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Spatiotemporal Trends in Three Smoothed Overdose Death Rates in US Counties, 2012–2020

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The paneled maps depict spatiotemporal trends in 3 smoothed overdose death rates for contiguous US counties in 2012, 2014, 2016, 2018, and 2020. The 3 overdose death rates are any opioid, synthetic opioids, and psychostimulants with abuse potential.

Any opioids: In 2012, the death rate due to any opioids was higher in the Southwest and the Midwest (including Appalachia) compared with the rest of the country. Over time, the death rate due to any opioids continued to be high in the Southwest and the Midwest, but in 2016, these rates spread throughout the Northeast, the Rust Belt, and along the East Coast. By 2020, the death rate due to any opioids was high in most counties of the US, with especially high rates in the Northeast, Midwest (including Appalachia), the Rust Belt, along the East Coast (including most of Florida), along the Gulf Coast of Louisiana, Mississippi, and Alabama, and in the Southwest (particularly New Mexico, Arizona, and Colorado).

Synthetic opioids: The rate of overdose deaths due to synthetic opioids was low until 2016, when rates increased in the Northeast and Rust Belt. Then, from 2016 to 2020, increases in overdose deaths spread gradually throughout the Midwest (including Appalachia), the East Coast (including most of Florida), the Gulf Coast of Louisiana and Mississippi, and the Southwest (particularly Arizona, New Mexico, Colorado, and Utah).

Psychostimulants with abuse potential: The maps showing the rate of overdose deaths due to psychostimulants with abuse potential are similar to the maps showing the rate of overdose deaths due to synthetic opioids: we found low rates of overdose deaths for nearly all counties in the contiguous US through 2016. In 2018, we began to observe higher rates of overdose deaths due to psychostimulants in Appalachia (particularly West Virginia), the Mountain region, and the West Coast (particularly Northern California). By 2020, higher rates of overdose deaths due to psychostimulants had spread throughout Appalachia and into Maine. Higher rates were found also along the Gulf Coast, and in Missouri, Oklahoma, and Minnesota. The Southwest (particularly New Mexico and Arizona), and California and Washington also had higher rates of these overdose deaths in 2020 compared with previous years.

Spatiotemporal trends in smoothed overdose death rates (any opioid, synthetic opioids, and psychostimulants) in US counties (N = 3,107), 2012–2020. Mortality rates were calculated by using restricted county-level data from the National Vital Statistics System; rates were mapped for 2012, 2014, 2016, 2018, and 2020.

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