Overdose Death Maps

In 2018, an average of 41 people died each day from overdoses involving prescription opioids, totaling nearly 15,000 deaths.1  While prescription opioids were involved in 32% of all opioid overdose deaths in 2018, there was a 13.5% decrease in prescription opioid-involved death rates from 2017 to 2018.

  • Rates decreased in males and females, persons aged 15–64 years, non-Hispanic whites, Hispanics, non-Hispanic American Indian/Alaska Natives, and across all urbanization levels.
  • Rates remained stable in the Northeast and decreased in the Midwest, South, and the West.
  • Seventeen states experienced declines in prescription opioid-involved death rates, with no states experiencing significant increases.
  • The largest relative decrease occurred in Ohio (–40.5%), whereas, the largest absolute decrease occurred in West Virginia (–4.1 per 100,000) which also had the highest rate in 2018 (13.1 per 100,000).
Calculating Prescription Opioid Overdose Deaths

When looking at overdose deaths from prescription opioids, CDC analyzes the following:

  • Natural opioids: Pain medications like morphine and codeine
  • Semi-synthetic opioids: Pain medications like oxycodone, hydrocodone, hydromorphone, and oxymorphone
  • Methadone: A synthetic opioid used to treat pain, but it can also be provided through opioid treatment programs to treat opioid use disorders

Current information reported about overdose deaths does not distinguish pharmaceutical fentanyl from illegally-made fentanyl. In order to account for increases in illicitly manufactured fentanyl, CDC Injury Center separates synthetic opioids (other than methadone) from prescription opioid death calculations.

2017-2018 Overdose Map

* Drug overdose deaths, as defined, that have natural and semi-synthetic opioids (T40.2) or methadone (T40.3) as a contributing cause.

* Categories of deaths are not exclusive as deaths might involve more than one drug category. Summing of categories will result in more than the total number of deaths in a year.

* Analyses were limited to states meeting the following criteria: For states with very good to excellent reporting, ≥90% of drug overdose deaths mention at least one specific drug in 2017, with the change in drug overdose deaths mentioning of at least one specific drug differing by <10 percentage points between 2017 and 2018. States with good reporting had 80% to <90% of drug overdose deaths mention at least one specific drug in 2017, with the change in the percentage of drug overdose deaths mentioning at least one specific drug differing by <10 percentage points between 2017 and 2018. States included also were required to have stable rate estimates, i.e., based on ≥20 deaths, in at least two drug categories (i.e., opioids, prescription opioids, synthetic opioids other than methadone, and heroin).

* Statistically significant (P-value <0.05).

  • Rate comparisons between states should not be made due to variations in reporting across states.

2016-2017 Overdose Map

  • Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14.
  • Rates shown are for the number of deaths per 100,000 population. Age-adjusted death rates were calculated using the direct method and the 2000 standard population.
  • Drug overdose deaths, as defined, that have natural and semi-synthetic opioids (T40.2) and methadone (T40.3) as contributing causes.
  • Analyses were limited to states meeting the following criteria: For states with very good to excellent reporting, ≥90% of drug overdose deaths mention at least one specific drug in 2016, with the change in drug overdose deaths mentions of at least one specific drug differing by no more than 10 percentage points (pp) between 2016 and 2017. States with good reporting had 80% – ‹90% of drug overdose deaths mention of at least one specific drug in 2016, with the change in the percentage of drug overdose deaths mentioning at least one specific drug differing by no more than 10 percentage points between 2016 and 2017. States included also were required to have stable rate estimates, based on ≥20 deaths, in at least two drug categories (i.e., opioids, prescription opioids, synthetic opioids other than methadone, heroin).
  • Rate comparisons between states should not be made due to variations in reporting across states.

2015-2016 Overdose Map

References

  1. Wilson N, Kariisa M, Seth P, et al. Drug and Opioid-Involved Overdose Deaths—United States, 2017-2018. MMWR Morb Mortal Wkly Rep 2020;69:290-297.
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