Nonfatal Overdoses: All Opioids

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 all opioid overdoses per 10,000 ED visits. These suspected all opioid 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 opioid 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.

map of US suspected opioid overdoses February 2019 to February 2020

CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual Trends in Emergency Department Visits for Suspected All Opioid Overdose§, January 2018 to February 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 Opioid 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 6.29 9.74 2.92 7.85 6.69 7.46 12.3 13.74 14.77 16.48 19.53 21.06 27.21 26.55 significant increase
State
Alabama 18.7 -0.19 6.26 8.23 -0.73 -0.18 7.59 -5.98 -11.84 -9.32 -16.78 -26.38 -11.7 -5.4 no significant change
Alaska 4.28 55.52 28.03 10.76 4.95 13.49 39.4 5.22 -17.57 6.27 -21.75 27.63 32.45 9.77 no significant change
Arizona -4.99 26.98 20.34 8.12 0.21 -10.41 6.08 -9.84 -7.69 -9.31 -16.08 -11.52 4.36 -19.49 significant decrease
Arkansas -3.8 -6.82 -25.74 -8.1 -39.43 -27.8 12.01 -5.69 0.75 -10.31 -5.94 -8.83 37.3 -6.19 no significant change
California** . . . . . . . . . . . . . .
Colorado -20.47 21.43 11.33 56.84 17.15 21.68 13.53 9.62 -0.68 18.48 16.82 33.27 19.44 13.37 no significant change
Connecticut†† . . . . . . 4.2 22.76 11.74 15.16 16.43 41.4 27.75 27.73 significant increase
Delaware†† . . . . . . . . . -17.42 13.49 18.6 18.74 45.22 significant increase
District of Columbia ¶¶ -9.01 -32.86 8.69 -24.89 -24.24 18.35 -15.54 34.23 52.31 24.69 45.43 26.24 37.1 94.21 significant increase
Florida 21.39 27.96 34.48 29.77 24.51 33.65 36.6 47.77 72.25 77.92 57.49 47.47 50.08 46.5 significant increase
Georgia 5.3 -1.6 -8.07 4.2 12.21 18.27 11.44 15.81 14.35 16.87 -5.4 -12.02 7.94 35.16 significant increase
Hawaii** . . . . . . . . . . . . . .
Idaho†† . . . . . . . . . . . . . .
Illinois 17.88 7.64 -2.53 22.73 17.39 18.16 40.01 19.03 18.55 0.26 15.55 12.38 43.91 48.57 significant increase
Indiana -13.25 -11.8 -10.27 -10.66 4.46 -3.81 14.18 16.55 9.27 5.72 14.71 39.17 59.32 65.77 significant increase
Iowa** . . . . . . . . . . . . . .
Kansas 48.08 17 15.61 16.13 7.06 12.03 21.66 6.17 12.74 3.39 24.74 28.97 4.63 39.26 significant increase
Kentucky†† -11.78 -17.54 3.77 24.81 12.15 3.7 3.01 -2.02 6.67 3.73 21.89 30.64 17.39 16 significant increase
Louisiana 13.01 14.02 -34.56 -15.3 2.17 -0.19 8.11 37.12 34 50.13 30.22 68.57 116.35 110.25 significant increase
Maine -31.97 -3.79 -30.38 -24.2 2.87 -7.67 34.81 -10.26 6.2 12.96 -3.83 3.39 46.73 10.47 no significant change
Maryland†† . 3.51 -6.41 6 20.31 7.97 34.22 23.3 12.57 -9.8 . . . -15.65 significant decrease
Massachusetts -0.93 3.89 -11.75 -16.07 -17.92 -8.26 -10.51 -0.39 15.04 7.1 17.81 37.08 27.66 25.87 significant increase
Michigan 7.41 56.67 51.55 60 28.02 41.42 27.89 29.05 42.53 49.06 63.05 27.36 33.31 6.18 no significant change
Minnesota** . . . . . . . . . . . . . .
Mississippi†† . . . . . . . . . . . . . .
Missouri 87.41 66.84 -30.86 3.02 -3.99 -3.97 21.4 20.21 57.86 4.84 -3.16 -27.59 -36.76 -2.68 no significant change
Montana 4.46 2.82 36.87 -28.35 72.62 -22.43 -0.76 -46.65 58.86 32.18 -1.07 -0.78 0.36 no significant change
Nebraska** . . . . . . . . . . . . . .
Nevada -18.56 -16.12 10.46 0.11 -29.14 -17.94 -3.72 -5.03 8.5 -4.51 -1.02 -2.88 10.39 18.56 no significant change
New Hampshire -15.64 -10.43 -15.04 -16.36 22.54 -16.43 -33.98 -38.69 -24.61 -30.7 -32.15 -15.14 -25.26 -25.41 significant decrease
New Jersey 9.19 18.76 -3.54 -3.4 -12.19 -5.25 28.58 25.12 1.84 23.3 14.97 25.56 23.56 27.61 significant increase
New Mexico 1.09 16.61 4.85 -5.89 27.92 -12.41 0.55 17.47 31.5 33.55 6.31 1.37 -3.36 6.5 no significant change
New York State -28.82 -15.05 -5.36 -16.83 -11.19 0.51 3.97 27.32 49.52 45.58 67 165.07 157.25 105.86 significant increase
North Carolina -8.97 -1.54 0.38 -2.85 3.86 1.97 4.97 -4.3 -18.79 -14.24 4.53 8.61 7.99 1.2 no significant change
North Dakota§§ . . . . . . . . . . . . . .
Ohio -0.8 -2.45 -9.66 5.53 -3.1 9.72 -5.83 -10.84 -5.89 4 -1.54 -10.41 1.25 -4.17 no significant change
Oklahoma** . . . . . . . . . . . . . .
Oregon ¶¶ 23.11 -9.61 -10.32 -14.03 -8.08 -3.66 -12.97 -2.16 -27.65 -2.23 4.33 -8.12 5.44 7.56 no significant change
Pennsylvania -5.31 6.25 -1.25 0.78 -8.63 -8.58 -15.81 -0.68 -18.78 10.67 7.85 11.25 20.54 40.9 significant increase
Puerto Rico** . . . . . . . . . . . . . .
Rhode Island†† . . -5.61 19.46 20.53 -5.77 14.94 49.44 -8.72 -10.55 15.89 27.41 -22.24 6.14 no significant change
South Carolina†† . . . . . . . . . . . . . .
South Dakota
Tennessee 32.62 30.45 5.33 20.97 38.27 12.24 21.12 5.01 29.08 24.01 11.93 -2.76 -3.33 3.27 no significant change
Texas§§ . . . . . . . . . . . . . .
Utah 3.79 -1.8 31.19 23.37 22.31 -12.49 4.19 -2.4 11.4 -2.85 -23.99 -16.52 -33.35 23.55 significant increase
Vermont -25.71 26.96 -25.49 -5.22 -53.29 -53.95 -38.28 -16.54 -25.54 -4.7 5.48 102.21 7.84 2.48 no significant change
Virginia 6.48 -7.13 -12.21 -4.57 10.11 24.54 -1.1 14.43 11.06 25.65 10.53 0.78 34.02 52.14 significant increase
Washington 23.44 12.61 5.37 -1.91 8.79 20.56 26.91 19.77 23.35 37.86 -0.78 11.2 15.8 33.65 significant increase
West Virginia†† . . . . . . . . . . 76.95 45.45 33.05 40.44 significant increase
Wisconsin†† . . 13.09 41.45 11.11 24.2 89.75 83.93 63.26 25.7 . . . .
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 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 Opioid Overdose§, January 2018 to February 2020, by OD2A-funded Jurisdiction

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Monthly Percent Change
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 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 3.89 9.26 0.39 7.19 6.59 -4.05 3.89 -7.39 -1.26 -1.69 -6.14 -3.9 6.41 2.95 5.32 6.57 6.93 0.35 5.35 -6.62 0.68 -1.07 -4.95 1.52 7.77 significant increase
State                                                
Alabama 10.17 1.79 -8.6 3.32 3.05 -3.98 0.18 4.74 4.87 3.78 -0.54 -0.27 -7.36 8.36 -6.91 -5.24 3.62 3.5 -12.45 -1.79 7.86 -4.76 -12.02 19.62 -0.74 no significant change
Alaska 1.98 30.42 12.9 6.38 -18.55 12.31 13.96 -6.6 31.16 -17.97 -40.67 5.04 52.08 7.37 -2.33 0.79 -11.92 37.94 -13.99 -26.83 69.1 -39.6 -3.23 9.01 26.05 no significant change
Arizona 6.96 3.92 5.57 2.11 17.71 -0.4 0.82 -7.57 5.56 -13.16 2.53 -22.78 42.95 -1.52 -5.15 -5.36 5.23 17.94 -14.3 -5.36 3.7 -19.64 8.1 -8.93 10.29 no significant change
Arkansas 10.02 36.58 -23.82 17.88 -8.3 -13.93 23.13 -5.7 -1.34 -0.17 -5.74 -16.21 6.56 8.84 -5.72 -22.3 9.29 33.54 3.68 0.74 -12.17 4.7 -8.64 26.18 -27.19 no significant change
California** . . . . . . . . . . . . . . . . . . . . . . . . .
Colorado -22.91 10.6 -9.02 1.85 14.1 -1.5 4.94 8.85 -6.18 3.57 -14.24 -5.92 17.71 1.39 28.18 -23.92 18.51 -8.09 1.33 -1.38 11.92 2.12 -2.16 -15.68 11.72 no significant change
Connecticut†† . . . . . . 0.28 -5.29 4.31 -7.03 -26.43 7.27 5.52 -4.93 15.44 11.67 10.4 0.41 18.13 -13.78 7.5 -6.01 -10.65 -3.09 5.5 no significant change
Delaware†† . . . . . . . . . -26.08 3.99 -16.78 -19.33 56.57 -2.97 18.63 5.12 -5.43 19.99 -13.13 -14.3 1.58 8.67 -16.68 -1.34 no significant change
District of Columbia ¶¶ 2.2 -26.51 36.87 15.06 -21.55 20.28 -0.73 -15.96 25.24 -10.49 -35.47 35.08 -24.59 18.97 -5.41 16.05 22.56 -14.16 57.78 -4.65 2.53 4.39 -43.99 46.71 6.82 no significant change
Florida -6.98 -1.85 8.56 16.88 1.99 -3.58 1.39 -12.43 -0.31 15.86 -1.22 5.2 -1.95 3.15 4.76 12.13 9.48 -1.45 9.67 2.08 2.97 2.55 -7.51 7.06 -4.29 no significant change
Georgia -9.65 12.97 6.33 -13.47 17.01 -2.76 -17.01 5.42 1.77 24.3 -4.24 -7.01 -15.58 5.55 20.53 -6.82 23.33 -8.37 -13.75 4.09 4.01 0.61 -10.95 14.09 5.71 no significant change
Hawaii** . . . . . . . . . . . . . . . . . . . . . . . . .
Idaho†† . . . . . . . . . . . . . . . . . . -25.35 1.43 18.28 -24.67 -4.67 29.48 0.1 no significant change
Illinois 18.27 5.84 -10.06 14.96 0.48 -8.14 20.19 -6.1 16.81 -15.89 2.68 -13.34 7.99 -4.15 13.24 9.95 1.14 8.84 2.18 -6.48 -1.21 -3.06 -0.14 10.97 11.49 significant increase
Indiana 10.26 5.99 -4.54 3.33 12.3 -11.23 -0.52 6.75 4.11 -13.54 -19.15 -2.32 12.11 7.83 -4.96 20.81 3.41 5.38 1.53 0.09 0.73 -6.19 -1.91 11.82 16.65 significant increase
Iowa** . . . . . . . . . . . . . . . . . . . . . . . . .
Kansas 10.99 15.43 -8.94 11.08 -1.32 -1.41 17.78 -5.9 -9.4 -5.84 -8.57 35.88 -12.31 14.06 -8.53 2.4 3.25 7.07 2.79 -0.08 -16.92 13.61 -5.47 10.24 16.71 no significant change
Kentucky†† 18.89 -8.55 -12.77 20.49 3.88 1.2 6.72 -18.5 -1.9 -12.73 0.59 -1.96 11.13 15.08 4.92 8.26 -3.95 0.53 1.51 -11.27 -4.61 2.55 7.81 -11.9 9.82 no significant change
Louisiana 6.58 71.57 -7.45 -20.46 15.28 -0.42 5.63 -7.3 -5.81 9.92 -9.18 -20.55 7.53 -1.54 19.8 -4.06 12.62 7.86 33.97 -9.41 5.52 -4.66 17.56 1.97 4.5 no significant change
Maine -0.85 27.36 -8.55 -8.84 15.01 -5.31 -18.69 2.55 -6.24 17.75 -1.69 -34.44 40.22 -7.84 -0.43 23.73 3.21 -33.14 11.94 21.37 -0.27 0.25 5.69 -6.96 5.57 no significant change
Maryland†† 11.26 12.51 -3.98 -8.89 12.29 -10.77 0.96 -10.44 9.98 . . . . 1.73 8.76 3.41 0.77 10.92 -7.25 -18.23 -11.88 -2.48 -6.55 7.12 1.1 no significant change
Massachusetts 9.44 14.15 4.27 6 1.83 -6.05 -0.97 -18.29 4.05 4.22 -5.34 -9.71 14.77 -3.05 -0.83 3.66 13.82 -8.35 10.23 -5.63 -3.13 14.64 10.14 -15.92 13.17 significant increase
Michigan -0.68 2.85 -0.31 23.13 -2.6 -0.37 0.34 -2.65 -3.35 -6.8 3.25 -2.83 44.87 -0.52 5.24 -1.48 7.6 -9.91 1.26 7.52 1.08 1.95 -19.35 1.7 15.39 significant increase
Minnesota** . . . . . . . . . . . . . . . . . . . . . . . . .
Mississippi†† . . . . . . . . . . . . . . . . . . -15.42 13.96 0.1 8.09 -23.4 46.03 39.51 significant increase
Missouri -13.62 103.81 -46.78 47.91 3.66 -10.8 32.79 -43.82 51.78 4.44 19.9 3.12 -23.1 -15.55 -20.7 37.84 3.69 12.77 31.5 -26.22 0.8 -3.53 -10.34 -9.94 18.35 no significant change
Montana 5.15 -22 36.91 -29.91 35.86 1.71 13.35 -24.32 1.37 22.1 -17.61 9.79 3.5 3.83 -28.33 68.87 -38.95 30.13 -39.07 125.36 -15.65 -8.61 -17.37 11.05 no significant change
Nebraska** . . . . . . . . . . . . . . . . . . . . . . . . .
Nevada 2.95 -13.97 9.66 19.11 0.65 -5.2 -6.9 -18.55 14.96 -9.4 -0.29 -6.32 6.03 13.3 -0.62 -15.69 16.56 11.23 -8.17 -6.95 1.19 -6.09 -2.17 6.49 13.88 no significant change
New Hampshire 1.37 14.99 -4.24 -9.2 7.63 -7.33 9.25 -11.24 13.61 7.27 -28.15 -1.71 7.64 9.06 -5.73 33.04 -26.6 -26.79 1.45 9.13 4.44 5.03 -10.14 -13.43 7.42 no significant change
New Jersey -1.8 26.66 1.91 15.82 1.62 -11.83 21.42 -2.39 -9.68 0.35 -18.82 -4.81 6.81 2.87 2.05 5.28 9.65 19.66 18.16 -20.55 9.36 -6.43 -11.34 -6.33 10.31 no significant change
New Mexico -9.79 35.59 1.97 -1.31 13.16 -15.43 1.11 -5.47 -22.17 13.91 -7.96 10.06 4.05 21.92 -8.48 34.15 -22.51 -2.92 18.11 5.82 -20.96 -9.33 -12.23 4.91 14.67 no significant change
New York State -4.19 22.19 15.43 0.94 12.2 6.91 0.49 -19.72 -1.55 -6.07 -42.38 1.2 54.86 0.51 1.44 7.78 26.98 10.59 23.05 -5.72 -4.14 7.75 -8.54 -1.79 23.93 significant increase
North Carolina 2.07 5.22 0.98 2.76 10.47 -12.19 9.09 12.37 -13.32 -11.78 -5.57 -4.87 10.4 7.27 -2.26 9.85 8.47 -9.62 -0.54 -4.65 -8.46 7.54 -1.89 -5.41 3.46 no significant change
North Dakota§§ . . . . . . . . . . . . . . . . . . . . . . . . .
Ohio 9.62 7.24 -4.65 13.88 1.86 15.16 3.75 -16.44 -7.33 -5.87 0.96 -13.23 7.81 -0.69 11.38 4.58 15.33 -1.16 -1.77 -11.8 2.41 -10.88 -8.14 -1.94 2.03 no significant change
Oklahoma** . . . . . . . . . . . . . . . . . . . . . . . . .
Oregon ¶¶ 26.42 -6.43 20.15 -4.39 -1.46 4.79 -10.19 20.82 -28.47 5.27 0.37 6.97 -7.17 -7.17 15.18 2.23 3.28 -5.34 0.97 -10.65 -3.35 12.34 -11.61 22.76 -5.31 no significant change
Pennsylvania -9.42 23.1 8.54 2.51 15.63 0.43 4.32 3.76 -23.23 -2.32 -14.34 -5.48 1.64 14.42 10.77 -7.07 15.7 -7.51 23.06 -15.15 4.61 -4.81 -11.64 2.41 18.81 significant increase
Puerto Rico** . . . . . . . . . . . . . . . . . . . . . . . . .
Rhode Island†† . . -5.3 11.72 15.13 -25.17 18.42 23.24 3.72 -15.67 -19.77 35.11 -27.28 2.9 19.86 12.72 -9.99 -8.72 53.97 -24.73 1.65 9.26 -11.8 -17.54 -0.74 no significant change
South Carolina†† . . . . . . . . . . . . . . . . -5.06 0.16 9.41 -19.35 7.15 8.97 1.62 3.02 -17.52 significant decrease
South Dakota
Tennessee -4.78 18.27 -7.47 -8.31 33.06 -7.47 -2.67 -16.62 12.29 10.7 -2.32 14.42 -6.34 -4.5 6.26 4.81 8.01 -0.16 -15.62 2.49 7.88 -0.09 -15.13 13.74 0.06 no significant change
Texas§§ . . . . . . . . . . . . . . . . . . . . . . . . .
Utah -8.22 -5.62 -0.97 6.99 23.6 -9.36 -2.01 -8.64 2.73 12.24 -3.36 1.2 -13.17 26.1 -6.88 6.06 -11.56 7.92 -8.21 4.29 -10.41 -12.18 6.12 -19.2 60.96 significant increase
Vermont -19.29 39.12 -27.19 77.48 2.75 -13.66 -13.13 12.53 -24.43 1.49 -38.5 25.16 37.93 -18.36 -7.37 -12.54 1.28 15.73 17.48 0.4 -3.29 12.33 17.9 -33.25 31.07 no significant change
Virginia 17.68 8.18 9.25 17.92 -12.29 3.12 13.48 -9.56 -10.76 4.69 -11.26 -15.65 2.64 2.27 18.75 36.06 -0.8 -18.11 31.31 -12.22 0.97 -7.91 -19.08 12.17 16.52 significant increase
Washington 10.77 5.03 6.37 6.6 -3.93 -6.08 9.03 -7.22 -1.52 20.42 -3.4 -10.5 1.04 -1.72 -0.98 18.23 6.46 -1.13 2.9 -4.45 10.06 -13.33 8.26 -6.8 16.62 significant increase
West Virginia†† . . . . . . . . . . -1.8 8.16 5.69 24.72 6.57 18.9 -15.66 -9.36 24.69 -5.07 2.72 7.31 -19.28 -1.06 11.56 no significant change
Wisconsin†† 14.86 4.56 1.4 32.14 -4.31 -28.65 3.57 -2.23 15.33 . . . . . 26.83 3.8 6.96 9 0.39 -13.21 -11.21 13.48 -1 5.98 9.78 no significant change
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 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 Opioid Overdoses§, January 2018 to February 2020¶ by Sex and Age

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CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual and Monthly Percent Changes† in Suspected All Opioid Overdoses§, January 2018 to February 2020¶ by Sex and Age
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, Jan 2020 to Feb 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 4.23 9.89 3.26 7.66 3.85 7 12.78 15.64 14.47 15.93 21.93 23.61 31.31 29.76 significant increase 3.29 9.53 0.95 7.97 4.86 -4.51 4.48 -6.45 -1.97 -1.89 -6.14 -5.64 8.47 2.68 5.71 4.75 7.7 1.18 7.11 -7.58 0.04 1 -5.15 0.86 9.59 significant increase
Female 9.46 9.05 2.04 7.03 11.3 7.35 10.94 9.44 14.39 16.91 14.66 16.23 19.94 19.98 significant increase 4.8 8.48 -0.25 4.67 9.51 -3.49 3.13 -8.89 0.07 -0.91 -6.48 -0.09 2.88 3.18 4.16 9.2 5.09 -1.02 2.16 -4.69 2.23 -4.32 -4.66 3.42 3.97 significant increase
Age group
0-14 35.1 56.71 12.84 -9.4 8.45 16.62 -14.15 9.77 -4.25 -0.86 -2.48 7.57 -2.1 4.64 no significant change -9.87 10.35 45.77 -11.88 5.14 15.8 -5.31 -7 5.92 -14.35 -17.14 22.65 7.17 -18.78 9.93 5.3 16.51 -16.9 18.18 -16.01 10.85 -15.93 -5.93 6.28 18.22 no significant change
15-24 -8.51 4.14 -12.26 -10.98 -9.61 -2.65 -3.27 4.05 -2.91 9.62 13.88 23.92 17.81 15.62 significant increase -2.95 13.68 -3.47 8.18 4.46 -7.59 -1.3 -2.26 -6.48 0 -6.55 -3.27 10.01 -3.1 -1.65 9.97 12.33 -7.69 6.33 -8.98 5.79 3.46 -0.11 -5.23 6.81 no significant change
25-34 0.53 3.06 2.92 7.62 -1.46 3.5 6.68 5.98 12.15 15.56 17.94 15.77 19.23 17.02 significant increase 7.83 4.63 -1.95 8.96 1.89 -3.81 4.32 -7.96 -0.77 -1.15 -3.2 -7.44 10.1 5 2.69 0.16 6.75 -0.82 4.05 -3 2.13 -0.59 -4.32 -4.74 9.68 significant increase
35-54 8.34 6.04 6.41 12.22 18.27 12.9 17.54 20.98 21.92 19.49 24.41 27.68 38.74 36.21 significant increase 10.66 4.69 -0.52 3.34 8.96 -6.42 6.35 -5.51 1.86 -0.71 -5.37 -8.49 7.55 5.72 5.27 9.61 3.16 -2.65 10.18 -4.87 0.53 0.78 -3.03 0.24 7.95 significant increase
55 and up 10.02 18.76 10.94 17.29 12 15.39 23.37 20.3 18.87 20.07 26.47 24.43 32.77 32 significant increase -0.89 6.72 1.32 10.22 -1.17 -2.93 6.38 -3.39 -0.46 0.03 -4.94 -0.71 5.53 -0.62 6.93 5.85 1.65 4.22 2.95 -4.31 1.27 2.44 -6.22 6.03 8.01 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.

Access the latest data. Learn what can be done about overdoseand related harms. CDC VitalSigns