Nonfatal Overdoses: All Drugs

The drug overdose data presented below come from CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) system. CDC has analyzed data from syndromic surveillance of suspected drug overdoses. Data presented here include percent change estimates in rates of suspected drug overdoses per 10,000 ED visits. These suspected all drug overdose percent change estimates may change as CDC receives updated data, so estimates should be interpreted with caution.

The map below provides annual percent change estimates in rates of all drug overdoses per 10,000 ED visits for the most recent month of data. The “About This Map” section provides the specific data for the map and also all other annual percent change estimates. The other tables provide annual and monthly percent change estimates overall, by state, and by sex and age group.

Trends in Emergency Department Visits for Suspected All Drug Overdose, January 2019 to January 2020

CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual Trends in Emergency Department Visits for Suspected All Drug Overdose§, January 2018 to January 2020, by OD2A-funded Jurisdiction

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CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual Trends† in Emergency Department Visits for Suspected All Drug Overdose§, January 2018 to January 2020,¶ by OD2A-funded Jurisdiction
January 2018 to January 2019 February 2018 to
February 2019
March 2018 to March 2019 April 2018 to April 2019 May 2018 to May 2019 June 2018 to June 2019 July 2018 to July 2019 August 2018 to
August 2019
September 2018 to September 2019 October 2018 to October 2019 November 2018 to November 2019 December 2018 to December 2019 January 2019 to January 2020 Category, January 2019 to January 2020
Number of States 32 33 35 35 35 35 36 36 36 37 36 36 36
Overall 5.3 7.14 -0.85 2.46 4.27 5.72 4.46 5.52 5.86 8.99 8.63 9.54 13.02 significant increase
State                          
Alabama 15.09 -3.57 -0.23 -3.47 3.36 -1.19 3.21 -2.54 -16.44 -1.18 -10.34 -16.12 -9.74 significant decrease
Alaska -4.09 10.4 -3.69 -13.34 -5.81 8.84 14.2 -18.89 19.43 0.21 -6.83 22.04 23.85 no significant change
Arizona 2.13 11.24 2.93 3.23 -3.1 -5.76 2.02 -9.01 -7.71 -10.53 -18.1 -14.57 -4.71 no significant change
Arkansas 6.38 -3.09 -12.59 -7.6 -21.85 -9.81 -5.13 -9.6 18.98 9.4 1.23 -8.43 -4.02 no significant change
California**
Colorado -8.11 6.61 0.81 14.59 7.68 2.65 -4.69 2.28 0.54 9.68 11.85 14.04 -6.26 no significant change
Connecticut†† 2.56 17.76 9.07 16.28 21.21 22.88 14.14 significant increase
Delaware†† -10.55 6.67 6.41 7.16 no significant change
District of Columbia 16.95 19.2 24.26 -6.67 8.18 16.1 -22.52 3.1 -12.88 31.82 14.9 6.61 5.5 no significant change
Florida 20.77 20.18 17.07 15.54 15.41 20.41 11.75 16.66 28.84 34.35 26.64 24.14 26.11 significant increase
Georgia 14.23 3.97 -14.06 -2.66 0.36 8.2 6.62 5.49 -0.57 0.68 -6.05 -10.3 -6.15 no significant change
Hawaii**
Idaho††
Illinois 6.66 5.92 -6.57 9.25 7.34 13.39 20.87 10.63 11.06 0.64 8.84 7.96 22.9 significant increase
Indiana 0.51 -0.84 -9.73 -1.61 -3.9 -5.47 6.83 -2.08 4.55 -1.32 0.69 6.26 14.75 significant increase
Iowa**
Kansas 10.36 18.93 -2.71 2.38 8.21 9.01 -4.44 -0.33 13.01 -0.44 4.43 6.98 0.38 no significant change
Kentucky††
Louisiana 16.98 6.26 -14.23 -11 12.9 5 8.59 22.7 26.12 28.2 23.21 25.92 40.97 significant increase
Maine -18.4 -2.46 -18 -8.22 2.89 5.51 -24.73 -7.37 -3.51 2.73 -6.77 -1.82 20.6 significant increase
Maryland†† 0.37 -10.29 0.3 5.62 9.57 17.84 14.39 1.42 -5.48
Massachusetts -2.27 2.41 -5.97 -3.04 -6.49 -1.54 -0.65 -0.1 2.81 1.04 3.36 6.9 7.02 significant increase
Michigan 2.37 34.1 20.36 27.93 15.68 14.65 8.46 21.91 18.77 29.26 28.44 21.1 27.64 significant increase
Minnesota**
Mississippi††
Missouri 19.62 13.49 -14.8 -11.87 -6.59 -8.93 -3.75 -0.96 14.26 7.42 -1.73 5.19 0.26 no significant change
Montana -5.07 26.27 5.76 3.77 -9.6 5.43 -7.7 -6.72 -22.86 -2.55 -8.25 1.59 -1.97 no significant change
Nebraska**
Nevada -14.19 -7.29 -0.8 -0.07 -10.82 -6.9 0.61 5.56 14.3 4.26 -10.6 2.24 7.26 no significant change
New Hampshire -1.09 7.08 -0.95 -13.2 25.78 1.79 -9.43 -20.34 -39.38 -38.15 -16.59 3.48 -21.46 significant decrease
New Jersey -0.25 10.91 -14.99 -10.89 -11.93 -8.21 1.53 -5.83 -13.27 4.05 -4 8.95 10.27 significant increase
New Mexico 13.08 10.86 -4.09 -2.61 0.24 -18.27 -5.42 -7.51 10.78 -9.32 -4.61 -18.83 -21.15 significant decrease
New York State -13.06 19.31 8.5 1.65 7.2 7.76 1.47 20.74 24.7 22.98 30.13 62.39 63.98 significant increase
North Carolina -1.97 -3.29 -2.58 -2.44 2.81 3.41 2.49 -5.05 -12.46 -6.24 -2.78 -0.64 3.11 no significant change
North Dakota§§
Ohio 0.6 -4.66 -13.01 -0.79 -2.47 2.51 -0.37 -5.62 -3.96 3.88 3.14 5.49 8.15 significant increase
Oklahoma**
Oregon 7.56 -8.49 -9.84 -11.45 -6.03 4.06 -6.58 -1.79 -13.84 -6.53 -3.37 -5.36 6.34 no significant change
Pennsylvania -6.37 -2.42 -10.76 -7.47 -3.86 -7.4 -10.96 -2.9 -12.05 2.06 1.47 3.56 11.48 significant increase
Puerto Rico**
Rhode Island†† -13.89 11.64 -2.04 2.97 3.95 18.59 5 8.93 10.99 1.11 -6.3 no significant change
South Carolina††
South Dakota -8.47 1.57 9.81 -4.24 13.41 54.81 59.21 1.32 -13.35 -1.35 11.07 32.84 -8.84 no significant change
Tennessee 17.67 8.62 4 8.02 14.65 5.87 5.7 0.07 11.19 3.79 4.08 -2.24 -1.53 no significant change
Texas§§
Utah 1.07 5.71 17.5 10.13 7.58 0.83 1.78 1.76 7.34 3.82 0.88 -2.91 -12.57 significant decrease
Vermont -6.41 -0.71 -18.49 15.74 -34.19 -37.16 -30.93 -21.18 -7.05 -27.43 -20.42 25.56 -12.1 no significant change
Virginia 4.1 -4.25 -4.15 -5.96 9.04 10.49 -2.37 -1.45 -6.7 2.93 4.82 -22.72 -7.86 significant decrease
Washington 2.39 -2.33 -0.99 -4.13 3.2 8.12 15.54 3.44 7.25 8.73 -3.66 2.89 6.9 no significant change
West Virginia†† 30.89 26.84 19.12 significant increase
Wisconsin†† 28.71 25.08 26.5 23.56 30.82 41.45 23.22 18.39

 

* See DOSE System page.

† To account for changes occurring across time, annual trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Annual change, controlling for seasonal effects, was estimated as the change from the final month of previous year to the final month of the current year (e.g., January 2018 to January 2019). Significance testing was conducted using chi-square tests. Data table provides the annual rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.

§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.

¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.

** The state/territory does not share data from syndromic surveillance systems for DOSE.

†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.

§§ State does not participate in OD2A DOSE ED data sharing.

CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Monthly Trends in Emergency Department Visits for Suspected All Drug Overdose§, January 2018 to January 2020, by OD2A-funded Jurisdiction

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Monthly Percent Changes
January 2018 to February 2018 February 2018 to March 2018 March 2018 to April 2018 April 2018 to May 2018 May 2018 to June 2018 June 2018 to July 2018 July 2018 to August 2018 August 2018 to September 2018 September 2018 to October 2018 October 2018 to November 2018 November 2018 to December 2018 December 2018 to January 2019 January 2019 to February 2019 February 2019 to March 2019 March 2019 to April 2019 April 2019 to May 2019 May 2019 to June 2019 June 2019 to July 2019 July 2019 to August 2019 August 2019 to September 2019 September 2019 to October 2019 October 2019 to November 2019 November 2019 to December 2019 December 2019 to January 2020 Category, December 2019 to January 2020
(35 states) (35 states) (36 states) (36 states) (36 states) (36 states) (36 states) (36 states) (36 states) (35 states) (36 states) (36 states) (36 states) (37 states) (38 states) (38 states) (39 states) (39 states) (41 states) (41 states) (41 states) (41 states) (41 states) (41 states)
Overall 2.95 8.12 1.17 3.72 2.81 0.42 2.28 -4.4 -2.44 -0.66 -7.47 -0.99 4.13 0.65 5 5.27 4.27 -0.88 3.33 -4.1 0.48 -1.43 -6.7 2.22 significant increase
State                                                
Alabama 10.26 4.69 3.31 -4.39 5.57 -4.96 5.76 3.49 -7.33 5.39 -7.18 1.4 -7.61 8.31 -0.05 2.38 0.93 -0.73 -0.13 -11.27 9.6 -4.39 -13.17 9.11 no significant change
Alaska -1.4 17.35 12.22 -15.43 -10.53 16.1 18.45 -26.46 28.41 3.31 -32.27 7.43 13.49 2.37 0.97 -8.07 3.38 21.82 -15.87 8.28 7.74 -3.94 -11.29 9.03 no significant change
Arizona 7.74 5.32 5.36 -3.06 13.02 -1.1 5.14 -5.57 1.31 -7.17 -2.55 -13.34 17.34 -2.55 5.67 -9.01 9.91 7.06 -6.22 -4.23 -1.79 -15.02 1.65 -3.33 no significant change
Arkansas 8 10.81 -6.8 9.15 -6.08 6.35 -0.59 -18.01 0.3 4.32 -3.58 6.4 -1.62 -0.05 -1.48 -7.69 8.39 11.86 -5.28 7.92 -7.77 -3.47 -12.78 11.51 no significant change
California**
Colorado -14.11 4.52 0.29 -3.02 4.85 9.08 -1.46 -2.92 -1.12 -1.48 -12.61 13 -0.35 -1.16 13.99 -8.87 -0.05 1.28 5.73 -4.57 7.87 0.46 -10.9 -7.11 no significant change
Connecticut†† -0.22 -6.3 0.49 -4.22 -11.91 0.16 2.53 -3.52 11.96 8.16 9.11 -1.17 14.57 -13.22 7.13 -0.16 -10.69 -6.97 no significant change
Delaware†† -22.28 9.74 -11.34 -12.71 31.4 5.72 2.81 5.63 -3.37 7.92 -8.94 -5.39 -7.31 9.46 -10.72 no significant change
District of Columbia -1.74 0.12 22.22 -4.89 -0.36 45.07 -11.5 4.99 -24.15 -6.44 0.78 6.45 0.15 4.38 -8.21 10.25 6.93 -3.18 17.77 -11.28 14.77 -18.45 -6.49 5.35 no significant change
Florida 2.15 4.42 5.47 9.84 2 4.15 -0.76 -9.38 -2.65 4.49 -1.01 1.61 1.64 1.71 4.09 9.72 6.42 -3.34 3.6 0.08 1.51 -1.51 -2.97 3.22 significant increase
Georgia 9.7 13.92 -3.74 -0.1 -1.61 3.45 -8.19 3.96 -2.06 1.49 -4.79 3.39 -0.15 -5.84 9.03 3 6.08 1.94 -9.16 -2.02 -0.82 -5.29 -9.11 8.18 significant increase
Hawaii**
Idaho†† -3.51 3.77 8.41 -5.78 -14.21 24.85 significant increase
Illinois 8.08 7.56 -6.32 9.47 -2.96 -3.15 9.39 -2.58 8.79 -8.99 -3.83 -6.17 7.33 -5.12 9.54 7.56 2.5 3.24 0.12 -2.2 -1.41 -1.58 -4.61 6.81 significant increase
Indiana 6.7 8.81 -0.94 5.32 -0.03 -7.06 9.11 -3.4 0.46 -4.18 -11.89 -0.08 5.27 -0.95 7.97 2.87 -1.67 5.04 0.01 3.14 -5.18 -2.23 -7.02 7.9 significant increase
Iowa**
Kansas -3.62 20.62 -2.06 -2.23 2.66 7.13 -3.09 -6.72 2.4 1.07 -14.26 12.39 3.86 -1.33 3.06 3.33 3.42 -6.09 1.08 5.76 -9.78 6.01 -12.17 5.47 no significant change
Kentucky†† 14.99 -7.51 -9.79 16.66 2.19 2.51
Louisiana 9.68 25.19 2.5 -13.45 8.03 1.32 2.5 -8.11 -2.39 -4.24 7.93 -7.66 -0.38 1.05 6.36 9.79 0.47 4.79 15.81 -5.54 -0.78 -7.97 10.3 3.38 no significant change
Maine -6.62 17.17 -5.39 -5.89 4.64 -1.61 -6.15 6.86 -12.22 12.24 3.15 -20.17 11.61 -1.49 5.89 5.5 7.31 -29.81 15.5 11.32 -6.54 1.85 8.63 -1.95 no significant change
Maryland†† 8.94 10.19 -2.54 -2.8 0.94 -4.32 2.41 -8.38 6.2 -1.52 8.98 2.35 4.71 2.91 -0.59 -18.76 -1.03 -3.68 -7.21 2.17 no significant change
Massachusetts 0.88 11.76 -1.59 5.72 2.75 -4.78 3.84 -8.4 -0.79 7.13 -6.3 -10.09 5.72 2.61 1.48 1.96 8.18 -3.93 4.41 -5.73 -2.5 9.59 -3.1 -9.99 significant decrease
Michigan -3.97 8.76 0.86 6.94 4.84 1.9 -6.18 1.1 -4.71 -0.26 -3.25 -2.48 25.8 -2.38 7.21 -3.3 3.92 -3.6 5.46 -1.5 3.7 -0.89 -8.78 2.78 no significant change
Minnesota**
Mississippi†† 14.69 -11.79 -3.79 -2.39 -4.84 2.1 no significant change
Missouri -2.47 24.16 -3.92 8.57 5.98 1.38 5.13 -14.34 -0.14 9.36 -9.77 -0.67 -7.47 -6.78 -0.62 15.07 3.33 7.14 8.17 -1.18 -6.12 0.05 -3.42 -5.33 no significant change
Montana -7.09 0.51 -7.66 31.2 -15.5 6.68 7.65 1.78 -0.93 1.66 -14.08 -1.83 23.59 -15.82 -9.4 14.3 -1.45 -6.61 8.8 -15.82 25.14 -4.28 -4.87 -5.26 no significant change
Nebraska**
Nevada -0.33 -5.43 5.97 9.61 -0.08 -5.57 -5.37 -3.84 1.4 -2.24 -7.09 -0.89 7.69 1.19 6.74 -2.18 4.31 2.05 -0.71 4.12 -7.51 -16.17 6.25 3.98 no significant change
New Hampshire -4.38 19.48 3.72 -10.31 4.85 2.13 3.58 -6.74 3.92 3.13 -23.41 9.6 3.52 10.53 -9.12 29.97 -15.15 -9.12 -8.89 -29.03 6.03 39.09 -4.98 -16.82 significant decrease
New Jersey -2.05 22.08 -2.94 11.01 4.54 -6.84 15.52 -4.12 -12.16 2.13 -15.96 -4.8 8.9 -6.43 1.74 9.73 8.96 3.05 7.14 -11.69 5.37 -5.77 -4.62 -3.65 no significant change
New Mexico 3.09 21.03 -1.49 7.51 4.35 -7.42 -1.89 -6.34 -4.17 -1.6 -0.67 2.91 1.07 4.71 0.04 10.66 -14.92 7.13 -4.06 12.18 -21.56 3.51 -15.48 -0.02 no significant change
New York State -2.32 11.09 8.7 2.39 6.07 7.47 -4.4 -7.69 1.53 -3.67 -28.22 1.93 34.05 1.02 1.84 7.98 6.62 1.19 13.76 -4.67 0.13 1.93 -10.42 2.92 no significant change
North Carolina 1.03 5.18 0.6 2.6 2.62 -4.84 8.48 1.08 -6.19 -3.55 -4.99 -2.89 -0.33 5.95 0.74 8.12 3.22 -5.7 0.51 -6.81 0.48 0 -2.9 0.77 no significant change
North Dakota§§
Ohio 7.94 8.69 -4.47 6.43 2.95 4.43 4.58 -8.69 -5.09 -2.49 -8.41 -3.08 2.29 -0.82 8.94 4.63 8.21 1.5 -0.93 -7.09 2.65 -3.17 -6.33 -0.63 no significant change
Oklahoma**
Oregon 11.21 -1.39 10.93 -0.11 -9.17 3.67 1.88 2.36 -4.02 -4.66 -0.09 -1.38 -5.38 -2.85 8.95 6.01 0.58 -6.94 7.11 -10.21 4.12 -1.43 -2.16 10.82 significant increase
Pennsylvania -2.17 12.97 4.25 -2.1 7.29 4.51 2.6 0.89 -14.89 -0.32 -10.05 -6.28 1.96 3.32 8.08 1.73 3.34 0.49 11.89 -8.62 -1.24 -0.9 -8.2 0.89 no significant change
Puerto Rico**
Rhode Island†† -10.7 10.38 -1.29 -7.84 2.74 5.01 2.67 -8.13 0.1 1.9 -12.12 5.27 15.77 -3.15 3.76 -6.97 17.22 -7.02 6.51 -6.39 -8.8 -5.57 no significant change
South Carolina†† -2.58 1.28 -1.93 -7.96 -4.27 22.04 -9.65 0.07 no significant change
South Dakota -22.73 12.82 8.09 -12.06 -22.18 5.3 12.53 35.93 -8.53 -6.64 -14.82 21.14 -14.26 21.98 -5.74 4.14 6.24 8.3 -28.39 16.25 4.13 5.11 1.88 -16.86 no significant change
Tennessee 3.88 5.56 -0.3 -2.13 13.61 -3.33 -1.73 -5.9 2.86 1.53 -4.93 9.07 -4.11 1.07 3.55 3.88 4.9 -3.48 -6.95 4.55 -3.98 1.8 -10.69 9.85 significant increase
Texas§§
Utah -9.88 0.77 5.2 -1.91 6.36 -2.87 -0.11 0.33 7.49 -1.17 -9.46 8.31 -5.74 12.01 -1.4 -4.17 -0.32 -1.95 -0.13 5.83 3.96 -3.97 -12.86 -2.47 no significant change
Vermont -12.82 20.71 -24.41 38.52 9.35 -10.4 -8.18 2.89 11.54 -4.21 -26.88 17.44 -7.5 -0.9 7.32 -21.24 4.42 -1.53 4.78 21.34 -12.92 5.05 15.37 -17.78 no significant change
Virginia 6.64 7.78 4.73 -1.13 0.53 4.09 6.56 -0.18 -7.2 -6.03 -6 -4.13 -1.9 7.88 2.76 14.64 1.87 -8.03 7.57 -5.51 2.38 -4.3 -30.7 14.3 significant increase
Washington 1.96 -4.83 8.95 0.74 -1.27 -9.09 12.42 -3.6 2.67 5.84 -10.26 1.34 -2.75 -3.51 5.48 8.44 3.44 -2.85 0.65 -0.04 4.09 -6.22 -4.16 5.29 no significant change
West Virginia†† -3.35 1.75 0.72 17.59 11.59 0.29 5.04 -12.94 13.57 -1.07 -6.38 4.4 -6.34 -4.45 no significant change
Wisconsin†† 6.74 -7.83 11.4 7.67 -0.39 -4.42 -1.3 2.14 0.87 8.26 8.89 -2.71 1.2 6.72 -11.02 -3.09 3.6 -1.3 2.17 no significant change
Wyoming§§

* See DOSE System page.

† To account for changes occurring across time, monthly trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Monthly rate changes were calculated for all months with available data. Significance testing was conducted using chi-square tests. Data table provides the monthly rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.

§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.

¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.

** The state/territory does not share data from syndromic surveillance systems for DOSE.

†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.

§§ State does not participate in OD2A DOSE ED data sharing.

CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual and Monthly Percent Changes† in Suspected All Drug Overdoses§, January 2018 to January 2020 by Sex and Age Group

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CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual and Monthly Percent Changes† in Suspected All Drug Overdoses§, January 2018 to January 2020¶ by Sex and Age Group
Yearly Percent Change Monthly Percent Change
January 2018 to
January 2019
February 2018 to
February 2019
March 2018 to March 2019 April 2018 to
April 2019
May 2018 to
May 2019
June 2018 to June 2019 July 2018 to July 2019 August 2018 to
August 2019
September 2018 to September 2019 October 2018 to October 2019 November 2018 to November 2019 December 2018 to December 2019 January 2019 to January 2020 Category, January 2019 to January 2020 January 2018 to February 2018 February 2018 to March 2018 March 2018 to April 2018 April 2018 to May 2018 May 2018 to June 2018 June 2018 to July 2018 July 2018 to August 2018 August 2018 to September 2018 September 2018 to October 2018 October 2018 to November 2018 November 2018 to December 2018 December 2018 to January 2019 January 2019 to February 2019 February 2019 to March 2019 March 2019 to April 2019 April 2019 to May 2019 May 2019 to June 2019 June 2019 to July 2019 July 2019 to August 2019 August 2019 to September 2019 September 2019 to October 2019 October 2019 to November 2019 November 2019 to December 2019 December 2019 to January 2020 Category, December 2019 to January 2020
( 32 States ) ( 33 States ) ( 35 States ) ( 35 States ) ( 35 States ) ( 35 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 37 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 35 States ) ( 35 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 35 States ) ( 36 States ) ( 36 States ) ( 36 States ) ( 37 States ) ( 38 States ) ( 38 States ) ( 39 States ) ( 39 States ) ( 41 States ) ( 41 States ) ( 41 States ) ( 41 States ) ( 41 States ) ( 41 States )
Sex
Male 4.79 6.97 -0.52 2.69 3.14 6.39 4.68 7.97 7.4 10.32 11.19 13.97 17.53 significant increase 3.81 8.89 0.29 4.68 2.66 0.88 1.79 -4.82 -2.37 -0.94 -7.44 -2.62 5.23 1.6 4.05 5.15 5.8 -0.52 4.91 -5.19 0.24 -0.47 -5.36 0.54 no significant change
Female 5.7 7.1 -1.5 1.73 5.31 4.53 3.76 2.1 3.6 7.2 5.38 4.22 7.83 significant increase 1.95 7.27 2.23 2.22 2.94 -0.15 2.85 -3.88 -2.52 -0.19 -7.59 1.14 2.8 -0.47 5.89 5.24 2.33 -1.42 1.36 -2.67 0.99 -2.47 -8.33 4.61 significant increase
Age group
0-14 17.59 22.52 -4.87 -3.98 5.06 11.6 2.48 10.29 11.29 8.49 -5.66 -1.74 0.15 no significant change   -5.32 21.78 8 -0.31 -0.51 12.31 -1.56 -12.89 2.45 4.38 -18.36 12.91 -1.37 -4.38 8.65 8.2 7.13 2.58 5.66 -12.79 -0.28 -9.14 -15.42 16.09 significant increase
15-24 0.53 3.55 -6.11 -5.08 -0.22 2.52 -1.34 -1.44 -3 1.25 1.97 8.84 5.86 significant increase 0.15 6.95 1.97 -1.07 -4.34 -0.82 4.47 1.56 -0.77 2.11 -9.72 2.01 1.96 -2.65 3.56 4.05 -1.69 -5.11 4.01 0.14 4.07 2.27 -4.16 -0.5 no significant change
25-34 -0.94 1.2 -2.57 0.08 -1.06 2.92 0.95 2.57 3.07 10.02 9.79 6.46 11.53 significant increase 6.02 4.53 -1.13 5.51 1.66 -0.31 1.46 -3.85 -4.34 -0.45 -3.51 -6.33 7.62 1.58 2.45 3.61 6.14 -2.87 3.23 -3.42 1.76 -0.65 -6.4 -2 no significant change
35-54 4.67 5.06 2.95 8 8.13 7.44 6.73 9.74 9.48 9.94 12.7 13.76 20.71 significant increase 7.04 5.56 -0.75 5.07 4.28 -1.84 2.55 -3.59 -0.38 -1.87 -4.9 -6.41 7.34 3.56 4.54 5.42 3.2 -2.31 5.57 -3.78 0.08 0 -4.16 -0.51 no significant change
55 and up 10.6 12.56 6.86 11.78 12.26 12.74 14.21 10.09 12.57 16.58 19.22 15.45 18.38 significant increase 2.66 5.07 0.19 5.45 2.26 -0.5 4.59 -4.36 -2.54 0.37 -4.14 0.52 3.81 0.29 5 5.42 2.57 1.45 0.78 -2.13 0.96 1.44 -6.51 3.01 significant increase

* See DOSE System page.

† To account for changes occurring across time, annual trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Annual change, controlling for seasonal effects, was estimated as the change from the final month of previous year to the final month of the current year (e.g., January 2018 to January 2019). Significance testing was conducted using chi-square tests. Data table provides the annual rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.

§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.

¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.

** The state/territory does not share data from syndromic surveillance systems for DOSE.

†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.

§§ State does not participate in OD2A DOSE ED data sharing.

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