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.

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.

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

Injury from poisoning exists under several Injury Intents: unintentional (accidental), intentional self-harm, assault, undetermined and adverse effect and underdosing. Only injuries in the first four categories are reported here combined. The data show rates per 100,000 people in order to standardize between areas with different population levels. Except for age specific rates, we use age-adjusted rates because they take into account where one age group dominates a population and thus are more representative. We use diagnosis by hospital records for non-fatal injury and cause of death from death certificates for fatal injury information.

This dashboard provides in-depth analysis surrounding events and characteristics of individuals who experienced non-fatal and/or fatal opioid overdoses in the District of Columbia. It includes data on ambulance transports for overdoses, fatalities, naloxone distribution, harm reduction efforts and the results of our used syringe testing. Data is aggregated at the neighborhood and ward levels. Data on fatal opioid overdoses will include deaths from 2021-2024. Data on non-fatal opioid overdoses will include incidents from 2021-2024. Note: Fatal opioid overdose data are delayed by approximately 90 days due to toxicological testing.

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.

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

Annual number of deaths registered related to drug poisoning, by local authority, England and Wales.

Data Source: DC Office of the Chief Medical Examiner (OCME) and American Community Survey (ACS) 1-Year Estimates

Why This Matters

Opioid-related overdoses have been continuously rising since the late 1990s, with synthetic opioids (such as Tramadol or Fentanyl) being responsible for a sharp rise in opioid-related deaths since 2013.

Opioid Use Disorder (OUD) is treatable, and recovery is possible. Accessing treatment can help people regain their health and continue avoid the dangers associated with opioid misuse.

Several systemic inequities, including disparities in the treatment of mental health disorders, have led to Black individuals dying from opioid overdoses at a higher rate than white individuals.

The District Response

LIVE.LONG.DC (LLDC) is the District’s strategic plan to reduce opioid use, misuse, and related deaths. The plan provides a strategic framework that guides opioid work and investments.

The District does work to prevent, reduce the harm of, treat, and aid in the recovery of opioid use. This includes educational efforts, supplying Naloxone, no-cost rides to initial treatment appointments, and recovery support services.

The Interactive, Ward-specific map provides information about opioid use disorder and substance us disorder-related resources and services available in the District.

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)

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.

A. SUMMARY This dataset includes data on a variety of substance use services funded by the San Francisco Department of Public Health (SFDPH). This dataset only includes Drug MediCal-certified residential treatment, withdrawal management, and methadone treatment. Other private non-Drug Medi-Cal treatment providers may operate in the city. Withdrawal management discharges are inclusive of anyone who left withdrawal management after admission and may include someone who left before completing withdrawal management.

This dataset also includes naloxone distribution from the SFDPH Behavioral Health Services Naloxone Clearinghouse and the SFDPH-funded Drug Overdose Prevention and Education program. Both programs distribute naloxone to various community-based organizations who then distribute naloxone to their program participants. Programs may also receive naloxone from other sources. Data from these other sources is not included in this dataset.

Finally, this dataset includes the number of clients on medications for opioid use disorder (MOUD).

The number of people who were treated with methadone at a Drug Medi-Cal certified Opioid Treatment Program (OTP) by year is populated by the San Francisco Department of Public Health (SFDPH) Behavioral Health Services Quality Management (BHSQM) program. OTPs in San Francisco are required to submit patient billing data in an electronic medical record system called Avatar. BHSQM calculates the number of people who received methadone annually based on Avatar data. Data only from Drug MediCal certified OTPs were included in this dataset.

The number of people who receive buprenorphine by year is populated from the Controlled Substance Utilization Review and Evaluation System (CURES), administered by the California Department of Justice. All licensed prescribers in California are required to document controlled substance prescriptions in CURES. The Center on Substance Use and Health calculates the total number of people who received a buprenorphine prescription annually based on CURES data. Formulations of buprenorphine that are prescribed only for pain management are excluded.

People may receive buprenorphine and methadone in the same year, so you cannot add the Buprenorphine Clients by Year, and Methadone Clients by Year data together to get the total number of unique people receiving medications for opioid use disorder.

For more information on where to find treatment in San Francisco, visit findtreatment-sf.org. 

B. HOW THE DATASET IS CREATED This dataset is created by copying the data into this dataset from the SFDPH Behavioral Health Services Quality Management Program, the California Controlled Substance Utilization Review and Evaluation System (CURES), and the Office of Overdose Prevention.

C. UPDATE PROCESS Residential Substance Use Treatment, Withdrawal Management, Methadone, and Naloxone data are updated quarterly with a 45-day delay. Buprenorphine data are updated quarterly and when the state makes this data available, usually at a 5-month delay.

D. HOW TO USE THIS DATASET Throughout the year this dataset may include partial year data for methadone and buprenorphine treatment. As both methadone and buprenorphine are used as long-term treatments for opioid use disorder, many people on treatment at the end of one calendar year will continue into the next. For this reason, doubling (methadone), or quadrupling (buprenorphine) partial year data will not accurately project year-end totals.

E. RELATED DATASETS Overdose-Related 911 Responses by Emergency Medical Services Unintentional Overdose Death Rates by Race/Ethnicity Preliminary Unintentional Drug Overdose Deaths

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.

Total number of accidental overdose deaths in Pierce County

Accuracy:Data are from the "Quarterly PHU opioid-related deaths report" published quarterly by the Office of the Chief Coroner for Ontario (OCCO).Opioid-related deaths are defined as an acute intoxication/toxicity death resulting from the direct effects of the administration of exogenous substance(s) where one or more of the substances is an opioid, regardless of how the opioid was obtained. This excludes deaths due to chronic substance use, medical assistance in dying, trauma where an intoxicant contributed to the circumstances of the injury and deaths classified as homicide.Reports only include confirmed opioid-related deaths for which death investigation results have indicated an opioid directly contributed to the cause of death; these reports are created when approximately 80% of the deaths in the most recent quarter for the province have been confirmed. A breakdown of confirmed vs probable cases can be found in the Interactive Opioid Tool on the PHO website (https://www.publichealthontario.ca/en/dataandanalytics/pages/opioid.aspx)Deaths have been assigned to public health unit based on six-digit postal code of the residence of the decedent. If residence postal code was unavailable, the postal code of the incident location was used. If postal code of the incident location was unavailable, the postal code of the death location was used. This methodology aligns with how deaths are assigned in PHO's Interactive Opioid Tool. Update Frequency: Quarterly

Attributes:Quarter - Year and quarter of death.Number of confirmed opioid-related deaths of Ottawa residents – number of confirmed opioid-related deaths of Ottawa residents. Contact: Ottawa Public Health Epidemiology Team

opioid- and other drug-related overdose deaths have increased sharply and become a significant cause of mortality in Canada. In response, local governments, provinces, and territories have implemented a variety of interventions and the Government of Canada has committed to a targeted public health response

Data include counts of overdose fatalities (includes both opioid involved and non-opioid involved fatal overdoses) by incident municipality, rates of overdose fatalities, count of opioid-overdose related EMS runs, naloxone kits distributed, and heat maps.

Themes relating to the risk of opioid-related deaths during hospital admissions or shortly after hospital discharge.

Overdose mortality rates and ridit scores associated to SIAS classes.