Overdose deaths involving fentanyl and drugs that are similar in structure (analogs) are increasing and contributing to a complex illicit opioid crisis. This report analyzed opioid overdose data from 10 states participating in the State Unintentional Drug Overdose Reporting System (SUDORS), the component of the Enhanced State Opioid Overdose Surveillance program designed to track fatal opioid overdose data. SUDORS makes it possible to use toxicologic and death scene investigation data, previously unavailable across states, to provide insight into the opioid overdose epidemic. From July to December 2016, almost 3,000 opioid overdose deaths tested positive for fentanyl and over 700 opioid overdose deaths tested positive for fentanyl analogs, including an extremely potent fentanyl analog, carfentanil, which is used to sedate large animals.
- Journal Articles
- CDC Vital Signs
- Related Publications
- MMWR Articles
- Guides and Meeting Reports
- PBSS Data Briefs
- Dowell D, Noonan RK, Houry D. Underlying factors in drug overdose deaths. JAMA. Published online October 11, 2017. 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;318(11):1065-1067. DOI:10.1001/jama.2017.9308
- Dowell D, Haegerich TM. Changing the Conversation About Opioid Tapering. Ann Intern Med. [Epub ahead of print 18 July 2017] 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 Viewpoint 2017;318(7):1-2.
- 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. 13 June 2017. 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. Prehospital Emergency Care, May 2017. DOI: 10.1080/10903127.2017.1315203.
- 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 2017 pnx015. DOI: 10.1093/pm/pnx015.
- Jones CM, Baldwin GT, Compton WM. Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids. American Journal of Public Health, March 2017, Vol. 107, No. 3, pp. 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 Affairs, October 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. Journal of Emergency Medicine, September 2016. 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. Medical Care, October 2016, 54(10): 901 – 906.
- Easterling KW, Mack KA, Jones CM. Location of fatal prescription opioid-related deaths in 12 states, 2008-2010: Implications for prevention programs. Journal of Safety Research, September 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. American Journal of Public Health, August 2016, Vol. 106, No. 8, pp. 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 and Alcohol Dependence, 2016. 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 Affairs, 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. Prehospital Emergency Care (2015). DOI: 10.3109/10903127.2015.1076096.
- Frieden TR, Houry D. Reducing the risks of relief — the CDC opioid-prescribing guideline. New England Journal of Medicine. March 15, 2016. 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: 10.1001/jama.2016.1464.
- Scott LC, Lewis S. Opioids for Chronic Pain. JAMA, Patient Page. Published online March 15, 2016. 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 Feb 10; EPub ahead of print. doi: 10.1002/pds.3980.
- Wilson M. Compton, M.D., M.P.E., Christopher M. Jones, Pharm.D., M.P.H., and Grant T. Baldwin, Ph.D., M.P.H. Relationship between Nonmedical Prescription-Opioid Use and Heroin Use. New England Journal of Medicine. 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 and Alcohol Dependence (2015). DOI:10.1016/j.drugalcdep.2015.12.025.
- Deborah Fulton-Kehoe, Mark D. Sullivan, Judith A. Turner, Renu K. Garg, Amy M. Bauer, Thomas M. Wickizer, Gary M. Franklin. Opioid Poisonings in Washington State Medicaid. Medical Care, 2015; 53 (8): 679 DOI: 10.1097/MLR.0000000000000384. (CDC funded study)
- Jones C, Campopiano M, Baldwin G, McCance-Katz E. (2015). National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. American Journal of Public Health. 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. American Journal of Public Health. 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.
- Haegerich, T.M., Paulozzi, L., Manns, B., & Jones, C. J. (2014). What we know and don’t know about state and system level policy strategies to prevent prescription drug overdose. Drug and Alcohol Dependence. 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.
- 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(15):796-801.
- 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;27:329-338.
- 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; 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; 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. 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. JAMA 2013;309:657-659.
- Paulozzi LJ. Prescription drug overdoses: a review. Journal of Safety Research, 2012; 43(4): 283-289.
- Jones, C. Frequency of prescription pain reliever nonmedical use: 2002-2003 and 2009-2010. Arch Intern Med, 2012;172(16):1265-1267.
- Kenan K, Mack K, Paulozzi LJ. Trends in prescriptions for oxycodone and other commonly used opioids in the United States, 2000-2010. Open Med 2012:6(2)e41.
- 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 Medicine 2012;13:87-95.
- 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.
- 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.
- Paulozzi LJ, Stier, DD. Prescription drug laws, drug overdoses, and drug sales in New York and Pennsylvania. J Pub Health Policy 2010;31:422-432.
- 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; 104:1541-1548.
- 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;300:2613-2620.
- Paulozzi LJ, Xi L. Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type. Pharmacoepidemiol Drug Safety 2008;17:997-1005.
- Paulozzi LJ, Annest J. US data show sharply rising drug-induced death rates. Injury Prevention 2007;13:130-132.
- Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiology and Drug Safety 2006; 15:618-627.
- Paulozzi LJ and Ryan GW. Opioid analgesics and rates of fatal drug poisoning in the United States. Am J Prev Med. 2006;31:506–11.
- Paulozzi LJ. Opioid analgesic involvement in drug abuse deaths in the American metropolitan areas. American Journal of Public Health 2006; 96:1755-1757.
- Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiology and Drug Safety 2006; 15:618-627.
CDC Vital Signs
- 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)
Annual Surveillance Report
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 first Annual Surveillance Report of Drug-Related Risks and Outcomes – United States, 2017. Citation when using resources from this presentation [Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2017. Accessed [date] from https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf ]
CDC Health Alert Network (HAN) Advisories
- Centers for Disease Control and Prevention. CDC Health Advisory: Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities. HAN Health Advisory. August 25, 2016.
- Centers for Disease Control and Prevention. CDC Health Advisory: Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities. HAN Health Advisory. October 26, 2015.
CDC Grand Rounds
- 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.
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.
Integrating & Expanding Prescription Drug Monitoring Program Data: Lessons from Nine States [PDF – 1M]
A promising strategy for addressing the U.S. opioid overdose epidemic is improving the use of prescription drug monitoring programs (PDMPs). The Substance Abuse and Mental Health Services Administration (SAMHSA) funded nine states to better integrate PDMP data into health systems and to initiate and increase interstate data sharing. The project was called PDMP Electronic Health Records (EHRs) Integration and Interoperability Expansion (PEHRIIE) and funded Florida, Illinois, Indiana, Kansas, Maine, Ohio, Texas, Washington, and West Virginia from 2012 to 2016. CDC conducted a process and outcome evaluation of the program; and in collaboration with Brandeis University, used a comparative case study to describe the implementation process, identify successes and challenges, and explore the program’s effects on the stated goals.
Addressing Prescription Drug Abuse in the United States: Current Activities and Future Opportunities [PDF – 1M]
Created by the Department of Health and Human Services’ Behavioral Health Coordinating Committee Subcommittee on Prescription Drug Abuse, this publication is a review of current federal initiatives and literature focused on ensuring the safe use of prescription drugs with the potential for abuse and the treatment of prescription drug dependence. The report includes identified opportunities to enhance programmatic and policy efforts as well as future research on prescription drug abuse and overdose in the U.S. (This publication was developed pursuant to Section 1122 of the Food and Drug Administration Safety and Innovation Act of 2012 (FDASIA).)
References [PDF – 93 KB]
Prescription Painkiller Overdoses is one in a series of issue briefs highlighting key public health issues and important, science-based policy actions that can be taken to address them. Through this publication, CDC supports state-based efforts to reduce prescription drug abuse while ensuring patients have access to safe, effective pain treatment. The publication includes information about deaths and emergency department visits resulting from prescription painkiller overdoses, overdose trends, the most common drugs involved, and the regions and populations most severely affected. Recommendations on how health care providers, private insurance providers, and state and federal agencies can work to prevent unintentional drug overdoses are also included.
To assess the knowledge, response, and planning regarding prescription drug misuse and overdose, in late 2007 the Association of State and Territorial Health Officials (ASTHO) and CDC conducted interviews with state and territorial health officials and other senior leaders in nine states (Arkansas, Florida, Indiana, Kentucky, Montana, North Carolina, Oklahoma, Utah, and West Virginia). The resulting report, Prescription Drug Overdose: State Health Agencies Respond, outlines the state perceptions, partnerships, recommendations, policies, and other issues that are fundamental to understanding and responding to drug misuse.
- 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.
- 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 2016; 65(33);837–843.
- 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 2016; 65(33);844–849.
- 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 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 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 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 2015; 64(18):491-494.
- Rudd RA, Paulozzi LJ, et al. Increases in Heroin Overdose Deaths — 28 States, 2010 to 2012. MMWR 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 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 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 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 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 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 2012; 61(26): 493-497.
- Paulozzi LJ, Baldwin G, et al. CDC Grand Rounds: Prescription Drug Overdoses — a U.S. Epidemic. MMWR 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 2011; 60(43):1487-1492.
- Goldberger B, Thogmartin J, Johnson H, Paulozzi LJ, Rudd RA, Ibrahimova, A. Drug Overdose Deaths — Florida, 2003–2009. MMWR 2011; 60(26);869-872.
- Paulozzi LJ. Drug-induced deaths—United States 2003–2007. MMWR 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 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 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 2009; 58:1171-1175.
- Centers for Disease Control and Prevention. QuickStats: Percentage change in death rates for the leading causes of unintentional injury, by mechanism of injury — United States, 1999—2005. MMWR 2008; 57:701.
- Paulozzi L, Annest J. Unintentional poisoning deaths—United States, 1999-2004. MMWR 2007; 56:93-96.
- Burt A, Annest JL, Ballesteros MF, Budnitz DS. Nonfatal, unintentional medication exposures among young children—United States, 2001-2003. MMWR 2006; 55:1-5.
- Singleton M, Qin H, et al. Unintentional and undetermined poisoning deaths—11 states, 1990-2001. MMWR 2004; 53:233-8.
Guides and Meeting Reports
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)
Prescription Behavior Surveillance System Data Briefs
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.