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.

Accidental Drug Related Deaths by Individual Drugs Detected reports totals and subtotals of deaths attributable to accidental drug overdoses by place of death as reported by the Connecticut Office of the Chief Medical Examiner. Deaths are by grouped age, race, ethnicity, and gender and by the individuals drugs detected post-death. The companion dataset, Accidental Drug Related Deaths by Drug Type, reports subtotals by various aggregated categories. Domain

A. SUMMARY This dataset includes unintentional drug overdose death rates by race/ethnicity by year. This dataset is created using data from the California Electronic Death Registration System (CA-EDRS) via the Vital Records Business Intelligence System (VRBIS). Substance-related deaths are identified by reviewing the cause of death. Deaths caused by opioids, methamphetamine, and cocaine are included. Homicides and suicides are excluded. Ethnic and racial groups with fewer than 10 events are not tallied separately for privacy reasons but are included in the “all races” total.

Unintentional drug overdose death rates are calculated by dividing the total number of overdose deaths by race/ethnicity by the total population size for that demographic group and year and then multiplying by 100,000. The total population size is based on estimates from the US Census Bureau County Population Characteristics for San Francisco, 2022 Vintage by age, sex, race, and Hispanic origin.

These data differ from the data shared in the Preliminary Unintentional Drug Overdose Death by Year dataset since this dataset uses finalized counts of overdose deaths associated with cocaine, methamphetamine, and opioids only.

B. HOW THE DATASET IS CREATED This dataset is created by copying data from the Annual Substance Use Trends in San Francisco report from the San Francisco Department of Public Health Center on Substance Use and Health.

C. UPDATE PROCESS This dataset will be updated annually, typically at the end of the year.

D. HOW TO USE THIS DATASET N/A

E. RELATED DATASETS Overdose-Related 911 Responses by Emergency Medical Services Preliminary Unintentional Drug Overdose Deaths San Francisco Department of Public Health Substance Use Services

F. CHANGE LOG

• 12/16/2024 - Updated with 2023 data. Asian/Pacific Islander race/ethnicity group was changed to Asian.
• 12/16/2024 - Past year totals by race/ethnicity were revised after obtaining accurate race/ethnicity for some decedents that were previously marked as “unknown” race/ethnicity.

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

This data presents counts of provisional drug overdose deaths by selected drugs and U.S. Department of Health and Human Services (HHS) public health regions, based on provisional mortality data from the National Vital Statistics System. This data is limited to drug overdose deaths with an underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision (ICD-10) code numbers X40-X44 (unintentional), X60-X64 (suicide), X85 (homicide), or Y10-Y14 (undetermined intent). Specific drugs were identified using methods for searching literal text from death certificates.

The provisional data are based on a current flow of mortality data and include reported 12 month-ending provisional counts of drug overdose deaths by jurisdiction of occurrence and specified drug. Provisional drug overdose death counts presented on this page are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2022 would include deaths occurring from July 1, 2021, through June 30, 2022. Evaluation of trends over time should compare estimates from year to year (June 2021 and June 2022), rather than month to month, to avoid overlapping time periods. It is important to note that the data represent counts of deaths, and not mortality ratios or rates, which are the standard measure used to compare groups, and therefore should not be used to determine populations at disproportionate risk of drug overdose death.

Annual number of deaths registered related to drug poisoning in England and Wales by sex, region and whether selected substances were mentioned anywhere on the death certificate, with or without other drugs or alcohol, and involvement in suicides.

A. SUMMARY This dataset includes data from the Office of the Chief Medical Examiner on the number of preliminary unintentional fatal drug overdoses per month.

B. HOW THE DATASET IS CREATED The Office of the Chief Medical Examiner releases a monthly report containing the previous month’s preliminary count of unintentional fatal drug overdoses. This dataset is manually updated based on that report.

The San Francisco Office of the Chief Medical Examiner (OCME) investigates any unknown cause of death for deaths that occur in San Francisco. OCME uses drug testing, death scene investigation, autopsy, medical record, and informant information to determine the cause of death. Preliminary determinations are generally based on drug testing and death scene investigations.

Preliminary deaths reported by the medical examiner consist of two categories: (a) cases that are still under investigation and involve suspected acute toxicity from opioids, cocaine, or methamphetamine; and (b) cases that have been finalized and were attributed to acute toxicity from any substance (including prescribed medication and over-the-counter medication).

C. UPDATE PROCESS This dataset is updated monthly following the release of the monthly accidental fatal drug overdose report from the Office of the Chief Medical Examiner. Department of Public Health staff manually copy data from the Office of the Chief Medical Examiner’s report to update this dataset.

D. HOW TO USE THIS DATASET This dataset is updated each month to include the most recent month’s preliminary accidental fatal drug overdose count. Counts from previous months are often also updated as it can take more than a month for the Office of the Chief Medical Examiner to finish reviewing cases.

E. RELATED DATASETS San Francisco Department of Public Health Substance Use Services Overdose-Related 911 Responses by Emergency Medical Services (EMS) Unintentional Drug Overdose Death Rate by Race/Ethnicity

This data presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts. Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts. Reporting of the specific drugs and drug classes involved in drug overdose deaths varies by jurisdiction, and comparisons of death rates involving specific drugs across selected jurisdictions should not be made. Provisional data presented will be updated on a monthly basis as additional records are received. For more information please visit: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

EMSIndicators:The number of individual patients administered naloxone by EMSThe number of naloxone administrations by EMSThe rate of EMS calls involving naloxone administrations per 10,000 residentsData Source:The Vermont Statewide Incident Reporting Network (SIREN) is a comprehensive electronic prehospital patient care data collection, analysis, and reporting system. EMS reporting serves several important functions, including legal documentation, quality improvement initiatives, billing, and evaluation of individual and agency performance measures.Law Enforcement Indicators:The Number of law enforcement responses to accidental opioid-related non-fatal overdosesData Source:The Drug Monitoring Initiative (DMI) was established by the Vermont Intelligence Center (VIC) in an effort to combat the opioid epidemic in Vermont. It serves as a repository of drug data for Vermont and manages overdose and seizure databases. Notes:Overdose data provided in this dashboard are derived from multiple sources and should be considered preliminary and therefore subject to change. Overdoses included are those that Vermont law enforcement responded to. Law enforcement personnel do not respond to every overdose, and therefore, the numbers in this report are not representative of all overdoses in the state. The overdoses included are limited to those that are suspected to have been caused, at least in part, by opioids. Inclusion is based on law enforcement's perception and representation in Records Management Systems (RMS). All Vermont law enforcement agencies are represented, with the exception of Norwich Police Department, Hartford Police Department, and Windsor Police Department, due to RMS access. Questions regarding this dataset can be directed to the Vermont Intelligence Center at dps.vicdrugs@vermont.gov.Overdoses Indicators:The number of accidental and undetermined opioid-related deathsThe number of accidental and undetermined opioid-related deaths with cocaine involvementThe percent of accidental and undetermined opioid-related deaths with cocaine involvementThe rate of accidental and undetermined opioid-related deathsThe rate of heroin nonfatal overdose per 10,000 ED visitsThe rate of opioid nonfatal overdose per 10,000 ED visitsThe rate of stimulant nonfatal overdose per 10,000 ED visitsData Source:Vermont requires towns to report all births, marriages, and deaths. These records, particularly birth and death records are used to study and monitor the health of a population. Deaths are reported via the Electronic Death Registration System. Vermont publishes annual Vital Statistics reports.The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) captures and analyzes recent Emergency Department visit data for trends and signals of abnormal activity that may indicate the occurrence of significant public health events.Population Health Indicators:The percent of adolescents in grades 6-8 who used marijuana in the past 30 daysThe percent of adolescents in grades 9-12 who used marijuana in the past 30 daysThe percent of adolescents in grades 9-12 who drank any alcohol in the past 30 daysThe percent of adolescents in grades 9-12 who binge drank in the past 30 daysThe percent of adolescents in grades 9-12 who misused any prescription medications in the past 30 daysThe percent of adults who consumed alcohol in the past 30 daysThe percent of adults who binge drank in the past 30 daysThe percent of adults who used marijuana in the past 30 daysData Sources:The Vermont Youth Risk Behavior Survey (YRBS) is part of a national school-based surveillance system conducted by the Centers for Disease Control and Prevention (CDC). The YRBS monitors health risk behaviors that contribute to the leading causes of death and disability among youth and young adults.The Behavioral Risk Factor Surveillance System (BRFSS) is a telephone survey conducted annually among adults 18 and older. The Vermont BRFSS is completed by the Vermont Department of Health in collaboration with the Centers for Disease Control and Prevention (CDC).Notes:Prevalence estimates and trends for the 2021 Vermont YRBS were likely impacted by significant factors unique to 2021, including the COVID-19 pandemic and the delay of the survey administration period resulting in a younger population completing the survey. Students who participated in the 2021 YRBS may have had a different educational and social experience compared to previous participants. Disruptions, including remote learning, lack of social interactions, and extracurricular activities, are likely reflected in the survey results. As a result, no trend data is included in the 2021 report and caution should be used when interpreting and comparing the 2021 results to other years.The Vermont Department of Health (VDH) seeks to promote destigmatizing and equitable language. While the VDH uses the term "cannabis" to reflect updated terminology, the data sources referenced in this data brief use the term "marijuana" to refer to cannabis. Prescription Drugs Indicators:The average daily MMEThe average day's supplyThe average day's supply for opioid analgesic prescriptionsThe number of prescriptionsThe percent of the population receiving at least one prescriptionThe percent of prescriptionsThe proportion of opioid analgesic prescriptionsThe rate of prescriptions per 100 residentsData Source:The Vermont Prescription Monitoring System (VPMS) is an electronic data system that collects information on Schedule II-IV controlled substance prescriptions dispensed by pharmacies. VPMS proactively safeguards public health and safety while supporting the appropriate use of controlled substances. The program helps healthcare providers improve patient care. VPMS data is also a health statistics tool that is used to monitor statewide trends in the dispensing of prescriptions.Treatment Indicators:The number of times a new substance use disorder is diagnosed (Medicaid recipients index events)The number of times substance use disorder treatment is started within 14 days of diagnosis (Medicaid recipients initiation events)The number of times two or more treatment services are provided within 34 days of starting treatment (Medicaid recipients engagement events)The percent of times substance use disorder treatment is started within 14 days of diagnosis (Medicaid recipients initiation rate)The percent of times two or more treatment services are provided within 34 days of starting treatment (Medicaid recipients engagement rate)The MOUD treatment rate per 10,000 peopleThe number of people who received MOUD treatmentData Source:Vermont Medicaid ClaimsThe Vermont Prescription Monitoring System (VPMS)Substance Abuse Treatment Information System (SATIS)

National provisional drug overdose deaths by month and 2013 NCHS Urban–Rural Classification Scheme for Counties. Drug overdose deaths are identified using underlying cause-of-death codes from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined). Deaths are based on the county of residence in the United States. Death counts provided are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. Estimates for 2020 are based on provisional data. Estimates for 2018 and 2019 are based on final data. For more information on NCHS urban-rural classification, see: https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf

Deaths related to drug poisoning in England and Wales by cause of death, sex, age, substances involved in the death, geography and registration delay.

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

Life expectancy at birth, at the health region level, is decomposed by drug overdose deaths. Changes in mortality rates for a given cause of death change over time and contribute to the overall change in life expectancy.

This data visualization presents county-level provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. County-level provisional counts include deaths occurring within the 50 states and the District of Columbia, as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation resulting in an underestimate relative to final counts (see Technical Notes). The provisional data presented on the dashboard below include reported 12 month-ending provisional counts of death due to drug overdose by the decedent’s county of residence and the month in which death occurred. Percentages of deaths with a cause of death pending further investigation and a note on historical completeness (e.g. if the percent completeness was under 90% after 6 months) are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical Notes). Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Technical Notes Nature and Sources of Data Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics (NCHS) as of a specified cutoff date. The cutoff date is generally the first Sunday of each month. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from the state vital registration offices through the Vital Statistics Cooperative Program (VSCP). The timeliness of provisional mortality surveillance data in the National Vital Statistics System (NVSS) database varies by cause of death and jurisdiction in which the death occurred. The lag time (i.e., the time between when the death occurred and when the data are available for analysis) is longer for drug overdose deaths compared with other causes of death due to the time often needed to investigate these deaths (1). Thus, provisional estimates of drug overdose deaths are reported 6 months after the date of death. Provisional death counts presented in this data visualization are for “12 month-ending periods,” defined as the number of deaths occurring in the 12 month period ending in the month indicated. For example, the 12 month-ending period in June 2020 would include deaths occurring from July 1, 2019 through June 30, 2020. The 12 month-ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12 month-ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Cause of Death Classification and Definition of Drug Deaths Mortality statistics are compiled in accordance with the World Health Organizations (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regul

Analysis of ‘Drug overdose deaths’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://www.kaggle.com/ruchi798/drug-overdose-deaths on 13 February 2022.

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

Context

The rate of overdose deaths in Connecticut increased from 9.9 per 100,000 residents in 2012 to 28.5 per 100,000 residents in 2018-a 221 % increase-with the majority occurring among persons aged 35-64 (65.3 %), men (73.9 %), and non-Hispanic whites (78.5 %). Among deaths involving fentanyl, the overall deaths escalated from 5.2 deaths per 100,000 residents in 2015 to 21.3 deaths per 100,000 residents in 2018 and more than 50% of these fentanyl-related deaths involved polysubstance use.

Inspiration

• To examine trends in polysubstance detection associated with drug-related overdose deaths

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

This dataset provides model-based provisional estimates of the weekly numbers of drug overdose, suicide, and transportation-related deaths using “nowcasting” methods to account for the normal lag between the occurrence and reporting of these deaths. Estimates less than 10 are suppressed. These early model-based provisional estimates were generated using a multi-stage hierarchical Bayesian modeling process to generate smoothed estimates of the weekly numbers of death, accounting for reporting lags. These estimates are based on several assumptions about how the reporting lags have changed in recent months across different jurisdictions, and the resulting estimates differ from other sources of provisional mortality data. For now, these estimates should be considered highly uncertain until further evaluations can be done to determine the validity of these assumptions about timeliness. The true patterns in reporting lags will not be known until data are finalized, typically 11–12 months after the end of the calendar year. Importantly, these estimates are not a replacement for monthly provisional drug overdose death counts, or quarterly provisional mortality estimates. For more detail about the nowcasting methods and models, see:

Rossen LM, Hedegaard H, Warner M, Ahmad FB, Sutton PD. Early provisional estimates of drug overdose, suicide, and transportation-related deaths: Nowcasting methods to account for reporting lags. Vital Statistics Rapid Release; no 11. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://doi.org/10.15620/ cdc:101132

Data on drug overdose death rates in the United States, by age, sex, race, Hispanic origin, and drug type. Data are from Health, United States. SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality File. 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 indicator includes unintentional overdoses, homicides, and suicides from drug overdose. Death rate has been age-adjusted to the 2000 U.S. standard population. ICD-10 codes used to identify drug overdose related deaths are X40-X44, X60-X64, X85, and Y10-Y14.Drug overdose deaths have increased dramatically in the US over the past two decades. The first wave of deaths in the 1990s largely involved prescription opioids and was a consequence of increased prescribing of these drugs by medical providers. In the second wave that began in 2010, there was a rapid increase in the number of deaths involving heroin and, in the current wave that started in 2013, there has been a rise in the number of overdose deaths involving synthetic opioids, particularly illicitly manufactured fentanyl, which can be found in combination with heroin, counterfeit pills, cocaine, and other drugs. In Los Angeles County in recent years, the vast majority of all drug overdose deaths have involved fentanyl. Important inequities have been noted by sociodemographic characteristics, with low-income and Black individuals found to have the highest overdose death rates. Cities and communities can take an active role in preventing overdose deaths by promoting primary prevention and supporting evidence-based harm reduction and treatment strategies.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

Analysis of the risk of suicide and drug-related deaths among prisoners, including the number of deaths, standarised mortality ratios and age-standardised rates, England and Wales, 2008 to 2019.

Note: This Dataset is updated nightly and contains all downloadable Medical Examiner-Coroner records, January 1, 2018 to current, related to deaths that occurred in the County of Santa Clara under the Medical Examiner-Coroner’s jurisdiction and those deaths reportable to the Medical Examiner-Coroner (non-jurisdictional cases/NJA) but in which the office did not assume jurisdiction.

The Santa Clara County Medical Examiner- Coroner’s Office determines cause and manner of death for those deaths that fall under the jurisdiction of the Medical Examiner-Coroner, as defined by California Government code 27491.

The Medical Examiner-Coroner will not be responsible for data verification, interpretation or misinformation once data has been downloaded and manipulated from the dashboard.

Refer to the following document to know more of which deaths are reportable: https://medicalexaminer.sccgov.org/sites/g/files/exjcpb986/files/Reportable%20Death%20Chart%202018.pdf.