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.

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 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

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

Fatal drug overdoses have involved both xylazine and fentanyl. Xylazine is a non-opioid substance used in veterinary medicine. This study aimed to model changes in fatal xylazine-involved drug overdose deaths from 2019 to 2023 in Connecticut using overdose death data from the Office of the Chief Medical Examiner. Xylazine-involved drug overdose fatality rates were calculated by number of deaths per year per 100,000 population from 2019 to 2023. We used joinpoint regression modeling to evaluate quarterly overdose rates across age, number of drugs, and drug types with a significance level of p 

We collect data and report statistics on opioid, stimulant, and other substance use and their impact on health and well-being.

Source: Office of State Medical Examiners (OSME), Rhode Island Department of Health (RIDOH)

This data brief presents findings from the 2022 and 2023 National Surveys on Drug Use and Health (NSDUHs) on illegally made fentanyl (IMF) use among the noninstitutionalized, civilian U.S. population.

Introduction: The recreational use of fentanyl in combination with xylazine (i.e., “tranq-dope”) represents a rapidly emerging public health threat characterized by significant toxicity and mortality. This study quantified the interactions between these drugs on lethality and examined the effectiveness of potential rescue medications to prevent a lethal overdose.Methods: Male and female mice were administered acute doses of fentanyl, xylazine, or their combination via intraperitoneal injection, and lethality was determined 0.5, 1.0, 1.5, 2.0, and 24 h after administration. Both fentanyl and xylazine produced dose-dependent increases in lethality when administered alone.Results: A nonlethal dose of fentanyl (56 mg/kg) produced an approximately 5-fold decrease in the estimated LD50 for xylazine (i.e., the dose estimated to produce lethality in 50% of the population). Notably, a nonlethal dose of xylazine (100 mg/kg) produced an approximately 100-fold decrease in the estimated LD50 for fentanyl. Both drug combinations produced a synergistic interaction as determined via isobolographic analysis. The opioid receptor antagonist, naloxone (3 mg/kg), but not the alpha-2 adrenergic receptor antagonist, yohimbine (3 mg/kg), significantly decreased the lethality of a fentanyl-xylazine combination. Lethality was rapid, with death occurring within 10 min after a high dose combination and generally within 30 min at lower dose combinations. Males were more sensitive to the lethal effects of fentanyl-xylazine combinations under some conditions suggesting biologically relevant sex differences in sensitivity to fentanyl-xylazine lethality.Discussion: These data provide the first quantification of the lethal effects of “tranq-dope” and suggest that rapid administration of naloxone may be effective at preventing death following overdose.

This dataset and R code accompanies a manuscript submitted by Marks et al. to Lancet Public Health entitled "Identifying Counties at Risk of High Overdose Mortality Burden Throughout the Emerging Fentanyl Epidemic in the United States: A Predictive Statistical Modeling Study". The analyses and results are available in the manuscript. All publicly available data used in the study is included in this dataset, in addition to several additional variables. Since the study used restricted mortality records from the CDC, we have censored all variables derived from this restricted data. Given access to the restricted data, researchers can add these variables to this dataset in the indicated columns. The accompanying R Code was used for the analysis.

Background: The opioid epidemic has been extensively documented in the United States and Canada, but fewer data are available for Europe.Aim: To describe the trends in opioid use—volume of prescriptions, dosage and number of patients treated—in a Spanish population with more than 4.2 million inhabitants aged 18 years and older.Patients and Methods: Population-based cross-sectional analysis of opioid prescription in adults (≥18 years) from January 1, 2010 to December 31, 2018 in the region of Valencia, Spain. Outcomes were estimated on an annual basis: number of prescriptions, prescription rate per 100 inhabitants, dosage per capita (morphine mg equivalents, MME/c) and volume of patients treated (overall and by drug).Results: Over the study period, 2,107,756 unique patients were prescribed more than 35 million total treatments. The yearly number of treatments doubled, and total MME/c showed almost a threefold increase. Fentanyl MME/c more than tripled, accounting for 34.4% of the total MME/c in 2018. Oxycodone MME/c showed a 10-fold increase, while tapentadol, launched in 2011, showed the highest growth rates. The annual number of patients receiving at least one opioid prescription more than doubled, from 335,379 in 2010 to 722,838 in 2018.Conclusions: Even if proportions still seem far from epidemic, urgent research is warranted on the observed patterns of use, their appropriateness and their association with health and safety outcomes, especially for high-use and high-strength drugs.

ObjectivesFentanyl is a highly potent opioid and has, until recently, been considered an unwanted contaminant in the street drug supply among people who use drugs (PWUD). However, it has become a drug of choice for an increasing number of individuals. This systematic review evaluated intentional non-medical fentanyl use among PWUD, specifically by summarizing demographic variance, reasons for use, and resulting patterns of use.MethodsThe search strategy was developed with a combination of free text keywords and MeSH and non-MeSH keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO. Studies included were human studies with intentional use of non-medical fentanyl or analogues in individuals older than 13. Only peer-reviewed original articles available in English were included.ResultsThe search resulted in 4437 studies after de-duplication, of which 132 were selected for full-text review. Out of 41 papers included, it was found that individuals who use fentanyl intentionally were more likely to be young, male, and White. They were also more likely to have experienced overdoses, and report injection drug use. There is evidence that fentanyl seeking behaviours are motivated by greater potency, delay of withdrawal, lower cost, and greater availability.ConclusionsAmong PWUD, individuals who intentionally use fentanyl have severe substance use patterns, precarious living situations, and extensive overdose history. In response to the increasing number of individuals who use fentanyl, alternative treatment approaches need to be developed for more effective management of withdrawal and opioid use disorder.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021272111.

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 dataset is about ICE/HSI numerous efforts and operations which were developed and implemented strategies for combating Illicit Opioids,. This also builds upon many of the ICE's directorate’s core investigative authorities and capabilities in fighting Transnational Criminal Organizations(TCOs) and aligns with the National Drug Control Strategy. Throughout the year, HSI participated in and led numerous operations to help protect the United States from the scourge of fentanyl and fentanyl-related substances. From March through May 2023, HSI partnered with U.S. Customs and Border Protection (CBP) to lead Operation Blue Lotus, a surge in fentanyl interdictions that resulted in the seizure of over 8,200 pounds of fentanyl and 284 arrests.

Source: Office of State Medical Examiners (OSME), Rhode Island Department of Health (RIDOH) Note: Data are limited to opioid-involved accidental drug overdose deaths. Counts may not add to annual totals due to missing case information. Percentages may not add to 100 due to rounding. Percentages are displayed as decimals. Prescription medications include prescription opioids such as oxycodone, hydrocodone, and benzodiazepines. Illicit drugs include substances such as heroin, illicit fentanyl, and cocaine.

This data package includes the underlying data to replicate the charts, tables, and calculations presented in Stopping the flow: The effects of US-China cooperation on fentanyl markets and overdose deaths, PIIE Working Paper 25-9.

If you use the data, please cite as:

Noland, Marcus, Julieta Contreras, and Lucas Rengifo-Keller. 2025. Stopping the flow: The effects of US-China cooperation on fentanyl markets and overdose deaths. PIIE Working Paper 25-9. Washington: Peterson Institute for International Economics.

The ongoing “fourth wave” of the U.S. overdose epidemic has been marked by rising deaths co-involving fentanyl with stimulants such as methamphetamine and cocaine. Using data obtained from the CDC WONDER Multiple Cause of Death database, this serial cross-sectional study analyzed stimulant overdose mortality trends between 1999 and 2023. We stratified crude mortality rates by sex, race and ethnicity, and opioid co-involvement. We used Joinpoint regression to examine temporal trends and estimate annual percentage changes (APC) within time segments. From 1999 to 2023, methamphetamine-involved overdose deaths increased from 547 to 34,855, with mortality rates rising from 0.20 (95% CI, 0.18–0.21) to 10.41 (95% CI, 10.30–10.52) per 100,000 (AAPC: 18.49% [95% CI, 17.67–20.17]; p 

The opioid abuse epidemic is a growing concern and has far reaching effects on society. Government agencies are addressing opioid abuse in various ways. This story map application introduces key facts about the opioid abuse crisis and provides related data and resources for getting help and preventing opioid medication misuse.Story Content Includes:What is the Opioid Abuse Epidemic?What are Opioids?History of the EpidemicThe Science of AddictionWhat is the Role of Heroin and Fentanyl in the Opioid Crisis? ​A National Epidemic and Local CrisisThe City of TempeRisk FactorsSigns and Symptoms of Opioid AbuseNaloxone Distribution LocationsDrug Drop Off LocationsTreatment ResourcesRemember those We've LostResources & Acknowledgements

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

Pigs used in research are often subjected to procedures for which pain relief is crucial. However, the literature indicates that analgesics are under-reported and under-used in experiments involving pigs. Fentanyl is one of the opioids used to provide post-operative pain relief in experimental pigs. Analgesic requirements are often assessed using behavioral indicators such as activity. However, the effects of fentanyl on behavior in pigs are largely unknown. The aims of the current study were to investigate how fentanyl influences behavior in pigs, and if serotonin could be involved in fentanyl-induced behavioral side effects. The dataset contains data used for statistical analysis in the paper high and hyper: Fentanyl induces psycomotor side-effects in healthy pigs.