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. See below for important data limitations.

The map below provides monthly percent change estimates in rates of all drug overdoses per 10,000 ED visits for the most recent month of data. The “Data Table” below provides the specific data for the map. The “Monthly Percent Change by Sex and Age Group” section provides monthly percent change estimates for the most recent month of data overall and by sex and age group. Downloadable CSV files contain annual and monthly percent change estimates overall, by state, and by sex and age group, when available, from January 2018 to most recent month.

Trends in Emergency Department Visits - Suspected All Opioid Overdose - Overdose Data2Action

All opioids: CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Monthly Percent Change† in Suspected All Opioid Overdoses§, May 2021 to June 2021 by Sex and Age Group

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Monthly Percent Change by Sex
Sex May 2021 to June 2021
(N=38 states)
May 2021 to June 2021
Overall 0.36 no significant change
Male 0.9 no significant change
Female -0.77 no significant change


Monthly Percent Change by Age
Age group May 2021 to June 2021
(N=38 states)
May 2021 to June 2021
Overall 0.36 no significant change
0-14 1.71 no significant change
15-24 -9.45 significant decrease
25-34 -0.88 no significant change
35-54 1.85 no significant change
55 and up 0.67 no significant change


* See DOSE System page.

† To account for changes occurring across time, monthly and 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 sex and age group. Annual change, controlling for seasonal effects, was estimated as the change from a month in a previous year to the same month in a future 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. 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.

Data Limitations

 Important caveats to consider when interpreting the data include:

  1. Some data may be missing. Data sent from EDs to health departments may be delayed or may stop for a period of time. When EDs begin sharing data again, information about visits during the lapse may never be shared.
  2. Reporting facilities and the data they report can change. Several states continue efforts to onboard new facilities that can begin to share data in syndromic surveillance systems, and some facilities experience periodic interruptions or a cessation of syndromic surveillance data feeds. Some of these issues became more pronounced during the earlier phase of the COVID-19 pandemic. Syndromic data also can be updated with new information over time, for example, with additional diagnosis codes. Therefore, numbers and rates reported could change over time as more facilities began sharing data or sharing higher quality data as well as facilities that may stop sharing data for a period of time. Some EDs also had increases in the proportion of ED visits in syndromic data that contain diagnosis codes, which facilitate the identification of overdose-related visits.
  3. Data are updated over time. The chief complaint, or the reason for the ED visit, is available in syndromic surveillance systems within 48 hours for ~70% of ED visits. However, the chief complaint field may be incomplete. ED visit data may be updated over the course of several weeks, and relevant overdose discharge diagnosis codes or revised chief complaint text may be received during this time. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified.
  4. These are suspected overdoses. Because these data are not determined by toxicological testing, they are not considered confirmed cases, but “suspected” overdoses.
  5. Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.
  6. Overdose visit numbers are not mutually exclusive but rather reflect nesting of drug categories: numbers of suspected opioid-, heroin-, and stimulant-involved overdose visits are included in the numbers of suspected all drug overdose visits; suspected heroin-involved overdose visits are included in the numbers of suspected opioid-involved overdose visits; and some overdose visits involved multiple substances (e.g., a given overdose ED visit could have involved both opioids and stimulants).
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