Data on drug overdose death rates, by drug type and selected population characteristics. Please refer to the PDF or Excel version of this table in the HUS 2019 Data Finder (https://www.cdc.gov/nchs/hus/contents2019.htm) for critical information about measures, definitions, and changes over time. SOURCE: NCHS, National Vital Statistics System, numerator data from annual public-use Mortality Files; denominator data from U.S. Census Bureau national population estimates; and Murphy SL, Xu JQ, Kochanek KD, Arias E, Tejada-Vera B. Deaths: Final data for 2018. National Vital Statistics Reports; vol 69 no 13. Hyattsville, MD: National Center for Health Statistics.2021. Available from: https://www.cdc.gov/nchs/products/nvsr.htm. For more information on the National Vital Statistics System, see the corresponding Appendix entry at https://www.cdc.gov/nchs/data/hus/hus19-appendix-508.pdf.

Analysis of ‘💉 Opioid Overdose Deaths’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://www.kaggle.com/yamqwe/opioid-overdose-deathse on 13 February 2022.

--- Dataset description provided by original source is as follows ---

About this dataset

Opioid addiction and death rates in the U.S. and abroad have reached "epidemic" levels. The CDC's data reflects the incredible spike in overdoses caused by drugs containing opioids.

The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). Source: CDC

In-the-News:

• STAT: 26 overdoses in just hours: Inside a community on the front lines of the opioid epidemic
• NPR: Organ Donations Spike In The Wake Of The Opioid Epidemic, Deadly Opioid Overwhelms First Responders And Crime Labs in Ohio
• Scientific American: Wave of Overdoses with Little-Known Drug Raises Alarm Amid Opioid Crisis
• Washington Post: A 7-year-old told her bus driver she couldn’t wake her parents. Police found them dead at home.
• Wall Street Journal: For Small-Town Cops, Opioid Scourge Hits Close to Home
• Food & Drug Administration: FDA launches competition to spur innovative technologies to help reduce opioid overdose deaths

This data was compiled using the CDC's WONDER database. Opioid overdose deaths are defined as: deaths in which the underlying cause was drug overdose, and the ICD-10 code used was any of the following: T40.0 (Opium), T40.1 (Heroin), T40.2 (Other opioids), T40.3 (Methadone), T40.4 (Other synthetic narcotics), T40.6 (Other and unspecified narcotics).

Age-adjusted rate of drug overdose deaths and drug overdose deaths involving opioids
http://i.imgur.com/ObpzUKq.gif" alt="Opioid Death Rate" style="">
Source: CDC

What are opioids?
Opioids are substances that act on opioid receptors to produce morphine-like effects. Opioids are most often used medically to relieve pain. Opioids include opiates, an older term that refers to such drugs derived from opium, including morphine itself. Other opioids are semi-synthetic and synthetic drugs such as hydrocodone, oxycodone and fentanyl; antagonist drugs such as naloxone and endogenous peptides such as the endorphins.[4] The terms opiate and narcotic are sometimes encountered as synonyms for opioid. Source: Wikipedia

contributors-wanted See comment in Discussion

Footnotes

• The crude rate is per 100,000.
• Certain totals are hidden due to suppression constraints. More Information: http://wonder.cdc.gov/wonder/help/faq.html#Privacy.
• The population figures are briged-race estimates. The exceptions being years 2000 and 2010, in which Census counts are used.
• v1.1: Added Opioid Prescriptions Dispensed by US Retailers in that year (millions).

Citation: Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2014 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 1999-2014, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10.html on Oct 19, 2016 2:06:38 PM.

Citation for Opioid Prescription Data: IMS Health, Vector One: National, years 1991-1996, Data Extracted 2011. IMS Health, National Prescription Audit, years 1997-2013, Data Extracted 2014. Accessed at NIDA article linked (Figure 1) on Oct 23, 2016.

Data Use Restrictions:
The Public Health Service Act (42 U.S.C. 242m(d)) provides that the data collected by the National Center for Health Statistics (NCHS) may be used only for the purpose for which they were obtained; any effort to determine the identity of any reported cases, or to use the information for any purpose other than for health statistical reporting and analysis, is against the law. Therefore users will:
Use these data for health statistical reporting and analysis only.
For sub-national geography, do not present or publish death counts of 9 or fewer or death rates based on counts of nine or fewer (in figures, graphs, maps, tables, etc.).
Make no attempt to learn the identity of any person or establishment included in these data.
Make no disclosure or other use of the identity of any person or establishment discovered inadvertently and advise the NCHS Confidentiality Officer of any such discovery.
Eve Powell-Griner, Confidentiality Officer
National Center for Health Statistics
3311 Toledo Road, Rm 7116
Hyattsville, MD 20782
Telephone 301-458-4257 Fax 301-458-4021

This dataset was created by Health and contains around 800 samples along with Crude Rate, Crude Rate Lower 95% Confidence Interval, technical information and other features such as: - Year - Deaths - and more.

How to use this dataset

• Analyze Crude Rate Upper 95% Confidence Interval in relation to Prescriptions Dispensed By Us Retailers In That Year (millions)
• Study the influence of State on Crude Rate
• More datasets

Acknowledgements

If you use this dataset in your research, please credit Health

Start A New Notebook!

--- Original source retains full ownership of the source dataset ---

The National Hospital Care Survey (NHCS) collects data on patient care in hospital-based settings to describe patterns of health care delivery and utilization in the United States. Settings currently include inpatient and emergency departments (ED). From this collection, the NHCS contributes data that may inform emerging national health threats such as the current opioid public health emergency. The 2022 - 2024 NHCS are not yet fully operational so it is important to note that the data presented here are preliminary and not nationally representative.

The data are from 24 hospitals submitting inpatient and 23 hospitals submitting ED Uniform Bill (UB)-04 administrative claims from October 1, 2022–September 30, 2024. Even though the data are not nationally representative, they can provide insight into the use of opioids and other overdose drugs. The NHCS data is submitted from various types of hospitals (e.g., general/acute, children’s, etc.) and can show results from a variety of indicators related to drug use, such as overall drug use, comorbidities, and drug and polydrug overdose. NHCS data can also be used to report on patient conditions within the hospital over time.

In 2023, around 72,776 people in the United States died from a drug overdose that involved fentanyl. This was the second-highest number of fentanyl overdose deaths ever recorded in the United States, and a significant increase from the number of deaths reported in 2019. Fentanyl overdoses are now the driving force behind the opioid epidemic, accounting for the majority of overdose deaths in the United States. What is fentanyl? Fentanyl is an extremely potent synthetic opioid similar to morphine, but more powerful. It is a prescription drug but is also manufactured illegally and is sometimes mixed with other illicit drugs such as heroin and cocaine, often without the user’s knowledge. The potency of fentanyl makes it very addictive and puts users at a high risk for overdose. Illegally manufactured fentanyl has become more prevalent in the United States in recent years, leading to a huge increase in drug overdose deaths. In 2022, the rate of drug overdose death involving fentanyl was 22.7 per 100,000 population, compared to a rate of just one per 100,000 population in the year 2013. Fentanyl overdoses by gender and race/ethnicity As of 2022, the rate of drug overdose deaths involving fentanyl in the United States is over two times higher among men than women. Rates of overdose death involving fentanyl were low for both men and women until around the year 2014 when they began to quickly increase, especially for men. In 2022, there were around 19,880 drug overdose deaths among women that involved fentanyl compared to 53,958 such deaths among men. At that time, the rate of fentanyl overdose deaths was highest among non-Hispanic American Indian or Alaska Natives and lowest among non-Hispanic Asians. However, from the years 2014 to 2018, non-Hispanic whites had the highest fentanyl overdose death rates.

ObjectiveU.S. drug-related overdose deaths and Emergency Department (ED) visits rose in 2020 and again in 2021. Many academic studies and the news media attributed this rise primarily to increased drug use resulting from the societal disruptions related to the coronavirus (COVID-19) pandemic. A competing explanation is that higher overdose deaths and ED visits may have reflected a continuation of pre-pandemic trends in synthetic-opioid deaths, which began to rise in mid-2019. We assess the evidence on whether increases in overdose deaths and ED visits are likely to be related primarily to the COVID-19 pandemic, increased synthetic-opioid use, or some of both.MethodsWe use national data from the Centers for Disease Control and Prevention (CDC) on rolling 12-month drug-related deaths (2015–2021); CDC data on monthly ED visits (2019-September 2020) for EDs in 42 states; and ED visit data for 181 EDs in 24 states staffed by a national ED physician staffing group (January 2016-June 2022). We study drug overdose deaths per 100,000 persons during the pandemic period, and ED visits for drug overdoses, in both cases compared to predicted levels based on pre-pandemic trends.ResultsMortality. National overdose mortality increased from 21/100,000 in 2019 to 26/100,000 in 2020 and 30/100,000 in 2021. The rise in mortality began in mid-to-late half of 2019, and the 2020 increase is well-predicted by models that extrapolate pre-pandemic trends for rolling 12-month mortality to the pandemic period. Placebo analyses (which assume the pandemic started earlier or later than March 2020) do not provide evidence for a change in trend in or soon after March 2020. State-level analyses of actual mortality, relative to mortality predicted based on pre-pandemic trends, show no consistent pattern. The state-level results support state heterogeneity in overdose mortality trends, and do not support the pandemic being a major driver of overdose mortality.ED visits. ED overdose visits rose during our sample period, reflecting a worsening opioid epidemic, but rose at similar rates during the pre-pandemic and pandemic periods.ConclusionThe reasons for rising overdose mortality in 2020 and 2021 cannot be definitely determined. We lack a control group and thus cannot assess causation. However, the observed increases can be largely explained by a continuation of pre-pandemic trends toward rising synthetic-opioid deaths, principally fentanyl, that began in mid-to-late 2019. We do not find evidence supporting the pandemic as a major driver of rising mortality. Policymakers need to directly address the synthetic opioid epidemic, and not expect a respite as the pandemic recedes.

This data set includes the estimated number of individuals in Pennsylvania with Drug Use Disorder, which is an approximation for Opioid Use Disorder prevalence. The estimates are developed by applying mortality weights derived from the CDC’s National Center for Health Statistics to statewide illicit drug use estimates from the National Survey on Drug Use and Health (NSDUH, sponsored by the Substance Abuse and Mental Health Services Administration).

Data on prescription drug use in the past 30 days in the United States, by sex, race and Hispanic origin, and age group. Data are from Health, United States. SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

Data on use of selected substances in the past 30 days among 12th graders, 10th graders, and 8th graders in the United States, by sex and race. Data are from Health, United States. Source: Monitoring the Future, Institute for Social Research, University of Michigan, supported by National Institutes of Health, National Institute on Drug Abuse. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

This file contains death counts and death rates for drug overdose, suicide, homicide and firearm injuries at the United States national level (additional datasets exist for other levels of geography). The data is grouped by 3 different time periods including monthly, yearly, and trailing twelve months. Please see data dictionary for intents and mechanisms included in each measure.

Data on use of selected substances in the past 30 days among 12th graders, 10th graders, and 8th graders in the United States, by sex and race. Data are from Health, United States. Source: Monitoring the Future, Institute for Social Research, University of Michigan, supported by National Institutes of Health, National Institute on Drug Abuse. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

Data on prescription drug use in the past 30 days in the United States, by sex, race and Hispanic origin, and age group. Data are from Health, United States. SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

ObjectiveU.S. drug-related overdose deaths and Emergency Department (ED) visits rose in 2020 and again in 2021. Many academic studies and the news media attributed this rise primarily to increased drug use resulting from the societal disruptions related to the coronavirus (COVID-19) pandemic. A competing explanation is that higher overdose deaths and ED visits may have reflected a continuation of pre-pandemic trends in synthetic-opioid deaths, which began to rise in mid-2019. We assess the evidence on whether increases in overdose deaths and ED visits are likely to be related primarily to the COVID-19 pandemic, increased synthetic-opioid use, or some of both.MethodsWe use national data from the Centers for Disease Control and Prevention (CDC) on rolling 12-month drug-related deaths (2015–2021); CDC data on monthly ED visits (2019-September 2020) for EDs in 42 states; and ED visit data for 181 EDs in 24 states staffed by a national ED physician staffing group (January 2016-June 2022). We study drug overdose deaths per 100,000 persons during the pandemic period, and ED visits for drug overdoses, in both cases compared to predicted levels based on pre-pandemic trends.ResultsMortality. National overdose mortality increased from 21/100,000 in 2019 to 26/100,000 in 2020 and 30/100,000 in 2021. The rise in mortality began in mid-to-late half of 2019, and the 2020 increase is well-predicted by models that extrapolate pre-pandemic trends for rolling 12-month mortality to the pandemic period. Placebo analyses (which assume the pandemic started earlier or later than March 2020) do not provide evidence for a change in trend in or soon after March 2020. State-level analyses of actual mortality, relative to mortality predicted based on pre-pandemic trends, show no consistent pattern. The state-level results support state heterogeneity in overdose mortality trends, and do not support the pandemic being a major driver of overdose mortality.ED visits. ED overdose visits rose during our sample period, reflecting a worsening opioid epidemic, but rose at similar rates during the pre-pandemic and pandemic periods.ConclusionThe reasons for rising overdose mortality in 2020 and 2021 cannot be definitely determined. We lack a control group and thus cannot assess causation. However, the observed increases can be largely explained by a continuation of pre-pandemic trends toward rising synthetic-opioid deaths, principally fentanyl, that began in mid-to-late 2019. We do not find evidence supporting the pandemic as a major driver of rising mortality. Policymakers need to directly address the synthetic opioid epidemic, and not expect a respite as the pandemic recedes.

This repository includes data from the Health Resources & Services Administration's Area Health Resources Files (years 2000, 2004-2019), CDC Wonder, National Conference of State Legislatures, and the Drug Enforcement Agency's Automation of Reports and Consolidated Orders System (ARCOS).

Please cite the following publication when using this dataset:

KN Griffith, Y Feyman, SG Auty, EL Crable, TW Levengood. (in press). County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access, Data in Brief.

These data were originally collected for the following research article:

Griffith, KN, Feyman, Y, Crable, EL, & Levengood, TW. (in press). “Implications of county-level variation in U.S. opioid distribution.” Drug and Alcohol Dependence.

"Using ED data to track trends in nonfatal drug overdoses is a critical strategy for expanding overdose surveillance and tailoring prevention resources to populations most affected, including initiation of medication-assisted treatment in ED settings and subsequent linkage to care for substance use disorders." - Nonfatal Drug Overdoses Treated in Emergency Departments — United States, 2016–2017, CDC MMWR Weekly / April 3, 2020 / 69(13);371–376 - https://www.cdc.gov/mmwr/volumes/69/wr/mm6913a3.htmNotes:As of April 2019, this map contains the most recent data available at the sub-county level for deaths (2012-2016), hospitalizations (2012-2015) and emergency room visits (2011-2015).All data comes from the New Mexico Department of Health Indicator Based Information System (NM-IBIS)Click on individual map layer items below ("Layers") for information about sources and methods for each data set.For Hospitalization and Emergency Room data, three NM hospitals do not report: 2 Indian Health Service Hospitals in northwestern New Mexico, and the Veteran's Administration Hospital in Albuquerque.

The National Hospital Care Survey (NHCS) collects data on patient care in hospital-based settings to describe patterns of health care delivery and utilization in the United States. Settings currently include inpatient and emergency departments (ED). From this collection, the NHCS contributes data that may inform emerging national health threats such as the current opioid public health emergency. The 2023 - 2024 NHCS are not yet fully operational so it is important to note that the data presented here are preliminary and not nationally representative.

The data are from 47 hospitals submitting inpatient and 39 hospitals submitting ED Uniform Bill (UB)-04 administrative claims from January 1, 2023–December 31, 2024. Even though the data are not nationally representative, they can provide insight into the use of opioids and other overdose drugs. The NHCS data is submitted from various types of hospitals (e.g., general/acute, children’s, etc.) and can show results from a variety of indicators related to drug use, such as overall drug use, comorbidities, and drug and polydrug overdose. NHCS data can also be used to report on patient conditions within the hospital over time.

According to Cognitive Market Research, the Global Opioids Market Size will be USD XX Billion in 2023 and is set to achieve a market size of USD XX Billion by the end of 2031 growing at a CAGR of XX% from 2024 to 2031.

  The global opioid market will expand significantly by XX% CAGR between 2024 and 2030.
  The Pain Relief segment accounts for the largest market share and is anticipated to a healthy growth over the approaching years.
  The hospital pharmacies had a market share of about XX% in 2023.
  The Extended Release /Long-Acting Opioids holds the largest share and is expected to grow in the coming years as well.
  The injectable segment is the market's largest contributor and is anticipated to expand at a CAGR of XX% during the projected period.
  The oxycodone segment holds the largest share and is expected to grow in the coming years as well.
  North America region dominated the market and accounted for the highest revenue of XX% in 2023 and it is projected that it will grow at a CAGR of XX% in the future.

Market Dynamics of the Opioids

Rising prevalence of chronic pain conditions globally

The increased prescription of painkillers during post-operative procedures and an increase in patients with terminally chronic pain or diseases including HIV, and severe cough brought on by lung infections are two causes that are anticipated to increase opioid use as a pain reliever. Chronic pain affects an estimated 20% of the global population, with conditions such as arthritis, cancer, and lower back pain contributing to the growing demand for effective pain management solutions. In the past, it resulted in a demand surge for opioids and boosted growth. Another factor for the growth of the opioid drug market is the spike in the number of surgeries. According to the National Health Interview Survey (NHIS) conducted by the Centers for Disease Control and Prevention (CDC) in 2019, the prevalence of high-impact chronic pain in the United States was 7.4 percent.

(Source-https://www.cdc.gov/nchs/data/databriefs/db390-H.pdf)

The aging population’s vulnerability is at high risk of chronic diseases such as cardiovascular diseases, arthritis, and cancer due to the high comorbid conditions. Declining fertility and mortality rates are some factors contributing to the geriatric population's rise. The impact of chronic pain increases with age and is highest among adults aged 65 years and above. Therefore, the rising geriatric population is anticipated to increase the demand for opioid drugs to manage chronic pain. According to the World Health Organization (WHO), the geriatric population increased from 1.0 million in 2020 to 1.4 million in 2021.

(Source-https://www.who.int/news-room/fact-sheets/detail/ageing-and-health)

Opioid addiction and its side effects pose significant challenges to the market

One of the major challenges for this market is the high potential for abuse and addiction, physicians have scaled back their pain management prescriptions, decreasing global scales. The rising prevalence of opioid abuse is expected to stifle market growth, as practitioners are hesitant to prescribe opioids as pain relievers. The patient may become tolerant and need more and more drugs to achieve the effect of smoothing the pain. Moreover, using opioids for an extended period can develop a dependency, and after leaving the drug, the patient may suffer from withdrawal symptoms such as anxiety, irritability, drug cravings, tremors (shaking), and others. The heightened regulatory scrutiny has resulted in stricter guidelines for prescribing opioids, impacting accessibility for patients in genuine need of pain relief. Regulatory changes often aim to strike a balance between ensuring access for patients and preventing misuse. The forecasted period illustrates a decrease in the opioid market growth due to the adversities and the negative effects of opioids. Researchers and experts have considered this and are making constant efforts to reduce and minimize the negative side effects of opioids. As per the record, drug overdose in the year 2018, had 657 deaths.

(Source-https://www.mass.gov/doc/opioid-related-overdose-deaths-among-ma-residents-august-2018/download)

Furthermore, the Millennium Health's Signals report (2020) revealed that there was a rise in non-prescribe...

Characteristics associated with low availability of treatment facilities and high rates of opioid overdose mortality were analyzed using a cross-sectional analysis design that combined county-level data from January 1, 2017, to December 31, 2021. Data for 3,130 counties in 50 states and Washington D.C. from several sources were accessed through PolicyMap, including American Community Survey (ACS), the Centers for Disease Control and Prevention (CDC), the United States Bureau of Labor Statistics (BLS), and the Substance Abuse and Mental Health Services Administration (SAMSHA).

This data set includes the estimated number of individuals in Pennsylvania with Drug Use Disorder, which is an approximation for Opioid Use Disorder prevalence. The estimates are developed by applying mortality weights derived from the CDC’s National Center for Health Statistics to statewide illicit drug use estimates from the National Survey on Drug Use and Health (NSDUH, sponsored by the Substance Abuse and Mental Health Services Administration).

Overview

Opioids continue to remain a huge problem in many parts of the country. The Centers for Disease Control and Prevention recently analyzed opioid prescribing patterns in U.S. counties. Researchers found that while the amount of opioids prescribed dropped 18.2 percent nationally from 2010 to 2015, there was enormous variance in prescribing patterns by county.

The amount of opioids prescribed nationally peaked at the equivalent of 782 milligrams of morphine annually per capita in 2010 and fell to 640 in 2015. That’s an improvement, but it’s still three times higher than it was in 1999, Dr. Anne Schuchat, the CDC's principal deputy director, told the AP earlier this month.

Nearly half of all counties saw a significant decrease in prescription amounts from 2010 to 2015, but another 22.6 percent saw an increase of at least 10 percent during that time. The CDC analysis found that in 2015, the highest-prescribing counties had per-capita prescription amounts that were six times that of the lowest-prescribing counties.

The CDC analysis also found certain demographic and health characteristics were linked to -- but did not fully account for -- higher prescribing amounts. Counties with high prescribing often had these factors in common:

• Larger percentages of non-Hispanic white residents
• A higher prevalence of diabetes and arthritis
• Higher rates of unemployment
• Higher rates of Medicaid enrollment
• Were micropolitan areas (defined as counties with fewer than 50,000 people but with an urban cluster of at least 10,000 people)

The results of the CDC's look at possible contributing factors can be found here: https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm?s_cid=mm6626a4_w#T2_down

The CDC produced a county-level map of the per-capita data here: https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm?s_cid=mm6626a4_w#F2_down

The CDC also looked at other factors -- including the rate of prescriptions written (which dropped 13.1 percent nationally from 2012-2015); the number of high-dosage prescriptions written (which dropped 41.4 percent from 2010-2015); and the average daily milligrams of morphine equivalent per prescription, which dropped from 58.0 in 2010 to 48.1 in 2015. The one factor that rose was days' supply per prescription, which went up from 15.5 days' worth of medication in 2010 to 17.7 days in 2015.

CDC researchers point out that despite prescription amounts for legal drugs declining in many places, opiate-related deaths have continued to rise. Opioid overdoses -- from both legal and illegal drugs -- kill 91 people each day in the U.S. In 2015, roughly 15,000 people died from prescription opiate-related overdoses, according to CDC data.

The CDC researchers described their findings in detail in this report: http://bit.ly/2vH3AUW The report and data analysis will be used as a baseline to determine whether the CDC's 2016 guidelines for opioid prescribing (https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm#B1_down) have been effective, a CDC spokeswoman said.

About This Data

This data was obtained by the CDC from QuintilesIMS Transactional Data Warehouse, which provides estimates of the number of opioid prescriptions dispensed in the United States based on a sample of approximately 59,000 pharmacies, representing 88 percent of prescriptions in the United States.

Prescriptions can vary widely by drug, dosage, and days' supply. Instead of merely counting the number of prescriptions written or pills dispensed, the CDC normalized the data to arrive at a single unit of measurement of opioids per capita for each county. The prescription amounts are measured in "Morphine Milligram Equivalents," or MMEs.

MMEs are a medically accepted method of measuring all the opioids a patient might be ingesting, so as to prevent overdoses and reduce the risk of addiction. In 2016, the CDC published guidelines recommending that clinicians use caution when increasing dosages past 50 MME a day, and to avoid reaching 90 MME a day except in the most extreme cases. General information about opioid dosing can be found here: https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf

The CDC placed each county into quartiles based on 2015 per-capita prescribing levels. In measuring change from 2010 to 2015, the CDC considered whether prescribing amounts had risen more than 10 percent ("Increased"), dropped more than 10 percent ("Decreased"), or stayed "Stable" (no change, or changes of less than 10 percent in either direction). These flags are included in the dataset.

The counties in the highest-prescribing quartile had an average of 1,319 MME per capita, while the counties in the lowest quartile had an average of 203 MME per capita.

Using This Data

According to the CDC's analysis, the national average daily MME per prescription in 2015 was 48.1. You can divide your county's annual per-capita MME by this number to find out the number of days' prescriptions per person in your county.

For Example: Surry County, N.C. has an annual 2015 per-capita MME of 2431.6. Divide that by 48.1 and you'll get 50.5.

This can be phrased as: "The prescription amounts in 2015 were the equivalent of a 50-day supply of opioids for every person in Surry County."

The CDC did similar calculations in a 2015 report, but instead of using the average daily MME prescription determined by this data, used as a basic guideline a 'typical' prescription of 5 mg of hydrocodone (5 MME) every 4 hours, for a total of 30 MME/day. Using this example, enough opioids were prescribed in Surry County, NC in 2015 to medicate every person in the county around the clock for 81 days.

You can also rank the counties in your state. To do this, click on "Rank Prescription Amounts in your state" under the 'Queries' tab in the upper right-hand bar on this page. Type the name of your state over the "STATE_NAME" placeholder text in the query. The resulting table will show you the counties in your state, ordered by 2015 MMEs. You can export this table. Keep in mind that the prescription data reflects where prescriptions were dispensed, not where recipients live.

Look for counties where prescription amounts have increased more than 10 percent since 2010. To do this, click on "Increasing prescription amounts" under the 'Queries' tab in the upper right-hand bar on this page. Type the name of your state over the "STATE_NAME". The resulting table will show you all the counties in your state that have seen prescription amounts increase by at least 10 percent, ordered by 2015 MMEs. You can export this table. Keep in mind that the prescription data reflects where prescriptions were dispensed, not where recipients live.

Data should be attributed to the CDC, based on raw prescription data obtained from QuintilesIMS, a pharmaceutical analytics company. Please give The Associated Press a contributing line on any story or graphic produced from this data distribution.

Caveats

• The county-level data reflects where an opioid is dispensed. Some of these prescriptions may have been obtained by people outside the county.

• Some counties did not have data robust enough for CDC to analyze. Of the 3,143 counties in the U.S., 180 counties did not have 2015 per-capita MME data that could be used. Still more counties did not have 2010 data. In all, the CDC was able to calculate a per-capita MME for both years in 2,734 counties.

• The data do not take into account illegal use of opiate drugs such as heroin.

• The data do not reflect drugs dispensed directly by a medical provider.

• Cold and cough products containing opioids and buprenorphine products indicated for conditions other than pain were excluded.

• The data does not include any details on the appropriateness of the prescriptions, or whether the opioids were dispensed for chronic, acute or end-of-life pain.

• The MME is calculated on an annual basis per capita. The CDC used American Community Survey data for population. Population estimates include all people in a county, including children.

AP Coverage of the Opioid Epidemic

The Associated Press has an ongoing series, Overcoming Opioids, running through this year, chronicling efforts to climb out of the worst drug epidemic in U.S. history. For earlier parts of this series, see: https://apnews.com/tag/OvercomingOpioids

If you have any questions about this data or its use, leave a comment in the discussion forum here or email Data Journalist Meghan Hoyer at mhoyer@ap.org

This repository includes data from the Health Resources & Services Administration's Area Health Resources Files (years 2000, 2004-2019), CDC Wonder, National Conference of State Legislatures, and the Drug Enforcement Agency's Automation of Reports and Consolidated Orders System (ARCOS).

Please cite the following publication when using this dataset:

KN Griffith, Y Feyman, SG Auty, EL Crable, TW Levengood. (2021). County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access. Data in Brief 35: e106779. https://doi.org/10.1016/j.dib.2021.106779

These data were originally collected for the following research article:

Griffith, KN, Feyman, Y, Crable, EL, & Levengood, TW. (2021). “Implications of county-level variation in U.S. opioid distribution.” Drug and Alcohol Dependence 219: e108501. https://doi.org/10.1016/j.drugalcdep.2020.108501