CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program

CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program captures different types of data for both fatal and nonfatal overdoses.

Twelve states were initially funded in September 2016, and an additional 20 states and the District of Columbia were funded in September 2017, to share data on nonfatal overdoses with CDC on a quarterly basis. The most current data available comes from the most recent state data received during April 2019. CDC’s ESOOS program captures some data via CDC’s National Syndromic Surveillance Program (NSSP)’s BioSense platform.

ESOOS collects data from multiple sources, including ED hospital billing data and syndromic surveillance data:

  • Hospital billing data are collected by hospitals and shared with state and local partners. Hospital billing data include a standardized discharge diagnostic code (i.e., International Classification of Diseases, Tenth Edition, Clinical Modification, ICD-10-CM) used to categorize a visit as an overdose. The time lag between the date of a particular ED visit and the availability of billing data varies widely by state (e.g., monthly to annually).
  • Syndromic surveillance data include information on the purpose of an ED visit using the chief complaint free text field and a standardized discharge diagnostic code (i.e., ICD-10-CM) typically included in hospital billing data. These data can serve as an early warning system. They have become an important resource for tracking public health outbreaks, and can provide value in uncovering trends in suspected overdoses quickly.

See the Case Definition page for more detailed information on how the ESOOS program defines an overdose in their data.

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