opioida prescribing rates overall and for high dosage prescriptionsb (≥ 90 MME/day)c —
United States, 2006–2017
Source: IQVIA™ Transactional Data Warehouse.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol and Butrans® and Belbuca®
(buprenorphine), were identified using the National Drug Code.bHigh dosage prescriptions were defined as opioid prescriptions resulting in a daily dosage of ≥ 90 morphine milligram equivalents.cTemporal trends from 2006 to 2017 were evaluated by applying joinpoint regression methodology. This modeling approach simultaneously identified statistically significant trends as well as shifts in
trends that occurred within a time series. A maximum of two joinpoints was allowed. Different dash types correspond to year groupings as determined by joinpoint regression.
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Prescribing rate
per 100 persons
Year
High Dosage
Overall
Temporal trendsc
Overall
2006–2010
2010–2014
2014–2017
High Dosage
2006–2009
2009–2017
Opioid Prescribing Practices
Annual opioida prescribing rates by days of supply per prescriptionb — United States, 2006–2017
Source: IQVIA™ Transactional Data Warehouse.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol and Butrans®
and Belbuca® (buprenorphine), were identified using the National Drug Code.bTemporal trends from 2006 to 2017 were evaluated by applying joinpoint regression methodology. This modeling approach simultaneously identified statistically significant trends as well
as shifts in trends that occurred within a time series. A maximum of two joinpoints was allowed. Different dash types correspond to year groupings as determined by joinpoint regression.
0.0
10.0
20.0
30.0
40.0
50.0
60.0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Prescribing rate
per 100 persons
Year
< 30 days
≥ 30 days
Temporal trendsb
< 30 days
2006–2010
2010–2014
2014–2107
≥ 30 days
2006–2010
2010–2015
2015–2017
Opioid Prescribing Practices
Average daily morphine milligram equivalents (MME) per opioida prescriptionb —
United States, 2006–2017
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Average MME
per day
Year
Source: IQVIA™ Transactional Data Warehouse.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol and Butrans®
and Belbuca® (buprenorphine), were identified using the National Drug Code.bTemporal trends from 2006 to 2017 were evaluated by applying joinpoint regression methodology. This modeling approach simultaneously identified statistically significant trends as well
as shifts in trends that occurred within a time series. A maximum of two joinpoints was allowed. Different dash types correspond to year groupings as determined by joinpoint regression.
Temporal trendsb
2006–2010
2010–2013
2013–2017
Opioid Prescribing Practices
Average days of supply per opioida prescriptionb — United States, 2006–2017
10.0
11.0
12.0
13.0
14.0
15.0
16.0
17.0
18.0
19.0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Average days
of supply
Year
Source: IQVIA™ Transactional Data Warehouse.aOpioid prescriptions, including codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, tramadol and Butrans®
and Belbuca® (buprenorphine), were identified using the National Drug Code.bTemporal trends from 2006 to 2017 were evaluated by applying joinpoint regression methodology. This modeling approach simultaneously identified statistically significant trends as well
as shifts in trends that occurred within a time series. A maximum of two joinpoints was allowed. Different dash types correspond to year groupings as determined by joinpoint regression.
Temporal trendsb
2006–2009
2009–2013
2013–2017
Drug Use, Misuse, Substance Use Disorder, and Treatment
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of illicit drug use and prescription drug misusea in the past year, persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aMisuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one’s own medication; use in greater amounts, more often, or longer
than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.bMarijuana was classified as an illicit substance in NSDUH because it remains an illegal substance (Schedule I drug) under federal law.cOpioids include heroin use, prescription pain reliever misuse, or both; therefore, the numbers for heroin use and prescription pain reliever misuse do not add to those for opioid misuse
because of poly-drug use. This category includes misuse of prescription fentanyl but excludes use of illicit fentanyl.
b
c
4.3
2.2 2.1
0.6
13.9
0.4
4.4
1.9
0.5
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
1
Percent
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Marijuana
Heroin
Opioids
Cocaine
Methamphetamine
Substance Category
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of prescription drug misusea in the past year by sex, persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aMisuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one’s own medication; use in greater amounts, more often,
or longer than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.
4.8
2.2 2.3
0.5
3.8
2.31.9
0.6
0.0
1.0
2.0
3.0
4.0
5.0
6.0
Prescription pain relievers Prescription tranquilizers Prescription stimulants Prescription sedatives
Percent
Male Female
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of prescription drug misusea in the past year by race/ethnicity,b persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aMisuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one’s own medication; use in greater amounts, more often, or longer
than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.bAll race/ethnicity categories other than “Hispanic” are non-Hispanic. Data on two or more races are not included.cLow precision for Native Hawaiian/other Pacific Islander race, no estimate reported.
4.5
2.6 2.5
0.7
3.9
1.5
0.8
0.3
4.2
1.81.6
0.5
3.9
1.5
0.8
0.3
4.2
0.8
1.81.8
0.7
1.2
0.2
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
Prescription pain relievers Prescription tranquilizers Prescription stimulants Prescription sedatives
Percent
White Black Hispanic American Indian/Alaska Native Native Hawaiian/other Pacific Islander Asian
c
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of prescription drug misusea in the past year by age group, persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aMisuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one’s own medication; use in greater amounts, more often, or longer
than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.
3.5
1.7
1.7
0.4
7.1
5.3
7.5
0.7
6.9
3.3
3.9
0.9
5.3
2.2
1.7
0.4
4.3
1.8
1.1
0.8
3.7
1.7
0.8
0.3
4.4
2.3
0.8
0.6
3.8
1.6
0.5
0.5
2.2
0.8
0.2 0
.5
1.2
0.7
0.2 0
.4
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Prescription pain relievers Prescription tranquilizers Prescription stimulants Prescription sedatives
Percent
12–17 18–25 26–34 35–39 40–44 45–49 50–54 55–59 60–64 65+
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of prescription pain reliever misusea in the past year by region, persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aMisuse of prescription drugs is defined as use in any way not directed by a doctor, including use without a prescription of one’s own medication; use in greater amounts, more often, or longer
than told to take a drug; or use in any other way not directed by a doctor. Prescription drugs do not include over-the-counter drugs.
4.1 per 100,000 population
5.0 per 100,000 population
3.8 per 100,000 population
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of illicit drug use in the past year by sex, persons 12+ years old —
United States, 2016
Source: 2016 National Survey on Drug Use and Health (NSDUH). Substance Abuse and Mental Health Services Administration. Rockville, MD.aMarijuana was classified as an illicit substance in NSDUH because it remains an illegal substance (Schedule I drug) under federal law.
16.7
0.5
2.5
0.6
11.3
0.31.3
0.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
Marijuana Heroin Cocaine Methamphetamine
Percent
Male Female
a
Drug Use, Misuse, Substance Use Disorder, and Treatment
14
.2
0.4
2.0
0.6
16
.6
0.3
1.9
0.2
11
.9
0.2 1
.7
0.4
19
.4
0.3
2.0
1.0
12
.8
0.1 1
.5
0.6
6.9
0.7
0.1
0.0
5.0
10.0
15.0
20.0
25.0
Marijuana Heroin Cocaine Methamphetamine
Percent
White Black Hispanic American Indian/Alaska Native Native Hawaiian/Other Pacific Islander Asian
Self-reported prevalence of illicit drug use in the past year by race/ethnicity,a persons 12+ years old —
United States, 2016
Source: 2016 National Survey on Drug Use and Health (NSDUH). Substance Abuse and Mental Health Services Administration. Rockville, MD.aAll race/ethnicity categories other than “Hispanic” are non-Hispanic. Data on two or more races are not included.bMarijuana was classified as an illicit substance in NSDUH because it remains an illegal substance (Schedule I drug) under federal law.cLow precision for Asian race, no estimate reported.
cb
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of illicit drug use in the past year by age group, persons 12+ years old —
United States, 2016
12
.0
0.1 0.5
0.1
33
.0
0.7
5.6
0.8
22
.3
0.9
3.8
0.9
14
.7
0.5 1
.5
0.8
10
.3
0.4 1.2
0.8
11
.1
0.2 1
.4
0.4
9.1
0.2 0.9
0.7
10
.5
0.5 1
.4
0.7
7.1
0.1 0.7
0.1
3.3
0.2
0.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Marijuana Heroin Cocaine Methamphetamine
Percent
12–17 18–25 26–34 35–39 40–44 45–49 50–54 55–59 60–64 65+
b
Source: 2016 National Survey on Drug Use and Health (NSDUH). Substance Abuse and Mental Health Services Administration. Rockville, MD.aMarijuana was classified as an illicit substance in NSDUH because it remains an illegal substance (Schedule I drug) under federal law.bLow precision for age 65+, no estimate reported.cPercents are rounded to the nearest tenth. Because of the rounding, some percents equal to 0.0 are displayed. These prevalence estimates are rounded down from < 0.05 percent and
do not represent an absence of persons displaying a particular characteristic.
a c
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of marijuana use in the past year by region, persons 12+ years old —
United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.
15.1 per 100,000 population
17.4 per 100,000 population
13.1 per 100,000 population
11.7 per 100,000 population
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of heroin use in the past year by region, persons 12+ years old —
United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.
0.3 per 100,000 population
0.5 per 100,000 population
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of cocaine use in the past year by region, persons 12+ years old —
United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.
2.4 per 100,000 population
2.6 per 100,000 population
1.5 per 100,000 population
1.4 per 100,000 population
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of methamphetamine use in the past year by region, persons
12+ years old — United States, 2016
0.5 per 100,000 population
0.8 per 100,000 population
0.4 per 100,000 population
0.2 per 100,000 population
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of substance use disordera in the past year, persons 12+ years old —
United States, 2016
0.7
0.2 0.20.1
1.5
0.2
0.8
0.3 0.3
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1
Percent
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Marijuana
Heroin
Opioids
Cocaine
Methamphetamines
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aSubstance use disorder is defined as meeting criteria for illicit or prescription drug dependence or abuse. Dependence or abuse is based on definitions found in the 4th edition
of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).bOpioids include heroin use, prescription pain reliever misuse, or both; therefore, the numbers for heroin use and prescription pain reliever misuse do not add to those for
opioid misuse because of poly-drug use. This category includes misuse of prescription fentanyl but excludes use of illicit fentanyl.
b
Substance Category
Drug Use, Misuse, Substance Use Disorder, and Treatment
Self-reported prevalence of illicit and prescription drug treatmenta in the past year, persons
12+ years old — United States, 2016
Source: 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Rockville, MD.aIllicit or prescription drug treatment refers to treatment received in order to reduce or stop illicit drug use or prescription drug use, or for medical problems associated with illicit drug use or
prescription drug use. It includes treatment received at any location, such as a hospital (inpatient), rehabilitation facility (inpatient or outpatient), mental health center, emergency room, private
doctor's office, self-help group, or prison/jail. Illicit drug use includes the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. A specialty facility
includes a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center.
0.8
0.5
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
Any location Specialty facility
Percent
Nonfatal Overdose Hospitalizations and Emergency Department (ED) Visits
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related hospitalizationsa by selected substances —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when
HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the
Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth quarter of
2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69.cFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-CM/PCS
contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
96.2
23.2
5.31.7
16.7
5.8 4.7
0.0
20.0
40.0
60.0
80.0
100.0
120.0
All drug All opioid Heroin Methadone Other opioids Cocaine Methamphetamine
Rate per
100,000 persons
b c
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related hospitalizationsa by selected substances and sex —
United States, 2015
86.5
22.8
7.21.7
14.57.7 5.9
105.7
23.4
3.3 1.6
18.8
3.9 3.6
0.0
20.0
40.0
60.0
80.0
100.0
120.0
All drug All opioid Heroin Methadone Other opioids Cocaine Methamphetamine
Rate per
100,000 persons
Male Female
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015,
when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please
see the Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth
quarter of 2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. cFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-
CM/PCS contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
b c
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related hospitalizationsa by selected substances and age
group — United States, 2015
15
.4
0.8
0.1 0.7
10
3.5
9.1
2.3
0.4 6
.6
11
6.3
24
.2
12
.3
1.3
11
.5
11
4.6
29
.5
13
.2
2.2
15
11
9.4
28
7.8
2.3
18
.6
13
6.9
36
.3
5.9
2.8
28
.2
12
7.5
42
.4
4.0
3.3
35
.7
10
3.7
28
.7
0.6 1.4
26
.8
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
All drug All opioid Heroin Methadone Other opioids
Rate per
100,000
persons
0–14 15–19 20–24 25–34 35–44 45–54 55–64 65+
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when HCUP
transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the Surveillance
Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth quarter of 2015,
includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. cBecause the relative standard error was > 30% or the standard error = 0 for age group 0–14, the value of the estimate was considered unreliable and was not reported.dFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-CM/PCS
contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
b c d
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related hospitalizationsa by selected substances and
age group — United States, 2015
0.20.6
1.6
3.6
5.1
8.07.7
9.89.2
7.7
13.2
6.3
9.1
3.6
1.7
0.6
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
Cocaine Methamphetamine
Rate per
100,000
persons
0–14 15–19 20–24 25–34 35–44 45–54 55–64 65+
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when
HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the
Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of all opioida poisoning-related hospitalizationsb by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when
HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the
Surveillance Report technical notes for a discussion of transition.aFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth quarter of
2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. bIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
24.4 per 100,000 population
26.1 per 100,000 population
23.8 per 100,000 population
18.9 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of heroin poisoning-related hospitalizationsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015,
when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition;
please see the Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
7.4 per 100,000 population
8.4 per 100,000 population
4.0 per 100,000 population
3.1 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of methadone poisoning-related hospitalizationsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when HCUP
transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the Surveillance
Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
1.8 per 100,000 population
1.9 per 100,000 population
1.6 per 100,000 population
1.5 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of cocaine poisoning-related hospitalizationsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when
HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the
Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
6.6 per 100,000 population
9.5 per 100,000 population
5.5 per 100,000 population
2.1 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of methamphetamine poisoning-related hospitalizationsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from
2015, when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the
transition; please see the Surveillance Report technical notes for a discussion of transition.aIn-hospital deaths and patients who transferred from another hospital were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
4.6 per 100,000 population
7.7 per 100,000 population
4.1 per 100,000 population
1.7 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related emergency department visitsa by selected
substances — United States, 2015
174.6
44.0
25.9
1.1
17.3
3.0 5.2
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
All drug All opioid Heroin Methadone Other opioids Cocaine Methamphetamine
Rate per
100,000 persons
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when HCUP
transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the Surveillance
Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth quarter of 2015,
includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. cFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-CM/PCS
contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
b c
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related emergency department visitsa by selected substances
and sex — United States, 2015
167.2
54.0
35.7
1.3
17.5
3.9 6.2
182.1
34.0
16.1
1.0
17.1
2.2 4.2
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
200.0
All drug All opioid Heroin Methadone Other opioids Cocaine Methamphetamine
Rate per
100,000
persons
Male Female
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015,
when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please
see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth
quarter of 2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. cFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-
CM/PCS contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
b c
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related emergency department visitsa by selected substances
and age group — United States, 2015
13
4.5
4.0
0.1 3.9
30
7.7
26
.5
11
.2
0.3 1
5.2
28
1.1
99
.7
73
.2
1.1
26
.0
26
0.6
11
1.4
81
.8
2.3
28
.6
18
0.7
59
.5
35
.9
1.9
22
.2
14
5.8
41
.6
18
.5
1.5
22
.0
10
7.1
28
.5
8.2
1.7
18
.8
88
.9
14
.1
1.0
0.5 1
2.6
0.0
25.0
50.0
75.0
100.0
125.0
150.0
175.0
200.0
225.0
250.0
275.0
300.0
325.0
All drug All opioid Heroin Methadone Other opioids
Rate per
100,000
persons
0–14 15–19 20–24 25–34 35–44 45–54 55–64 65+
c
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015, when
HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition; please see the
Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.bFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth quarter of
2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. cFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.09 or external cause of injury E850.2; for the fourth quarter of 2015, includes ICD-10-CM/PCS
contributing causes T40.0, T40.2, T40.4, T40.6, T40.69.
b
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of drug poisoning-related emergency department visitsa by selected substances
and age group — United States, 2015
0.7
3.9
2.0
8.3
5.1
11.8
6.4
10.3
4.7
6.4
3.82.9
2.01.2
0.4 0.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
Cocaine Methamphetamine
Rate per
100,000
persons
0–14 15–19 20–24 25–34 35–44 45–54 55–64 65+
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015,
when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition;
please see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of all opioida poisoning-related emergency department visitsb by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from 2015,
when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the transition;
please see the Surveillance Report technical notes for a discussion of transition.aFor the first three quarters of 2015, includes ICD-9-CM principal diagnosis code of 965.00, 965.01, 965.02, 965.09 or external cause of injury E850.0, E850.1, E850.2; for the fourth
quarter of 2015, includes ICD-10-CM/PCS contributing causes T40.0, T40.1, T40.2, T40.3, T40.6, T40.69. bPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
56.0 per 100,000 population
77.9 per 100,000 population
32.8 per 100,000 population
27.6 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of heroin poisoning-related emergency department visitsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from
2015, when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the
transition; please see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
36.8 per 100,000 population
58.1 per 100,000 population
15.4 per 100,000 population
10.2 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of methadone poisoning-related emergency department visitsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from
2015, when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the
transition; please see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
1.3 per 100,000 population
1.6 per 100,000 population
1.1 per 100,000 population
0.9 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of cocaine poisoning-related emergency department visitsa by region —
United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from
2015, when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the
transition; please see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
3.5 per 100,000 population
3.7 per 100,000 population
3.4 per 100,000 population
1.5 per 100,000 population
Nonfatal Overdose Hospitalizations and (ED) Visits
Age-adjusted rates of methamphetamine poisoning-related emergency department visitsa by region
— United States, 2015
Source: Weighted national estimates from Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2015, Agency for Healthcare Research and Quality. Data are from
2015, when HCUP transitioned from using ICD-9-CM to ICD-10-CM/PCM diagnosis codes and should not be compared with other years. Results may have been affected by the
transition; please see the Surveillance Report technical notes for a discussion of transition.aPersons who were hospitalized, died, or transferred to another facility were excluded. Visits with missing age and gender were excluded. Numbers subject to rounding error.
6.0 per 100,000 population
6.8 per 100,000 population
5.0 per 100,000 population
2.3 per 100,000 population
Drug Overdose Mortality
Drug Overdose Mortality
Age-adjusted rates of drug overdose deathsa and drug overdose deaths involving any opioidb
for all intents and for unintentional intent by year — United States, 1999–2016
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Rate per
100,000
persons
Year
Drug overdose deaths (of all
intents)
Unintentional drug overdose
deaths
Drug overdose deaths involving any
opioid (of all intents)
Unintentional drug overdose
deaths involving any opioid
Source: National Vital Statistics System, Mortality File, CDC WONDER.aDeaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). All drug overdose deaths are identified using underlying cause-of-death codes X40–X44
(unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined). Unintentional drug overdose deaths are identified using underlying cause-of-death codes X40–X44. Note that
overall drug overdose deaths and opioid overdose deaths include deaths of any intent. In 2016, 5.7% of drug overdose deaths had undetermined intent; this is a decrease from 14.7% of drug
overdose deaths that had an undetermined intent in 1999. Some of these deaths may be unintentional drug overdose deaths.bDrug overdose deaths, as defined, that involve opium (T40.0), heroin (T40.1), natural and semi-synthetic opioids (T40.2), methadone (T40.3), other synthetic opioids excluding methadone (T40.4),
and other and unspecified narcotics (T40.6).
Drug Overdose Mortality
Age-adjusted ratesa of drug overdose deaths by drug or drug class and year —
United States, 1999–2016
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
Rate per
100,000
persons
Year
Synthetic opioids other
than methadone
Prescription opioids
Heroin
Cocaine
Psychostimulants with
abuse potential
b
c
Source: National Vital Statistics System, Mortality File, CDC WONDER.aRate per 100,000 population age-adjusted to the 2000 U.S. standard population using the vintage year population of the data year. Because deaths might involve more than one drug, some
deaths are included in more than one category. Specification on death certificates of drugs involved with deaths varies over time. In 2016, 15% of drug overdose deaths did not include
information on the specific type of drug(s) involved Some of these deaths may have involved opioids or stimulants.bDrug overdose deaths that involve synthetic opioids other than methadone (T40.4).cDrug overdose deaths that involve natural and semi-synthetic opioids (T40.2) or methadone (T40.3). dDrug overdose deaths that involve psychostimulants with abuse potential (T43.6).
d
Drug Overdose Mortality
Ratesa of drug overdose deaths by drug or drug class and age group — United States, 2016
Source: National Vital Statistics System, Mortality File, CDC WONDER.aRate per 100,000 population using the vintage year population of the data year. Because deaths might involve more than one drug, some deaths are included in more than one category.
Specification on death certificates of drugs involved with deaths varies over time. In 2016, 15% of drug overdose deaths did not include information on the specific type of drug(s) involved. Some
of these deaths may have involved opioids or stimulants.bDrug overdose deaths that involve synthetic opioids other than methadone (T40.4).cDrug overdose deaths that involve natural and semi-synthetic opioids (T40.2) or methadone (T40.3).dDrug overdose deaths that involve psychostimulants with abuse potential (T43.6).
4.5
2.6
4.0
1.7
1.3
13
.6
7.7
11
.3
5.7
3.9
11
.9
9.2
9.0
6.0
4.5
9.0
10
.1
7.0
6.1
4.55
.4
8.4
4.3
4.2
3.0
0.8
1.9
0.6
0.6
0.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
Synthetic opioids other than
methadone
Prescription opioids Heroin Cocaine Psychostimulants with
abuse potential
Rate per
100,000
persons
15–24 25–34 35–44 45–54 55–64 ≥65
b
c
d
Drug Overdose Mortality
Age-adjusted ratesa of drug overdose deaths by sex — United States, 2016
8.9
6.2
7.5
4.7
3.43.54.3
2.41.8
1.4
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
Synthetic opioids other than
methadone
Prescription opioids Heroin Cocaine Psychostimulants with
abuse potential
Rate per
100,000
persons
Male Female
Source: National Vital Statistics System, Mortality File, CDC WONDER.aRate per 100,000 population age-adjusted to the 2000 U.S. standard population using the vintage year population of the data year. Because deaths might involve more than one drug, some
deaths are included in more than one category. Specification on death certificates of drugs involved with deaths varies over time. In 2016, 15% of drug overdose deaths did not include
information on the specific type of drug(s) involved. Some of these deaths may have involved opioids or stimulants.bDrug overdose deaths that involve synthetic opioids other than methadone (T40.4).cDrug overdose deaths that involve natural and semi-synthetic opioids (T40.2) or methadone (T40.3).dDrug overdose deaths that involve psychostimulants with abuse potential (T43.6).
b
c
d
Drug Overdose Mortality
Age-adjusted ratesa of drug overdose deaths by race/ethnicity — United States, 2016
8.2
7.0
6.3
3.43.0
5.6
3.3
4.5
6.1
1.2
0.6 0.7 0.5 0.40.8
4.1
6.5
5.0
2.1
6.9
2.7
2.1
2.8
2.01.5
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
Synthetic opioids other than
methadone
Prescription opioids Heroin Cocaine Psychostimulants with abuse
potential
Rate per
100,000
persons
White, non-Hispanic Black, non-Hispanic Asian/Pacific Islander, non-Hispanic American Indian/Alaska Native, non-Hispanic Hispanic
Source: National Vital Statistics System, Mortality File, CDC WONDER.aRate per 100,000 population age-adjusted to the 2000 U.S. standard population using the vintage year population of the data year. Because deaths might involve more than one drug, some
deaths are included in more than one category. Specification on death certificates of drugs involved with deaths varies over time. In 2016, 15% of drug overdose deaths did not include
information on the specific type of drug(s) involved. Some of these deaths may have involved opioids or stimulants.bDrug overdose deaths that involve synthetic opioids other than methadone (T40.4).cDrug overdose deaths that involve natural and semi-synthetic opioids (T40.2) or methadone (T40.3).dDrug overdose deaths that involve psychostimulants with abuse potential (T43.6).
b
c
d
Limitations
� Since four distinct data sources were used, terminology and definitions were not
standardized across all outcomes, and the most recent year of data varied by source.
• Comparability of data across sections is limited.
� In the mortality section, involved drugs were not specified in approximately 20% of drug
overdose deaths, potentially leading to an underestimate of rates by drug or drug class.
However, drug specificity has improved over time; in 2016, 15% of deaths lacked drug
specificity.
� Polysubstance use (i.e., the consumption of more than one drug over a defined period,
simultaneously or at different times) was not examined.
� For a detailed description of the data sources, definitions, and limitations, please refer
to the technical notes in the surveillance report.*
� www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surveillance-report.pdf
*Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States. Surveillance Special Report.
Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2018.
Conclusions
1. Opioid prescribing and high-dose prescribing continued to decrease
through 2017.
2. A low percentage of those needing treatment for substance abuse are able
to access it. In addition to expanding treatment options and access,
additional measures are needed to prevent illicit drug use and prescription
drug misuse in a dynamic drug landscape.
3. Drug overdose deaths in 2016 reached a new record high.
4. Heroin, synthetic opioids other than methadone (mostly illicitly
manufactured fentanyl), cocaine, and psychostimulants with abuse
potential were driving increases in overdose deaths in 2016.
CDC’s Opioid Overdose Prevention Efforts
CDC’s Mission
Prevent opioid-related harms and overdose deaths by:
� Conducting surveillance and research to improve data quality and track trends;
� Building state, local, and tribal capacity by scaling up effective public health
interventions;
� Supporting providers, health systems, and payers with tools,
recommendations, and guidance to improve patient safety;
� Partnering with public safety to respond quicker and more effectively; and
� Empowering consumers to make safe choices.
Conducting surveillance and research
� Enhanced State Opioid Overdose Surveillance (ESOOS)
• Funds 32 states and Washington, D.C., to increase timeliness and
comprehensiveness of nonfatal and fatal opioid overdose reporting and
dissemination of results to key stakeholders
• Serves as an early warning system to detect sharp increases (i.e., potential
outbreaks) or decreases (i.e., rapidly identify successful intervention efforts)
• Uses the State Unintentional Drug Overdose Report System (SUDORS) to
integrate data on opioid overdose deaths from death certificates and unique
medical examiner and coroner investigations, including toxicology reports.
• For more information: www.cdc.gov/drugoverdose/foa/state-opioid-mm.html
� Prevention for States (PfS)
• Funds 29 states to enhance and maximize prescription drug monitoring
programs, implement interventions, and evaluate the impact of state policies
• For more information:
www.cdc.gov/drugoverdose/states/state_prevention.html
� Data-Driven Prevention Initiative (DDPI)
• Funds 13 states and Washington, D.C., to improve data collection and
analysis around opioid misuse, abuse, and overdose, and develop
comprehensive prevention programs
• For more information: www.cdc.gov/drugoverdose/foa/ddpi.html
Building state, local, and tribal capacity
� CDC’s Guideline for Prescribing Opioids for Chronic Pain —
released March 2016
• Serves as a resource to providers treating chronic pain for adult patients in
primary care settings outside of end-of-life, palliative, and active cancer care.
• For more information: www.cdc.gov/drugoverdose/prescribing/resources.html
Supporting providers, health systems, and payers
� Heroin Response Strategy
• A collaboration between CDC and the Office of the National Drug Control
Policy and 10 High Intensity Drug Trafficking Areas (HIDTAs)
• Coordinates data sharing across public health and public safety, develops and
supports implementation of evidence-based strategies, and strengthens the
engagement of local communities to create targeted responses
Partnering with public safety
� Rx Awareness campaign
• Raises awareness about the risks of opioid misuse and abuse in order to
empower people to make safer choices
• For more information: www.cdc.gov/rxawareness/index.html
Empowering consumers
For more information, contact CDC
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the
official position of the Centers for Disease Control and Prevention.
For a detailed description of data sources, definitions, and statistical analyses, as well as an in-depth
presentation of results, please refer to:
Centers for Disease Control and Prevention. 2018 Surveillance Report of Drug-Related Risks and
Outcomes — United States. Surveillance Special Report. Centers for Disease Control and Prevention.
U.S. Department of Health and Human Services. www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-
drug-surveillance-report.pdf Published August 31, 2018.
For more information, see: www.cdc.gov/drugoverdose