Drug Overdose Deaths Involving Fentanyl, 2011–2016

March 21, 2019

Questions for Lead Author Merianne Spencer, M.P.H., Health Statistician, of “Drug Overdose Deaths Involving Fentanyl, 2011-2016.”

Q: Why did you decide to do a report specifically on drug overdose deaths involving fentanyl?

MS: Fentanyl, a synthetic opioid, is of interest to public health officials because of its increased involvement in drug overdose deaths and contributing role in the opioid epidemic. Understanding trends in drug overdose deaths involving fentanyl by demographic and regional characteristics can provide insights to better target interventions for populations at risk and to inform agencies working to combat this public health problem.


Q: Do you have any data that is more recent than 2016? 

MS: Mortality data for deaths occurring in 2017 are currently available for research use.  However, these data were not available at the time of the analysis for this study, and the text analyses required for preparing this report are time intensive.


Q: How did drug overdose deaths involving fentanyl vary by age, sex and race?

MS: The rates for drug overdose deaths involving fentanyl varied by age with the largest rates among adults aged 25-34 and 35-44. Exponential increases occurred in all age groups, with the greatest increases per year among adults aged 35-44, 25-34 and 15-24.

The rates for males and females were similar in 2011, 2012 and 2013.  In 2013, the rates for males and females began to diverge such that by 2016, the rate for males (8.6 per 100,000) was roughly 2.8 times the rate for females (3.1).

For race/ethnicity, non-Hispanic whites had higher rates than non-Hispanic blacks and Hispanics for the entire study period.  However, the annual percentage changes were greater among non-Hispanic blacks and Hispanics.


Q: Was there a specific finding in your report that surprised you?

MS: I was surprised to see how high the average annual percentage change in rates was for teenagers and young adults aged 15-24. While the death rate for this age group was not as high as the rates for persons aged 25-34 and 35-44, the average annual percentage increase in the rate was among the greatest, increasing an average of almost 94% each year from 2011 through 2016.


Q: What is the take home message for this report?

MS: The rise in drug overdose deaths involving fentanyl was noticeable in certain subpopulations and regions.  Overall, death rates, which were stable in 2011 and 2012, significantly increased from 2013 through 2016.

Death rates for males and females were similar in 2011 and 2012, but then diverged, with rates for males increasing faster than the rate for females starting in 2013. Non-Hispanic whites had the highest death rates; however, the rates for non-Hispanic blacks and Hispanics increased at a greater pace than those for non-Hispanic whites.  All age groups had increasing rates, but the greatest increases were among those aged 15-24, 25-34 and 35-44.  There were also regional differences, with the highest rates and greatest increase in rates occurring in the East Coast and Upper Midwest regions.

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QuickStats: Age-Adjusted Death Rates by State — United States, 2017

March 15, 2019

In 2017, the overall U.S. death rate was 731.9 per 100,000 standard population; rates varied by state.

The five states with the highest age-adjusted death rates were West Virginia (957.1 deaths per 100,000 standard population), Mississippi (951.3), Kentucky (929.9), Alabama (917.7), and Oklahoma (902.4).

The five states with the lowest death rates were Hawaii (584.9), California (618.7), New York (623.6), Connecticut (651.2), and Minnesota (656.4).

Source: National Vital Statistics System. Underlying cause of death data, 1999–2017. https://wonder.cdc.gov/ucd-icd10.html

https://www.cdc.gov/mmwr/volumes/68/wr/mm6810a7.htm 


Dementia Mortality in the United States, 2000–2017

March 14, 2019

A new NCHS report presents data on mortality attributable to dementia. Data for dementia as an underlying cause of death from 2000 through 2017 are shown by selected characteristics such as age, sex, race and Hispanic origin, and state of residence.

Trends in dementia deaths overall and by specific cause are presented. The reporting of dementia as a contributing cause of death is also described.

Key Findings:

  • In 2017, a total of 261,914 deaths attributable to dementia as an underlying cause of death were reported in the United States. Forty-six percent of these deaths were due to Alzheimer disease.
  • In 2017, the age-adjusted death rate for dementia as an underlying cause of death was 66.7 deaths per 100,000 U.S. standard population. Age-adjusted death rates were higher for females (72.7) than for males (56.4).
  • Death rates increased with age from 56.9 deaths per 100,000 among people aged 65–74 to 2,707.3 deaths per 100,000 among people aged 85 and over.
  • Age-adjusted death rates were higher among the non-Hispanic white population (70.8) compared with the non-Hispanic black population (65.0) and the Hispanic population (46.0).
  • Overall, age-adjusted death rates for dementia increased from 2000 to 2017.
  • Rates were steady from 2013 through 2016, and increased from 2016 to 2017. Patterns of reporting the individual dementia causes varied across states and across time.

Updated Provisional Drug Overdose Death Data: 12-Month Ending from August 2017-August 2018

March 13, 2019

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


QuickStats: Death Rates Attributed to Excessive Cold or Hypothermia Among Persons Aged 15 Years or Older, by Urbanization Level and Age Group

February 22, 2019

During 2015–2017, death rates attributed to excessive cold or hypothermia increased steadily with age among those aged 15 years or older in both metropolitan and nonmetropolitan counties.

The rate for persons aged 85 years or older reached 3.8 deaths per 100,000 in metropolitan counties and 7.3 in nonmetropolitan counties.

The lowest rates were among those aged 15–24 years (0.2 in metropolitan counties and 0.5 in nonmetropolitan counties). In each age category, death rates were lower in metropolitan counties and higher in nonmetropolitan counties.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data 2015–2017.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6807a8.htm


QuickStats: Death Rates for Motor Vehicle Traffic Injury, by Age Group — National Vital Statistics System, United States, 2015 and 2017

February 15, 2019

From 2015 to 2017, death rates for motor vehicle traffic injury increased for persons aged 15 years or older.

For infants and children younger than 15 years there was no statistically significant change from 2015 to 2017, and this group had the lowest death rate (2.0 deaths per 100,000) in 2017.

The highest death rate in 2017 was for persons aged 75 years or older (19.1), followed by a 15.3 death rate for persons aged 15–34 years, and 12.8 for persons aged 35–54 and 55–74 years.

Source: National Vital Statistics System. Underlying cause of death data, 1999–2017.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a8.htm?


Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016

December 12, 2018

Questions for Lead Author Holly Hedegaard, M.D., M.S.P.H., Health Statistician, and author of “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016.”

Q: Is there a specific finding in this report that surprised you?

HH: During the six years of the study, the relative ranking of the drugs most frequently involved in drug overdose deaths changed. In 2011, the drug most frequently involved in drug overdose deaths was oxycodone, in 2012-2015 was heroin and in 2016 was fentanyl. In 2016, fentanyl was involved in nearly 30% of the drug overdose deaths in the United States.

The drugs most frequently involved in drug overdose deaths also varied by the intent of the death. In 2016, the drugs most frequently involved in unintentional (accidental) drug overdose deaths were fentanyl, heroin and cocaine, while the drugs most frequently mentioned in suicides by drug overdose were oxycodone, diphenhydramine, hydrocodone, and alprazolam.


Q: How is the data in this report different from the recently released drug overdose data brief and provisional drug overdose numbers produced by NCHS?

HH: The drug overdose data brief and the provisional drug overdose numbers produced by NCHS involve analysis of death certificate data coded using the International Classification of Diseases, Tenth Revision (ICD-10). One limitation of this classification system is that, with a few exceptions, ICD–10 codes reflect broad categories of drugs rather than unique specific drugs.

In the National Vital Statistics Report, NCHS uses data from the literal text on death certificates to identify the specific drugs involved in the death. Using this method, we can look at the number of deaths involving specific drugs, such as oxycodone, hydrocodone, or fentanyl, for example, rather than be limited to the broader categories found with ICD-10 coded data, such as natural and semi-synthetic opioids or synthetic opioids other than methadone.


Q: What did your report find on the percentage of drug overdose deaths mentioning at least one specific drug or substance?

HH: Using the literal text to identify the specific drugs involved is dependent on whether or not the specific drugs are reported on the death certificate. The specificity of reporting has improved in recent years. In 2011, the specific drugs or drug classes involved were reported for 78% of drug overdose deaths; in 2016, the reporting increased to nearly 88% of drug overdose deaths.


Q: Do you have data that goes further back than 2011?

HH:  A previous report looked at the drugs most frequently involved in drug overdose deaths in 2010-2014. That report is available at https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_10.pdf


Q: Do you have data on drugs most frequently involved in drug overdose deaths that goes up to 2017?  If not, when do you expect that will be available?

NCHS does not currently have information on the drugs most frequently involved in drug overdose deaths in 2017. NCHS is currently preparing the data files for analysis. The results for 2017 will be available in 2019.


Q: What is the take home message for this report?

HH: The patterns in the specific drugs most frequently involved in drug overdose deaths can change from year to year. Complete and accurate reporting in the literal text on death certificates of the specific drugs involved provides critical information needed for understanding and preventing drug overdose deaths.