Overdose Death Maps

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.

Overdose Deaths Involving Prescription Opioids

46 people die every day from overdoses involving prescription opioids.1  In 2017, prescription opioids continue to contribute to the epidemic in the U.S. – they were involved in more than 35% of all opioid overdose deaths.

The most common drugs involved in prescription opioid overdose deaths include:

  • Methadone
  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)2

For people who died from prescription opioid overdose in 2017:

  • Overdose rates from prescription opioids significantly increased among people more than 65 years of age.
  • Overdose rates from prescription opioids were higher among non-Hispanic whites and American Indian or Alaskan Natives, compared to non-Hispanic blacks and Hispanics.
  • The rate of overdose deaths from prescription opioids among men was 6.1 per 100,000 people and the rate among women was 4.2 in 2017.

The highest overdose death rates from prescription opioids were in West Virginia, Maryland, Kentucky, and Utah.1

2016-2017 Overdose Map

Statistically significant changes in drug overdose death* rates involving prescription opioids§ by select states,¶ United States, 2016 to 2017.** Note: Rate comparisons between states should not be made due to variations in reporting across states.

*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).

**Absolute rate change is the difference between 2016 and 2017 rates. Percent change is the absolute rate change divided by the 2016 rate, multiplied by 100. Statistically significant at p<0.05 level. Nonoverlapping confidence intervals based on the gamma method were used if the number of deaths was <100 in 2016 or 2017, and z-tests were used if the number of deaths was ≥100 in both 2016 and 2017. Note that the method of comparing confidence intervals is a conservative method for statistical significance; caution should be observed when interpreting a nonsignificant difference when the lower and upper limits being compared overlap only slightly.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality. CDC WONDER, Atlanta, GA: US Department of Health and Human Services, CDC; 2018. https://wonder.cdc.gov/.

2015-2016 Overdose Map

References

  1. Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017. Morb Mortal Wkly Rep. ePub: 21 December 2018
  2. Hedegaard H, Bastian BA, Trinidad JP, Spencer M, Warner M. Drugs most frequently involved in drug overdose deaths: United States, 2011–2016. National Vital Statistics Reports; vol 67 no 9. Hyattsville, MD: National Center for Health Statistics. 2018.
CDC Guideline for Prescribing Opioids for Chronic Pain