This report analyzes the impact and demographic variation of drug overdose deaths involving cocaine and psychostimulants, showing death rates have increased across age groups, racial/ethnic groups, county urbanization levels, census regions, and multiple states. Death rates involving cocaine and psychostimulants with and without opioids have increased. Synthetic opioids appear to be the primary driver of cocaine-involved death rate increases, and recent data point to increasing synthetic opioid involvement in psychostimulant-involved deaths. Increases in deaths involving cocaine and psychostimulants with and without opioids in recent years illustrates the growing complexity of America’s current overdose crisis.
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- CDC Vital Signs
- Related Reports
- MMWR Articles
- Guides and Meeting Reports
- PBSS Data Briefs
- Schieber L, Guy G, Seth P, Young R, Mattson C, Mikosz C, Schieber R. Trends and Patterns of Geographic Variation in Opioid Prescribing Practices by States, United States, 2006-2017. JAMA Network Open. 2019;2(3):e190665. Doi:10.1001/jamanetworkopen.2019.0665
- Guy G, Zhang K, Schieber L, Young R, Dowell D. County-level Opioid Prescribing in the United States, 2015 and 2017. JAMA Internal Med. Published online February 11, 2019; doi:10.1001/jamainternmed.2018.6989
- Bohnert A, Guy G, Losby J. Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention’s 2016 Opioid Guidance. Ann Intern Med. 2018; 169(6):367-375. doi: 10.7326/M18-1243
- Lin DH, Jones CM, Compton WM, et. al. Prescription Drug Coverage for Treatment of Low Back Pain Among US Medicaid, Medicare Advantage, and Commercial Insurers. JAMA Network Open. 2018; 1(2), e180235. doi:10.1001/jamanetworkopen.2018.0235
- Johnson K, Jones C, Wilson C, et al. Federal Response to the Opioid Crisis. Current HIV/AIDS Report. 2018; 15:293–301. doi: 10.1007/s11904-018-0398-8
- Seth P, Rudd R, Noonan, R, Haegerich, T. Quantifying the Epidemic of Prescription Opioid Overdose Deaths. AJPH, 2018; 108(4),e1-e3. doi: 10.2105/AJPH.2017.304265
- Houry DE, Haegerich TM, Vivolo-Kantor A. Opportunities for Prevention and Intervention of Opioid Overdose in the Emergency Department. Ann Emerg Med. 2018; 108 (4) 500-502. doi: 10.1016/j.annemergmed.2018.01.052.
- Mercado MC, Sumner SA, Spelke MB, Bohm MK, Sugerman DE, Stanley C. Increase in Drug Overdose Deaths Involving Fentanyl—Rhode Island, January 2012–March 2014. Pain Med. 2018; 19(3):511-523. doi: 10.1093/pm/pnx015.
- Guy G, Pasalic E, Zhang K. Emergency department visits involving opioid overdoses – United States, 2010-2014. AJPM. 2017; 54 (1) 37-39. doi: j.amepre.2017.09.003
- Dowell D, Noonan RK, Houry D. Underlying factors in drug overdose deaths. JAMA. 2017;318(23):2295-2296. doi:10.1001/jama.2017.15971
- Dowell D, Arias E, Kochanek K, Anderson R, Guy GP, Losby J, Baldwin G. Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000-2015. JAMA. 2017;3 18(11):1065-1067. doi10.1001/jama.2017.9308
- Dowell D, Haegerich TM. Changing the Conversation About Opioid Tapering. Ann Intern Med. 2017;167(3):208-209. doi: 10.7326/M17-1402.
- Losby JL, Hyatt JD, Kanter MH, Baldwin G, Matsuoka D. Safer and more appropriate opioid prescribing: a large healthcare system’s comprehensive approach. J Eval Clin Pract. 2017;1–7. doi: 10.1111/jep.12756.
- Schuchat A, Houry DE, Gery Jr GP. New data on opioid use and prescribing in the United States. JAMA 2017; 318(7):1-2. doi:10.1001/jama.2017.8913
- Baird J, Faul M, Green TC, Howland J, Adams CA, George A, Mello MJ. A retrospective review of unintentional opioid overdose risk and mitigating factors among acutely injured trauma patients. Drug and Alcohol Dependence. 2017; 178:130-135. doi: 10.1016/j.drugalcdep.2017.04.030.
- Faul M, Lurie P, Kinsman JM, Dailey MW, Crabaugh C, Sasser SM. Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing. Prehosp Emerge Care.2017; 21(4): 411-419. doi: 10.1080/10903127.2017.1315203.
- Jones CM, Baldwin GT, Compton WM. Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids. AJPH. 2017; 107( 3):430-432. doi: 10.2105/AJPH.2016.303627.
- Dowell D, Zhang K, Noonan RK, Hockenberry JM. Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates. Health Aff .2016; 35(10):1-9. doi: 10.1377/hlthaff.2016.0448
- Neven D, Paulozzi L, Howell D, McPherson S, Murphy SM, Grohs B, Marsh L, Lederhos C, Roll J. A Randomized Controlled Trial of a Citywide Emergency Department Care Coordination Program to Reduce Prescription Opioid Related Emergency Department Visits. J Emerg Med 51(5) 498-507. doi: 10.1016/j.jemermed.2016.06.057.
- Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care.2016; 54(10): 901-906. doi:10.1097/MLR.0000000000000625
- Easterling KW, Mack KA, Jones CM. Location of fatal prescription opioid-related deaths in 12 states, 2008-2010: Implications for prevention programs. J Safety Res. 2016; 58:105-109. doi: 10.1016/j. jsr.2016.07.004
- Kattan JA, Tuazon E, Paone D, Dowell D, Vo L, Starrels JL, Jones CM, Kunins HV. Public Health Detailing—A Successful Strategy to Promote Judicious Opioid Analgesic Prescribing. AJPH. 2016; 106(8), 1430-1438. doi: 10.2105/AJPH.2016.303274.
- Chang HY, Lyapustina T, Rutkow L, Daubresse M, Richey M, Faul M, Stuart EA, Alexander GC. Impact of prescription drug monitoring programs and pill mill laws on high-volume opioid prescribers: A comparative interrupted time series analysis. Drug Alcohol Depend. 2016; 165, 1-8. doi: 10.1016/j.drugalcdep.2016.04.033.
- Zhou, C, Florence, C, Dowell, D. Payments For Opioids Shifted Substantially To Public And Private Insurers While Consumer Spending Declined, 1999–2012. Health Aff. 2016; 35(5): 824-831. doi:10.1377/hlthaff.2015.1103.
- Sumner SA, Mercado-Crespo MC, Spelke MB, Paulozzi LJ, Sugerman DE, Hillis SD, Stanley C. Use of naloxone by emergency medical services during opioid drug overdose resuscitation efforts. Prehosp Emerg Care. 2016; 20(2):220-225. doi:10.3109/10903127.2015.1076096.
- Frieden TR, Houry D. Reducing the risks of relief — the CDC opioid-prescribing guideline. N Engl J Med. 2016. 374: 1501-1504. doi:10.1056/NEJMp1515917.
- Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016; JAMA, Special Communication. Published online March 15, 2016. doi: 1001/jama.2016.1464.
- Scott LC, Lewis S. Opioids for Chronic Pain. JAMA Patient Page.; 315(15), 1672. doi:10.1001/jama.2016.3224.
- Paulozzi LJ, Zhou C, Jones CM, Xu L, Florence CS. Changes in the medical management of patients on opioid analgesics following a diagnosis of substance abuse. Pharmacoepidemiol Drug Saf.2016; (5)545-52. doi:10.1002/pds.3980.
- Compton WM, Jones CM, Baldwin GT, Relationship between Nonmedical Prescription-Opioid Use and Heroin Use. NEJM. 2016; 374:154-163. doi:10.1056/NEJMra1508490.
- Lyapustina T, Rutkow L, Chang H, Daubresse M, Ramji AF, Faul M, Stuart EA, and Alexander GC. Effect of a “pill mill” law on opioid prescribing and utilization: The case of Texas. Drug Alcohol Depen. 2016; 159 (1) 109-197. doi:10.1016/j.drugalcdep.2015.12.025.
- Fulton-Kehoe D, Sullivan MD, Turner JA, Garg RK, Bauer AM, Wickizer TM, Franklin GM. Opioid Poisonings in Washington State Medicaid. Med Care. 2015; 53 (8), 679 doi:10.1097/MLR.0000000000000384.
- Jones C, Campopiano M, Baldwin G, McCance-Katz E. (2015). National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. 2015; 105, (8), 55-63. doi:10.2105/AJPH.2015.302664.
- Faul M, Dailey MW, Sugerman DE, Sasser SM, Levy B, Paulozzi LJ. (2015). Disparity in naloxone administration by emergency medical service providers and the burden of drug overdose in US rural communities. AJPH, 2015; 105 (3), 26-32. doi:10.2105/AJPH.2014.302520.
- Mack KA, Zhang K, Paulozzi L, Jones C. Prescription Practices involving Opioid Analgesics among Americans with Medicaid, 2010. J Health Care Poor Underserved. 2015;26(1):182-98. doi: 1353/hpu.2015.0009
- Haegerich TM, Paulozzi L, Manns B, Jones CJ. What we know and don’t know about state and system level policy strategies to prevent prescription drug overdose. Drug Alcohol Depen.2014; 145: 34-37. doi: 10.1016/j.drugalcdep.2014.10.001.
- Jones C, Paulozzi L, Mack K. Sources of prescription opioid pain relievers by frequency of past-year nonmedical use: United States, 2008–2011. JAMA Int Med. 2014; 174(5):802-803. doi:1001/jamainternmed.2013.12809
- Baumblatt JA, Wiedeman C, Dunn J, Schaffner W, Paulozzi L, Jones T. High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Int Med. 2014; 174 (5):796-801. doi:10.1001/jamainternmed.2013.12711
- Paulozzi L, Zhang K, Jones C, Mack K. Risk of adverse health outcomes with increasing duration and regularity of opioid therapy. J Am Board Fam Med. 2014; 27 (3): 329-338.doi: 3122/jabfm.2014.03.130290
- Sauber-Schatz EK, Mack KA, Diekman ST, Paulozzi LJ, Associations between pain clinic density and distributions of opioid pain relievers, drug-related deaths, hospitalizations, emergency department visits and neonatal abstinence syndrome in Florida. Drug Alc Depend. 2013; 133 (1) 161-166. http://dx.doi.org/10.1016/j.drugalcdep.2013.05.017.
- Logan J, Liu Y, Paulozzi LJ, Zhang K, Jones C. Opioid prescribing in emergency departments: the prevalence of potentially inappropriate prescribing and misuse. Med Care. 2013; 51 (8).doi:10.1097.
- Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers – United States, 2002-2004 and 2008-2010. Drug Alc Depend. 2013; 132 (1-2): 95-100 Available at: http://dx.doi.org/10.1016/j.drugalcdep.2013.01.007.
- Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical overdose deaths, United States, 2010. 2013; 309(7):657-659. doi:10.1001/jama.2013.272
- Paulozzi LJ. Prescription drug overdoses: a review. J Safety Res. 2012; 43(4): 283-289. org/10.1016/j.jsr.2012.08.009
- Jones C. Frequency of prescription pain reliever nonmedical use: 2002-2003 and 2009-2010. Arch Intern Med.2012;172(16):1265- doi:10.1001/archinternmed.2012.2533
- Kenan K, Mack K, Paulozzi LJ. Open Med. 2012; 6(2)e41- doi:PMC3659213
- Paulozzi LJ, Kilbourne EM, Shah NG, Nolte KB, Desai HA, Landen MG, Harvey W, Loring LD. A history of being prescribed controlled substances and risk of drug overdose death. Pain Med. 2012; 13 (1):87-95. https://doi.org/10.1111/j.1526-4637.2011.01260.x
- Paulozzi LJ, Weisler RH, Patkar AA. A National Epidemic of Unintentional Prescription Opioid Overdose Deaths: How Physicians Can Help Control It. J Clin Psychiatry. 2011; 72(5):589-592.
- Paulozzi L, Kilbourne E, Desai H. Prescription drug monitoring programs and death rates from drug overdose. Pain Med. 2011;12:747-754. doi:1111/j.1526-4637.2011.01062.x
- Toblin R, Mack K, Perveen G, Paulozzi L. .A population-based survey of chronic pain and its treatment with prescription drugs. Pain. 2011; 152(6):1249-55. org/10.1016/j.pain.2010.12.036
2006 – 2010
- Paulozzi LJ, Stier, DD. Prescription drug laws, drug overdoses, and drug sales in New York and Pennsylvania. J Pub Health Policy. 2010; 31422-432. https://doi.org/10.1057/jphp.2010.27
- Toblin RL, Paulozzi LJ, Logan JE, Hall AJ, Kaplan JA. Mental illness and psychotropic drug use among prescription drug overdose deaths: a medical examiner chart review J Clin Psych. 2010;71: 491-496.
- Paulozzi LJ, Logan JE, Hall AJ, McKinstry E, Kaplan JA. A comparison of drug overdose deaths involving methadone and other opioid analgesics in West Virginia. Addiction. 2009; 104 (9):1541-1548. https://doi.org/10.1111/j.1360-0443.2009.02650.x
- Hall AJ, Logan JE, Toblin RL, Kaplan JA, Kraner JC, Bixler D, Crosby AE, Paulozzi LJ. Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA 2008; 300(22):2613-2620.
- Paulozzi LJ, Xi L. Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type. Pharmacoepidemiol Drug Saf. 2008;17(10): 997-1005. https://doi.org/10.1002/pds.1626
- Paulozzi LJ, Annest J. US data show sharply rising drug-induced death rates. Injury Prevention. 2007;13 (2):130-132. http://dx.doi.org/10.1136/ip.2006.014357
- Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol and Drug Saf. 2006; 15: 618-627. doi: 10.1002/pds.1276
- Paulozzi LJ,Ryan GW. Opioid analgesics and rates of fatal drug poisoning in the United States. Am J Prev Med. 2006; 31 (6):506–11. https://doi.org/10.1016/j.amepre.2006.08.017
- Paulozzi LJ. Opioid analgesic involvement in drug abuse deaths in the American metropolitan areas. AJPH. 2006; 96 (10):1755-1757. doi:10.2105/AJPH.2005.071647
- Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol and Drug Saf. 2006; 15 (9):618-627. org/10.1002/pds.1276
- Opioid Overdoses Treated in Emergency Departments – Identify Opportunities for Action (March 2018)
- Opioid Prescribing—Where You Live Matters (July 2017)
- Today’s Heroin Epidemic – More People at Risk, Multiple Drugs Abused (July 2015)
- Opioid Painkiller Prescribing – Where You Live Makes a Difference (July 2014)
- Prescription Painkiller Overdoses – A Growing Epidemic, Especially Among Women (July 2013)
- Use and Abuse of Methadone as a Painkiller (July 2012)
- Prescription Painkiller Overdoses in the US (November 2011)
Mack KA, Frazier L, Terplan M, et al. Addressing the Unique Challenges of Opioid Use Disorder in Women. CDC Grand Rounds, January 17, 2017, Atlanta, GA. Available at: https://www.youtube.com/watch?v=w8f6zJdVbv8.
- Summarizes the latest information available for various health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. This report covers latest data available on rates of opioid prescribing, substance use disorder, nonfatal hospitalizations and emergency department visits, and overdose deaths. National information, and some state information, is presented to serve as a resource to help address the ongoing national problem of drug abuse, addiction, and overdose.
Presentation available for download, and includes highlights of the data, maps, tables, and charts from the second Annual Surveillance Report of Drug-Related Risks and Outcomes – United States. Citation when using resources from this presentation [Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States. Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2018. Accessed 08/31/2018 from www.cdc.gov/drugoverdose/pdf/pubs/CDC_2018_Surveillance-Report_DataSummary_presentation.pdf
NCHS Data Publications
- Hedegaard H, Chen LH, Warner M. Drug-poisoning Deaths Involving Heroin: United States, 2000–2013. NCHS data brief, no. 190. Hyattsville, MD: National Center for Health Statistics, 2015.
- Frenk SM, Porter KS, Paulozzi LJ. Prescription opioid analgesic use among adults: United States, 1999–2012. NCHS data brief, no 189. Hyattsville, MD: National Center for Health Statistics. 2015.
- Chen LH, Hedegaard H, Warner M. Drug-poisoning deaths involving opioid analgesics: United States, 1999–2011. NCHS data brief, no 166. Hyattsville, MD: National Center for Health Statistics. 2014.
- NCHS. NCHS data on drug poisoning deaths. 2012. Available at: http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.html.
- Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980-2008. NCHS data brief, no. 81. Hyattsville, MD: National Center for Health Statistics, 2011.
- Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999–2006. NCHS data brief, no. 22. Hyattsville, MD: National Center for Health Statistics, 2009.
- Fingerhut LA. Increases in Poisoning and Methadone-Related Deaths: United States, 1999-2005. NCHS Health E-Stat. Hyattsville, MD: National Center for Health Statistics. 2008.
MMWR has an opioid series prepared by CDC providing weekly reports, surveillance summaries, and supplements on all public health topics from across the agency. Additional cross-cutting MMWR reports on opioids can be found here.
- Kariisa M, Scholl L, Wilson N, Seth P, Hoots B. Drug Overdose Deaths involving Cocaine and Psychostimulants with Abuse Potential – United States, 2003-2017. MMWR Morb Mortal Wkly Rep 2019:68(17);41-43.
- O’Malley-Olsen E, O’Donnell J, Mattson C, Schier J, Wilson N. Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected—27 States, July 2016 – December 2017. MMWR Morb Mortal Wkly Rep 2019:69(14);326-327.
- Springer Y, Gladden M, O’Donnell J, Seth P. Numbers of Fentanyl Drug Submissions—United States, 2010-2017. MMWR Morb Mortal Wkly Rep 2019: 68(2);41–43.
- 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.
- Mattson CM, O’Donnell J, Kariisa M, Seth P, Scholl L, Gladden RM. Opportunities to prevent Overdose Deaths involving prescription and illicit opioids, 11 states, July 2016-June 2017. MMWR Morb Mortal Wkly Rep.2018; 67(34);945–951. doi:http://dx.doi.org/10.15585/mmwr.mm6734a2.
- Cash R, Kinsman J, Crowe R, Rivard M, Faul M, Panchal A. Naloxone Administration Frequency During Emergency Medical Service Events — United States, 2012–2016.MMWR Morb Mortal Wkly Rep. 2018; 67(31);850–853. doi:http://dx.doi.org/10.15585/mmwr.mm6731a2.
- O’Donnell J, Gladden RM, Mattson CL, Kariisa M. Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017. MMWR Morb Mortal Wkly Rep.2018; 67(27);767–768. doi: http://dx.doi.org/10.15585/mmwr.mm6727a4
- Jackson K, Bohm M, Brooks J, Asher A, Nadle J, Bamberg W, Petit S, Ray S, Harrison L, Lynfield R, Dumyati G, Schaffner W, Townes J, See I. Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Persons Who Inject Drugs-Six Sites, 2005-2016.MMWR Morb Mortal Wkly Rep.2018;67(22):625-628. doi: http://dx.doi.org/10.15585/mmwr.mm6722a2
- Seth P, Scholl L, Rudd RA, Bacon S. Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants — United States, 2015–2016. MMWR Morb Mortal Wkly Rep. 2018; 67(12);349–358. doi: http://dx.doi.org/10.15585/mmwr.mm6712a1
- Vivolo-Kantor AM, Seth P, Gladden RM, et al. Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 2017. MMWR Morb Mortal Wkly Rep. 2018;67(9);279–285. doi: http://dx.doi.org/10.15585/mmwr.mm6709e1
- O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM. Deaths involving fentanyl, fentanyl analogs, and U-47700 — 10 states, July 1–December 31, 2016. MMWR Morb Mortal Wkly Rep 2017;66:1197–1202. doi: http://dx.doi.org/10.15585/mmwr.mm6643e1.
- O’Donnell JK, Gladden RM, Seth P. Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region — United States, 2006–2015. MMWR Morb Mortal Wkly Rep.2017;66:897–903. doi: http://dx.doi.org/10.15585/mmwr.mm6634a2.
- Guy Jr GP, Zhang K, Bohm MK, et al. Vital Signs: Changes in opioid prescribing in the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66(26):697-704. doi: http://dx.doi.org/10.15585/mmwr.mm6626a4
- Somerville NJ, O’Donnell J, Gladden RM, et al. Characteristics of Fentanyl Overdose — Massachusetts, 2014–2016. MMWR Morb Mortal Wkly Rep 2017;66:382–386. doi: http://dx.doi.org/10.15585/mmwr.mm6614a2
- Faul M, Bohm M, Alexander C. Methadone Prescribing and Overdose and the Association with Medicaid Preferred Drug List Policies — United States, 2007–2014. MMWR Morb Mortal Wkly Rep 2017;66:320–323. doi: http://dx.doi.org/10.15585/mmwr.mm6612a2
- Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016. doi: http://dx.doi.org/10.15585/mmwr.mm6550e1.
- Barbour KE, Boring M, Helmick CG, Murphy LB, Qin J. Prevalence of Severe Joint Pain Among Adults with Doctor-Diagnosed Arthritis — United States, 2002–2014. MMWR Morb Mortal Wkly Rep 2016;65:1052–1056. doi: http://dx.doi.org/10.15585/mmwr.mm6539a2
- García MC, Dodek AB, Kowalski T, et al. Declines in Opioid Prescribing After a Private Insurer Policy Change — Massachusetts, 2011–2015. MMWR Morb Mortal Wkly Rep 2016;65:1125–1131. doi: http://dx.doi.org/10.15585/mmwr.mm6541a1
- Gladden RM, Martinez P, Seth P. Fentanyl Law Enforcement Submissions and Increases in Synthetic Opioid–Involved Overdose Deaths — 27 States, 2013–2014. MMWR Morb Mortal Wkly Rep.2016; 65(33);837–843. doi: http://dx.doi.org/10.15585/mmwr.mm6533a2
- Peterson AB and Gladden RM, Delcher C, Spies E, Garcia-Williams A, Wang Y, Halpin J, Zibbell J, McCarty CL, DeFiore-Hyrmer J, DiOrio, M, and Goldberger B. Increases in fentanyl-related overdose deaths – Florida and Ohio, 2010-2015. MMWR Morb Mortal Wkly Rep.2016; 65(33);844–849. doi: http://dx.doi.org/10.15585/mmwr.mm6533a3
- Jones CM, Baldwin GT, Manocchio T, White JO, Mack KA. Trends in Methadone Distribution for Pain Treatment, Methadone Diversion, and Overdose Deaths — United States, 2002–2014. MMWR Morb Mortal Wkly Rep 2016; 65:667–671. doi: http://dx.doi.org/10.15585/mmwr.mm6526a2
- Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep.2016; 65:1–49. doi: http://dx.doi.org/10.15585/mmwr.rr6501e1
- Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2015; 64(50);1378-82.
- Related page: Drug Overdose Death Data
- Paulozzi LJ, Strickler GK, Kreiner PW, Koris CM. Controlled Substance Prescribing Patterns — Prescription Behavior Surveillance System, Eight States, 2013. MMWR Morb Mortal Wkly Rep.2015; 64(SS09):1-14.
- Jones CM, Logan J, Gladden RM, Bohm MK. Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013. MMWR Morb Mortal Wkly Rep 2015; 64(26):719-725.
- Paone D, Tuazon E, Kattan J, Nolan ML, O’Brien DB, Dowell D, Farley TA, Kunins HV. Decrease in Rate of Opioid Analgesic Overdose Deaths — Staten Island, New York City, 2011–2013. MMWR Morb Mortal Wkly Rep.2015; 64(18):491-494.
- Rudd RA, Paulozzi LJ, et al. Increases in Heroin Overdose Deaths — 28 States, 2010 to 2012. MMWR Morb Mortal Wkly Rep.2014; 63: 849-854.
- Johnson H, Paulozzi LJ, Porucznik C, Mack K, Herter B. Decline in drug overdose deaths after state policy changes – Florida, 2010-2012. MMWR Morb Mortal Wkly Rep.2014; 63(26):569-574.
- Jones CM, Paulozzi LJ, Mack KA. Alcohol Involvement in Opioid Pain Reliever and Benzodiazepine Drug Abuse–Related Emergency Department Visits and Drug-Related Deaths — United States, 2010. MMWR Morb Mortal Wkly Rep.2014; 63: 881-885.
- Paulozzi LJ, Mack KA, Hockenberry JM. Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012. MMWR Morb Mortal Wkly Rep.2014; 63(26);563-568.
- Johnson H, Paulozzi LJ, Porucznik C, Mack K, Herter B. Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012. MMWR Morb Mortal Wkly Rep.2014; 63(26);569-574.
- Mack KA, Jones CM, Paulozzi LJ. Vital Signs: Overdoses of Prescription Opioid Pain Relievers and Other Drugs Among Women — United States, 1999–2010. MMWR Morb Mortal Wkly Rep.2013; 62(26);537-542.
- Paulozzi LJ, Mack KA, Jones CM. Vital Signs: Risk for Overdose from Methadone Used for Pain Relief — United States, 1999–2010. MMWR Morb Mortal Wkly Rep.2012; 61(26): 493-497.
- Paulozzi LJ, Baldwin G, et al. CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic. MMWR Morb Mortal Wkly Rep.2012; 61(01):10-13.
- Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999—2008. MMWR Morb Mortal Wkly Rep.2011; 60(43):1487-1492.
- Goldberger B, Thogmartin J, Johnson H, Paulozzi LJ, Rudd RA, Ibrahimova, A. Drug Overdose Deaths — Florida, 2003–2009. MMWR Morb Mortal Wkly Rep 2011; 60(26);869-872.
- Paulozzi LJ. Drug-induced deaths—United States 2003–2007. MMWR Morb Mortal Wkly Rep.2011; 60(supp):60-61.
- Cai R, Crane E, Poneleit K, Paulozzi LJ. Emergency department visits involving nonmedical use of selected prescription drugs – United States, 2004–2008. MMWR Morb Mortal Wkly Rep.2010; 59:705-709.
- Mascola L, Dassey D, Fogleman S, Paulozzi LJ, Reed CG. Ecstasy overdoses as a New Year’s Eve rave—Los Angeles, California, 2010. MMWR Morb Mortal Wkly Rep.2010; 59:671-681.
- Coolen P, Best S, Lima A, Sabel J, Paulozzi LJ. Overdose deaths involving prescription opioids among Medicaid enrollees—Washington, 2004-2007. MMWR Morb Mortal Wkly Rep.2009; 58:1171-1175.
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Evidence-Based Strategies for Preventing Opioid Overdose: What’s Working in the United States
This resource consolidates the best evidence currently available for implementing overdose prevention strategies with demonstrated feasibility in the United States. It offers community leaders, local and regional organizers, non-profit groups, law enforcement, public health, and members of the public relevant research and examples of use in the field.
Prescription Drug Overdose Data & Statistics Guide to ICD-9-CM and ICD-10 Codes Related to Poisoning and Pain [PDF – 62K]
This guide provides a list of the International Classification of Disease (ICD) version 10 (ICD-10) and the ICD version 9 Clinical Modification (ICD-9-CM) codes for poisoning and pain. This list can be used to query databases featuring either morbidity (ICD-9-CM) or mortality (ICD-10) data.
Prescription Drug Overdose Data & Statistics Guide: CDC WONDER Multiple Causes of Death Dataset [PDF – 589K]
This guide provides an overview of the steps to query Multiple Causes of Death data in CDC WONDER. CDC WONDER (Wide-ranging Online Data for Epidemiologic Research) is a data system that provides public-use data sets about mortality (deaths), cancer incidence, HIV and AIDS, tuberculosis, vaccinations, natality (births), census data and many other health outcomes. Multiple Causes of Death (MCOD) mortality data are based on death certificates for U.S. residents. Each death certificate contains underlying cause and up to twenty multiple causes of death and demographic data.
From Epi to Policy: Prescription Drug Overdose: State Health Department Training and Technical Assistance Meeting [PDF – 4M]
This report was prepared to summarize a meeting of health officials from 15 states funded to receive training on how to take what we know about the epidemic of Prescription Drug Overdose and turn it into effective action. The meeting sought to combine CDC’s research and epidemiology on prescription drug overdose with real-world discussions of the challenges and successes states have faced in confronting the epidemic. (Atlanta, Georgia, April 22-23, 2013)
Patient Review and Restriction Programs: Lessons learned from state Medicaid programs [PDF – 4M]
This report is a summary of an expert meeting to examine current practices of Patient Review and Restriction (PRR) programs and share insights about the operation of such programs to prevent prescription drug abuse, diversion, and overdose. (CDC Expert Panel Meeting Report, Atlanta, Georgia, August 27-28, 2012)
From 2010 to 2015, annual overdose deaths involving opioids in the United States increased by nearly 57%, with a notable rise in deaths attributed to synthetic opioids other than methadone. A new Prescription Behavior Surveillance System (PBSS) Issue Brief compares trends in synthetic opioid overdose deaths in five states. The data show a close association between rising synthetic opioid overdose deaths and the rising availability of illicitly manufactured fentanyl.
Data released by the Commonwealth of Kentucky examines the relationship between rates of Neonatal Abstinence Syndrome (NAS) in various regions of the state versus risky opioid prescribing behaviors observed in these same regions. In the wake of the ongoing opioid epidemic, NAS has greatly increased nationwide, more than tripling from 2004 to 2013. Findings in Kentucky reveal a close association between NAS and high opioid prescribing rates in the preceding year among women of childbearing age.
An analysis of Washington prescription drug monitoring program (PDMP) data revealed that multiple provider episodes (MPEs) vary by age group and class of prescription drug. Opioids and opioid combinations had the highest number of days of overlapping prescriptions, and eight opioids had a mean daily dosage greater than 120 morphine milligram equivalents (MME). Findings indicate that MPEs, overlapping prescription, and mean daily dosages over 100 MMEs are patient risk factors to look for in PDMP data.
Maine’s PDMP data was analyzed to examine several patient risk measures for prescription drug misuse, abuse and overdose. Patients aged 35-54 had the highest rate of MPEs, and opioids were the drug class most frequently involved with MPEs. However, the rate of MPEs declined from 2010 to 2014, and this coincided with an increase in prescribing of buprenorphine, widely used in treating opioid dependence.