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.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual Trends† in Emergency Department Visits for Suspected All Drug Overdose§, January 2018 to February 2020,¶ by OD2A-funded Jurisdiction
| Jan 2018 to Jan 2019 | Feb 2018 to Feb 2019 | Mar 2018 to Mar 2019 | Apr 2018 to Apr 2019 | May 2018 to May 2019 | Jun 2018 to Jun 2019 | Jul 2018 to Jul 2019 | Aug 2018 to Aug 2019 | Sep 2018 to Sep 2019 | Oct 2018 to Oct 2019 | Nov 2018 to Nov 2019 | Dec 2018 to Dec 2019 | Jan 2019 to Jan 2020 | Feb 2019 to Feb 2020 | Category, Feb 2019 to Feb 2020 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of States | 33 | 34 | 36 | 36 | 36 | 36 | 37 | 37 | 37 | 38 | 37 | 37 | 37 | 38 | |
| Overall | 5.29 | 6.74 | -0.69 | 2.89 | 4.4 | 5.74 | 4.43 | 5.58 | 5.62 | 8.71 | 8.48 | 9.64 | 12.83 | 14.37 | 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 | 2.77 | no significant change |
| 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 | -7.8 | 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 | -13.04 | significant decrease |
| 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 | -2.96 | 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 | 4.41 | no significant change |
| Connecticut†† | . | . | . | . | . | . | 2.56 | 17.76 | 9.07 | 16.28 | 21.21 | 22.88 | 14.14 | 21.67 | significant increase |
| Delaware†† | . | . | . | . | . | . | . | . | . | -10.55 | 6.67 | 6.41 | 7.16 | 24.13 | significant increase |
| 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 | 38.97 | significant increase |
| 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 | 27.91 | 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 | 4.36 | 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 | 25.15 | 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 | 16.91 | 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 | 7.55 | no significant change |
| Kentucky†† | 5.38 | -6.86 | 7.56 | 24.37 | 9.89 | 6.36 | 2.83 | 8.57 | -1.1 | 1.83 | 9.44 | 13.7 | 4.26 | 2.63 | no significant change |
| 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 | 39.08 | 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 | 3.82 | no significant change |
| Maryland†† | . | 0.37 | -10.29 | 0.3 | 5.62 | 9.57 | 17.84 | 14.39 | 1.42 | -5.48 | . | . | . | -5.96 | no significant change |
| 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 | 8.59 | 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 | 11.22 | 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 | 16.45 | significant increase |
| 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 | -18.45 | significant decrease |
| 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 | 1.01 | 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 | -15.04 | 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 | 7.79 | 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 | -9.37 | no significant change |
| 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 | 38.82 | 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 | 2.17 | 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 | 10.33 | 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 | 14.09 | significant increase |
| 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 | 13.64 | 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 | 5.82 | 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 | 4.56 | 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 | 7.65 | significant increase |
| 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 | 9.6 | no significant change |
| 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 | -7.54 | 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 | -3.53 | no significant change |
| 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 | 24.01 | significant increase |
| West Virginia†† | . | . | . | . | . | . | . | . | . | . | 30.89 | 26.84 | 19.12 | 23.91 | significant increase |
| Wisconsin†† | . | . | 28.71 | 25.08 | 26.5 | 23.56 | 30.82 | 41.45 | 23.22 | 18.39 | . | . | . | . | |
| Wyoming§§ | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
* 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 iconpdf 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.
¶¶ Certain comparisons include data from two syndromic surveillance systems; some differences between the systems exist, such as the percent of missing discharge diagnosis codes.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Monthly Trends† in Emergency Department Visits for Suspected All Drug Overdose§, January 2018 to February 2020,¶ by OD2A-funded Jurisdiction
| Jan 2018 to Feb 2018 | Feb 2018 to Mar 2018 | Mar 2018 to Apr 2018 | Apr 2018 to May 2018 | May 2018 to Jun 2018 | Jun 2018 to Jul 2018 | Jul 2018 to Aug 2018 | Aug 2018 to Sept 2018 | Sept 2018 to Oct 2018 | Oct 2018 to Nov 2018 | Nov 2018 to Dec 2018 | Dec 2018 to Jan 2019 | Jan 2019 to Feb 2019 | Feb 2019 to Mar 2019 | Mar 2019 to Apr 2019 | Apr 2019 to May 2019 | May 2019 to Jun 2019 | Jun 2019 to Jul 2019 | Jul 2019 to Aug 2019 | Aug 2019 to Sept 2019 | Sep 2019 to Oct 2019 | Oct 2019 to Nov 2019 | Nov 2019 to Dec 2019 | Dec 2019 to Jan 2020 | Jan 2020 to Feb 2020 | Category Jan 2020 to Feb 2020 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of States | 35 | 35 | 36 | 36 | 36 | 36 | 37 | 37 | 37 | 36 | 37 | 37 | 37 | 38 | 39 | 39 | 40 | 40 | 42 | 42 | 42 | 42 | 42 | 42 | 42 | |
| Overall | 3.02 | 8.1 | 1.19 | 3.74 | 2.8 | 0.43 | 2.25 | -4.4 | -2.51 | -0.62 | -7.48 | -0.89 | 4.13 | 0.73 | 5.02 | 5.25 | 4.14 | -0.88 | 3.39 | -4.37 | 0.37 | -1.27 | -6.51 | 2.08 | 6.22 | 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 | 5.19 | 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 | -15.51 | 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 | 7.08 | 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 | -0.53 | 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 | 10.99 | significant increase |
| 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 | 9.29 | significant increase |
| 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 | 1.11 | 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 | 31.93 | significant increase |
| 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 | 3.1 | 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 | 11.04 | significant increase |
| Hawaii** | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | |
| Idaho†† | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | -3.51 | 3.77 | 8.41 | -5.78 | -14.21 | 24.85 | -6.19 | no significant change |
| 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 | 9.3 | 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 | 7.25 | 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 | 11.28 | no significant change |
| Kentucky†† | 18.04 | -9.12 | -8.8 | 17.89 | 1.87 | 2.64 | 0.88 | -4.32 | -5.52 | 0.6 | -7.97 | 3.49 | 4.33 | 4.95 | 5.46 | 4.16 | -1.4 | -0.76 | 6.51 | -12.84 | -2.72 | 8.11 | -4.39 | -5.1 | 2.69 | no significant change |
| 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 | -1.71 | 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 | -3.92 | 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 | 8.86 | significant increase |
| 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 | 7.28 | significant increase |
| 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 | 9.62 | significant increase |
| Minnesota** | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | |
| Mississippi†† | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | 14.69 | -11.79 | -3.79 | -2.39 | -4.84 | 2.1 | 22.15 | significant increase |
| 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 | 7.47 | 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 | 2.81 | 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 | 1.42 | 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 | 11.98 | no significant change |
| 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 | 6.46 | significant increase |
| 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 | 16.16 | significant increase |
| 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 | 13.48 | significant increase |
| 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 | -1.24 | 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 | 4.34 | 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 | 1.51 | no significant change |
| 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 | 3.93 | 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 | -0.75 | no significant change |
| South Carolina†† | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . | -2.58 | 1.28 | -1.93 | -7.96 | -4.27 | 22.04 | -9.65 | 0.07 | -5.16 | 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 | -1.66 | 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 | 4.83 | no significant change |
| 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 | 18.16 | significant increase |
| 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 | -2.71 | 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 | 2.72 | no significant change |
| 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 | 12.82 | significant increase |
| 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 | 4.76 | 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 | 7.45 | 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.
¶¶ Certain comparisons include data from two syndromic surveillance systems; some differences between the systems exist, such as the percent of missing discharge diagnosis codes.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual and Monthly Percent Changes† in Suspected All Drug Overdoses§, January 2018 to February 2020¶ by Sex and Age Group
| Yearly Percent Change | Monthly Percent Change | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 to Jan 2019 | Feb 2018 to Feb 2019 | Mar 2018 to Mar 2019 | Apr 2018 to Apr 2019 | May 2018 to May 2019 | Jun 2018 to Jun 2019 | Jul 2018 to Jul 2019 | Aug 2018 to Aug 2019 | Sep 2018 to Sep 2019 | Oct 2018 to Oct 2019 | Nov 2018 to Nov 2019 | Dec 2018 to Dec 2019 | Jan 2019 to Jan 2020 | Feb 2019 to Feb 2020 | Category, Feb 2019 to Feb 2020 | Jan 2018 to Feb 2018 | Feb 2018 to Mar 2018 | Mar 2018 to Apr 2018 | Apr 2018 to May 2018 | May 2018 to Jun 2018 | Jun 2018 to Jul 2018 | Jul 2018 to Aug 2018 | Aug 2018 to Sep 2018 | Sep 2018 to Oct 2018 | Oct 2018 to Nov 2018 | Nov 2018 to Dec 2018 | Dec 2018 to Jan 2019 | Jan 2019 to Feb 2019 | Feb 2019 to Mar 2019 | Mar 2019 to Apr 2019 | Apr 2019 to May 2019 | May 2019 to Jun 2019 | Jun 2019 to Jul 2019 | Jul 2019 to Aug 2019 | Aug 2019 to Sep 2019 | Sep 2019 to Oct 2019 | Oct 2019 to Nov 2019 | Nov 2019 to Dec 2019 | Dec 2019 to Jan 2020 | Jan 2020 to Feb 2020 | Category, Dec 2019 to Jan 2020 | ||
| Number of States | 33 | 34 | 36 | 36 | 36 | 36 | 37 | 37 | 37 | 38 | 37 | 37 | 37 | 38 | 35 | 35 | 36 | 36 | 36 | 36 | 37 | 37 | 37 | 36 | 37 | 37 | 37 | 38 | 39 | 39 | 40 | 40 | 42 | 42 | 42 | 42 | 42 | 42 | 42 | |||
| Sex | ||||||||||||||||||||||||||||||||||||||||||
| Male | 4.66 | 6.29 | -0.43 | 2.99 | 3.39 | 6.49 | 4.66 | 8.01 | 7.57 | 10.4 | 11.48 | 14.11 | 17.44 | 18.85 | significant increase | 3.9 | 8.89 | 0.31 | 4.69 | 2.64 | 0.9 | 1.99 | -5.02 | -2.44 | -0.83 | -7.42 | -2.57 | 5.08 | 1.88 | 4.04 | 5.21 | 5.66 | -0.64 | 5.16 | -5.28 | 0.09 | -0.2 | -5.44 | 0.39 | 7.45 | significant increase | |
| Female | 5.85 | 7.01 | -1.26 | 2.29 | 5.3 | 4.45 | 3.71 | 2.2 | 2.9 | 6.51 | 4.76 | 4.27 | 7.55 | 8.93 | significant increase | 2.01 | 7.23 | 2.24 | 2.24 | 2.95 | -0.16 | 2.54 | -3.64 | -2.59 | -0.25 | -7.64 | 1.31 | 2.97 | -0.6 | 5.96 | 5.12 | 2.21 | -1.25 | 1.2 | -3.16 | 0.94 | -2.44 | -7.83 | 4.48 | 4.5 | significant increase | |
| Age group | ||||||||||||||||||||||||||||||||||||||||||
| 0-14 | 17.05 | 22.39 | -4.11 | -3.29 | 4.94 | 12.05 | 2.45 | 10.18 | 9.43 | 7.79 | -6.46 | -1.86 | 0.82 | 7.94 | significant increase | -5.38 | 21.76 | 8.02 | -0.27 | -0.53 | 12.29 | -1.68 | -12.55 | 1.89 | 4.91 | -18.74 | 12.56 | -0.84 | -3.88 | 8.3 | 8.16 | 7.32 | 2.27 | 5.46 | -13.77 | 0.18 | -8.87 | -15.23 | 16.58 | 6.13 | significant increase | |
| 15-24 | 0.79 | 3.14 | -5.69 | -5.23 | 0.1 | 2.94 | -1.3 | -1.25 | -3.61 | 0.46 | 1.42 | 8.94 | 5.34 | 12.71 | significant increase | 0.12 | 6.95 | 2.02 | -1.07 | -4.4 | -0.78 | 4.26 | 1.49 | -0.91 | 2.24 | -9.66 | 2.21 | 1.71 | -2.38 | 3.2 | 4.36 | -1.73 | -4.99 | 3.96 | -0.72 | 3.76 | 2.68 | -3.54 | -0.86 | 9.33 | significant increase | |
| 25-34 | -0.99 | 0.67 | -2.52 | 0.83 | -0.6 | 3.28 | 0.81 | 2.6 | 3.06 | 9.96 | 10.05 | 6.66 | 11.49 | 10.25 | significant increase | 6.02 | 4.55 | -1.13 | 5.55 | 1.66 | -0.32 | 1.29 | -3.87 | -4.56 | -0.46 | -3.3 | -6.33 | 7.64 | 1.6 | 2.64 | 3.83 | 5.93 | -3 | 3.23 | -3.48 | 1.48 | -0.38 | -6.24 | -2.21 | 7.11 | significant increase | |
| 35-54 | 4.77 | 4.69 | 2.74 | 8.49 | 8.35 | 7.33 | 6.8 | 9.75 | 9.79 | 10.34 | 13.29 | 14.01 | 20.47 | 18.28 | significant increase | 7.11 | 5.58 | -0.77 | 5.08 | 4.26 | -1.82 | 2.63 | -3.6 | -0.53 | -1.92 | -4.74 | -6.27 | 7.23 | 3.49 | 4.81 | 5.33 | 2.96 | -2.2 | 5.59 | -3.54 | 0.01 | 0.1 | -4.26 | -0.78 | 6.15 | significant increase | |
| 55 and up | 10.53 | 12.44 | 7.15 | 12.03 | 11.75 | 12.03 | 14.19 | 10.26 | 12.19 | 15.65 | 18.38 | 15.47 | 18.08 | 18.16 | significant increase | 2.93 | 4.94 | 0.25 | 5.46 | 2.29 | -0.52 | 4.74 | -4.39 | -2.16 | 0.35 | -4.53 | 0.79 | 3.94 | 0.25 | 4.95 | 5.02 | 2.46 | 1.57 | 1.08 | -2.63 | 0.86 | 1.55 | -6.21 | 3.01 | 4.8 | 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.
