Provisional Drug Overdose Death Counts for Specific Drugs

Drug-Specific Mortality Counts

This data visualization presents counts of provisional drug overdose deaths by selected drugs and U.S. Department of Health and Human Services (HHS) public health regions, based on provisional mortality data from the National Vital Statistics System. The visualization is limited to drug overdose deaths identified using underlying cause of death codes from the International Statistical Classification of Diseases, 10th Revision (ICD-10): X40-X44 (unintentional), X60-X64 (suicide), X85 (homicide), or Y10-Y14 (undetermined intent). Specific drugs were identified using methods that search literal text from death certificates. Geographic patterns in drug overdose deaths involving specific drugs are shown across the ten HHS public health regions (see Technical Notes).

Figure 1 allows users to examine trends in provisional drug overdose death counts over time by selected drug type, nationally and by public health region. Figure 2 allows users to examine trends in overdose death counts across public health regions by drug type.

The provisional data on this page are based on a current flow of mortality data and include reported 12-month ending provisional counts of drug overdose deaths by jurisdiction of occurrence and specified drug. Provisional drug overdose death counts presented on this page are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2022 would include deaths occurring from July 1, 2021, through June 30, 2022. Evaluation of trends over time should compare estimates from year to year (June 2021 and June 2022), rather than month to month, to avoid overlapping time periods. It is important to note that the data represent counts of deaths, not mortality ratios or rates, which are the standard measure used to compare groups, and therefore these data should not be used to determine populations at disproportionate risk of drug overdose death.

Provisional data presented on this page will be updated on a biannual basis as additional records are received. Previously released estimates are revised to include additional data and record updates received since the previous release. As a result, the reliability of estimates for a 12-month period ending in a specific month will improve with each biannual release and estimates for previous time periods may change with the addition of updated data. More than one drug can be reported on a death certificate; consequently, the resulting death counts do not form discrete, mutually exclusive categories.

Provisional counts include deaths among U.S. residents in the United States, are shown as of the specified date, and may not include all deaths that occurred during a given time period.

Download Data for All Drugs

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Legend for Drug(s)

NOTES: Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Reported provisional counts are the number of deaths among U.S. residents occurring within the 50 states and the District of Columbia that were received and processed for the indicated 12-month period. Drug overdose deaths are identified using ICD-10 underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Deaths may involve other drugs in addition to the referent (i.e., listed) drug. Deaths involving more than one drug (e.g., fentanyl and cocaine) are included in both totals. Regions correspond to the U.S. Department of Health and Human Services public health regions: Region 1 (CT, MA, ME, NH, RI, and VT), Region 2 (NJ and NY), Region 3 (DC, DE, MD, PA, VA, and WV), Region 4 (AL, FL, GA, KY, MS, NC, SC, and TN), Region 5 (IL, IN, MI, MN, OH, and WI), Region 6 (AR, LA, NM, OK, and TX), Region 7 (IA, KS, MO, and NE), Region 8 (CO, MT, ND, SD, UT, and WY), Region 9 (AZ, CA, HI, and NV), and Region 10 (AK, ID, OR, and WA). Abbreviations: MDMA = 3,4-methylenedioxymethamphetamine.

Data Table for Figure 1. 12 Month-ending Provisional Number of Drug Overdose Deaths by selected drug(s)

Legend for Jurisdiction(s)

NOTES: Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Reported provisional counts are the number of deaths among U.S. residents occurring within the 50 states and the District of Columbia that were received and processed for the indicated 12-month period. Drug overdose deaths are identified using ICD-10 underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Deaths may involve other drugs in addition to the referent (i.e., listed drug). Deaths involving more than one drug (e.g., fentanyl and cocaine) are included in both totals. Regions correspond to the U.S. Department of Health and Human Services public health regions: Region 1 (CT, MA, ME, NH, RI, and VT), Region 2 (NJ and NY), Region 3 (DC, DE, MD, PA, VA, and WV), Region 4 (AL, FL, GA, KY, MS, NC, SC, and TN), Region 5 (IL, IN, MI, MN, OH, and WI), Region 6 (AR, LA, NM, OK, and TX), Region 7 (IA, KS, MO, and NE), Region 8 (CO, MT, ND, SD, UT, and WY), Region 9 (AZ, CA, HI, and NV), and Region 10 (AK, ID, OR, and WA). Abbreviations: MDMA = 3,4-methylenedioxymethamphetamine.

Data Table for Figure 2. 12 Month-ending Provisional Number of Drug Overdose Deaths by HHS Region

Technical Notes

Nature and source of data

Death certificate records (mortality data) from the National Vital Statistics System (NVSS) are submitted to the National Center for Health Statistics by the 57 jurisdictions in the United States. These records are maintained in a live, dynamic database and considered provisional until processed, reviewed, verified, and publicly released by National Center for Health Statistics as a final, static dataset. The final data set does not include literal text data, or information provided by those filling out the death certificate about the circumstances of death. Additionally, jurisdictions may continue to send updated death certificate information after the data year is considered final; these updates are not reflected in annual final mortality data files and official summary reports. Literal text data for all death certificates received before or after the release of the final file continue to be maintained in the dynamic NVSS database. As this dynamic database may include updates to death certificate data received after the closeout of the data years, death counts in this data visualization may differ from other published sources.

The ten HHS regions, excluding U.S. territories, presented on this page are:

Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont
Region 2: New Jersey and New York
Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia
Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee
Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
Region 7: Iowa, Kansas, Missouri, and Nebraska
Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming
Region 9: Arizona, California, Hawaii, and Nevada
Region 10: Alaska, Idaho, Oregon, and Washington

Drugs involved in drug overdose deaths were extracted from the death certificate literal text: including causes of death from Part I of the death certificate, conditions contributing to the death from Part II of the death certificate, and descriptions of how the injury occurred. Drug overdose deaths involving the specific drugs presented in Figures 1 and 2 were identified from these text fields using the method described below.

Identifying drug overdose deaths involving specific drugs

Mortality statistics are compiled in accordance with World Health Organization (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) (1). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on the use of the classification. Causes of death for the data presented on this page were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual (2).

This report includes decedents who resided and died in the United States and had an underlying cause of death of drug overdose. Drug overdose deaths are identified using underlying cause-of-death codes from the 10th Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined intent).

Specific drugs are identified as being involved in a drug overdose death when the drug or substance is mentioned in the literal text of the death certificate. Drugs or substances mentioned in literal text fields are assumed to be involved in the death unless contextual information indicates otherwise.

The data presented on this page use the Drugs Mentioned with Involvement (DMI) methodology to map search terms to a principal variant, which reflects a drug or drug group (3-9). Search terms include drug and pharmaceutical generic names, brand names, common usage or street names, abbreviations, metabolites, misspellings, and other variations.

Principal variants are linked to a unique ingredient identifier, which describes the substance’s molecular structure or descriptive information generated by the Global Substance Registration System, maintained by the U.S. Food and Drug Administration. For example, terms such as COCAIEN, COCAINE CRACK, COCAINE HYDROCHLORIDE, and COCAINETOXICITY are all mapped to the principal variant COCAINE. Principal variants are also categorized according to whether they referred to a specific drug or substance (e.g., oxycodone), a class of drug or substances (e.g., opioid), or nonspecific references (e.g., terms such as DRUG, MULTIDRUG, or POLYPHARMACY).

Referent drug groups serve as the unit of analysis for reporting drug overdose deaths of specific drugs. A referent drug group may include two or more principal variants reflecting a drug category. For example, the referent drug group fentanyl includes principal variants for fentanyl, including fentanyl analogs (e.g., CARFENTANIL), precursors (e.g., DEPROPIONYLFENTANYL), and metabolites (e.g., NORFENTANYL).

The methods used to identify specific drugs involved in the death (DMI methodology) are routinely enhanced to better search the literal text from death certificates. The latest list of search terms found in the literal text of data presented in this visualization is provided in an accompanying file, available from: Drug Specific Terms [CSV – 52 KB].More than one drug can be reported on a death certificate; consequently, the resulting death counts do not form discrete, mutually exclusive categories.

Counts of drug overdose deaths by specific drug are subject to change as additional search terms for drugs are identified. Therefore, findings from this report may differ from reports using final data or from provisional mortality data taken at a different time point. Further, determination of the source of the drugs or whether the drug was illegally manufactured cannot be determined from the literal text.

Methods based on literal text analysis are dependent on the quality and completeness of the information provided, which may vary by jurisdiction due to differences in reporting practices in systems that conduct death investigations and certify the cause and manner of unnatural and unexplained deaths (medicolegal death investigation systems) across the United States. Regional differences in the quality and completeness of death investigations and reporting must be considered when reviewing these findings.

Variations in the way drug overdose deaths are reported on death certificates, including the level of detail about the specific drugs involved, can impact comparability.

Source

National Center for Health Statistics, death certificate literal text data from the National Vital Statistics System as of March 1, 2026.

References

World Health Organization. International statistical classification of diseases and related health problems, 10^th 2008 ed. 2009.
National Vital Statistics System. Instructions for classifying the underlying cause of death. In: NCHS instruction manual: Part 2s. Published annually.
Trinidad JP, Warner M, Bastian BA, Miniño AM, Hedegaard H. Using literal text from the death certificate to enhance mortality statistics: Characterizing drug involvement in deaths. National Vital Statistics Reports; vol 65 no 9. Hyattsville, MD: National Center for Health Statistics. 2016. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_09.pdf
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. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf
Spencer MR, Warner M, Bastian BA, Trinidad JP, Hedegaard H. Drug overdose deaths involving fentanyl, 2011–2016. National Vital Statistics Reports; vol 68 no 3. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_03-508.pdf
Hedegaard H, Bastian BA, Trinidad JP, Spencer MR, Warner M. Regional differences in the drugs most frequently involved in drug overdose deaths: United States, 2017. National Vital Statistics Reports; vol 68 no 12. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_12-508.pdf.
Spencer MR, Warner M, Cisewski JA, Miniño A, Dodds D, Perera J, Ahmad FB. Estimates of drug overdose deaths involving fentanyl, methamphetamine, cocaine, heroin, and oxycodone: United States, 2021. Vital Statistics Rapid Release; no 27. Hyattsville, MD: National Center for Health Statistics. May 2023. Available from: https://www.cdc.gov/nchs/data/vsrr/vsrr027.pdf
Spencer MR, Cisewski JA, Warner M, Garnett MF. Drug overdose deaths involving xylazine: United States, 2018–2021. Vital Statistics Rapid Release; no 30. Hyattsville, MD: National Center for Health Statistics. 2023. Available from: https://www.cdc.gov/nchs/data/vsrr/vsrr030.pdf
Garnett MF, Cisewski JA, Ahmad FB. Drugs most frequently involved in drug overdose deaths: United States, 2017-2023. Natl Vital Stat Rep. 2026 Mar;75(1):1-13. DOI: https://dx.doi.org/10.15620/cdc/174640.

Suggested Citation

Ahmad FB, Cisewski JA, Garnett M. Provisional drug overdose death counts by specific drugs. National Center for Health Statistics. 2026. DOI: https://dx.doi.org/10.15620/cdc/20250305010