Monthly Provisional Drug Overdose Counts through September 2021

February 16, 2022

NCHS has released the next set of monthly provisional drug overdose death counts.  The monthly counts are released under the Vital Statistics Rapid Release program as an interactive data visualization.

Note that due to recent improvements in the timeliness of death certificate reporting, provisional estimates of drug overdose deaths will now be reported 4 months after the date of death, shortening the previous 6-month lag by 2 months (Please see the Technical Notes of the dashboard for more information). Thus, the new update today features data on the 12-month period ending in September 2021.


Drug Overdose Deaths in the U.S. Top 100,000 Annually

November 17, 2021

Provisional data from NCHS indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.

Read more here:

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

The interactive web dashboard is available at: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


Drug Overdose Deaths in the U.S. Up Nearly 30% in 2020

July 14, 2021

drug_OD_2020The CDC’s National Center for Health Statistics has released full-year 2020 provisional drug overdose death data that estimates 93,331 drug overdose deaths in the United States during 2020, an increase of 29.4% from the 72,151 deaths predicted in 2019.

The data featured in an interactive web data visualization estimates overdose deaths from opioids increased from 50,963 in 2019 to 69,710 in 2020. Overdose deaths from synthetic opioids (primarily fentanyl) and psychostimulants such as methamphetamine also increased in 2020 compared to 2019. Cocaine deaths also increased in 2020, as did deaths from natural and semi-synthetic opioids (such as prescription pain medication).


Urban-Rural Differences in Drug Overdose Death Rates, 1999-2019

March 17, 2021

Questions for Holly Hedegaard, Health Statistician and Lead Author of “Urban-Rural Differences in Drug Overdose Death Rates, 1999-2019.”

Q: How do drug overdose death rates in urban and rural areas compare?

HH: Over the past 20 years, rates of drug overdose deaths have increased in both urban and rural areas. Rates in rural areas were higher than in urban areas from 2007 through 2015, but in 2016 that pattern changed. From 2016 through 2019, rates have been higher in urban areas than in rural areas.

Although urban rates are higher than rural rates nationally, for 5 states (California, Connecticut, North Carolina, Vermont, and Virginia), rates are higher in rural areas than in urban areas.


Q: Is this the most recent data you have on this topic?  When do you plan on releasing 2020 data?

HH: Final 2020 data won’t be released until the end of 2021. In the interim, monthly provisional estimates of drug overdose death rates are available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


Q: Was there a specific finding in the data that surprised you from this report?

HH: In this report, we looked at trends in rates for drug overdose deaths involving certain types of opioids, including natural and semisynthetic opioids. This group includes such drugs as hydrocodone, oxycodone, and codeine – drugs that are often thought of as prescription opioids. In looking at the trends from 1999 through 2019, the rates of drug overdose deaths involving natural and semisynthetic opioids were higher in rural than in urban areas from 2004 through 2017, but in 2018 and 2019, the urban and rural rates were similar, because of a decline in the rates in rural areas. We will continue to monitor whether this decline in the rate continues.


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

HH: The key messages from this report are: 1) for the past 20 years, drug overdose death rates have increased in both urban and rural areas, and 2) there are urban-rural differences in the rates of drug overdose deaths involving specific types of drugs. For example, for the past 20 years, rates of drug overdose deaths involving cocaine or heroin have been consistently higher in urban areas than in rural areas. In contrast, in recent years, rates of drug overdose deaths involving psychostimulants (such as methamphetamine) have been higher in rural areas than in urban areas.


Q: Do you think rural counties will go back to having higher drug overdose death rates in the future?

HH: It’s impossible to predict what will happen in the future. While a lot of resources have been devoted to prevention and treatment of drug overdose in recent years, new drugs are becoming available all the time. NCHS will continue to monitor drug overdose deaths to identify patterns to help inform public health efforts.


Opioid-involved Emergency Department Visits in the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey

December 15, 2020

Questions for Geoffrey Jackson, Health Statistician and Lead Author of “Opioid-involved Emergency Department Visits in the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey.”

Q: Why did you decide to research opioid-involved emergency department (ED) visits?

GJ: From 2005 through 2014, it is estimated that the rate of ED visits due to opioid use increased 99.4%, from 89.1 per 100,000 population in 2005 to 177.7 per 100,000 population in 2014. We were struck by the large increase and know that ED data can provide critical information on opioid use-related treatments, such as opioid use disorder treatment, detoxification for safe opioid withdrawal, and management of adverse effects. NCHS hospital surveys can be used to monitor trends in opioid overdoses, as well as other opioid-related morbidity and mortality measures.


Q: Can describe the difference between the difference between the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey?

GJ: Even though both surveys collect data from hospital emergency departments, the mode of data collection differs between the two surveys. The National Hospital Care Survey (NHCS) is an all-electronic data collection of administrative claims or billing data. NCHS receives all inpatient, ED, and outpatient hospitals for a calendar year.  In addition, to patient demographics, diagnoses, procedures, laboratory tests, and medications, NHCS collects patient name, address, and Social Security number, which allows patients to be followed over time and linkage to external data sources, such as the National Death Index, providing a more complete picture of patient care and post-acute mortality.

In contrast, the National Hospital Ambulatory Medical Care Survey (NHAMCS) data collection relies on medical record abstraction by U.S. Census Bureau field representatives during a 4-week period. A random sample of about 100 ED visits are selected from all visits during the reporting period, and data are manually abstracted directly from medical records by Census staff. NHAMCS collects similar information as NHCS, but NHAMCS does not collect patient identifiers.  As a consequence, NHAMCS data cannot be linked to other sources nor can patients be collected over time.


Q: Was there a specific finding in the data that surprised you from this report?

GJ: One finding that surprised me was the increase in percentage the patients that died of an opioid overdose 90 days after their hospital visits. Specifically, of the patients with an opioid-involved ED visit that died with 91 and 365 days after their ED visit, 20.6% died with an opioid overdose, compared to approximately 15% that died within 90 days post-ED visit died of an opioid overdose.


Q: Is this the most recent data you have on this topic?

GJ: The most recent NHCS data available in the NCHS Research Data Center (RDC) are from 2016. The 2016 NHCS data are linked to the 2016 and 2017 National Death Index and include information on specific drugs mentioned on the death certificate from the Drug-Involved Mortality file. Additionally, the 2016 NHCS RDC data include identification of opioids using an enhanced methodology that uses natural language processing and machine learning techniques. The most recent NHAMCS public use data file available are from 2018.


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

GJ: NHCS is an important data source for studying opioid-involved ED visits. Through the collection of patient identifiers, the data can be linked to the National Death Index to provide information on post-acute mortality. The information on post-acute mortality is not available in other hospital data sources. Even though the NHCS data are not nationally representative, the NHCS data have similar distributions to NHAMCS data for national estimates of ED visits of male and female opioid-involved ED visits and for persons aged 35 and over.


Prevalence of Prescription Pain Medication Use Among Adults: United States, 2015–2018

June 24, 2020

FROM THE AUTHOR

In 2015–2018, 10.7% of U.S. adults used one or more prescription pain medications in the past 30 days.  Prescription pain medication use was higher among women than men overall and within each age category. Use increased with age overall and among men and women. Prescription pain medication use was lowest among non-Hispanic Asian adults, and use among Hispanic adults was lower than among non-Hispanic white adults. This same pattern of prescription pain medication use was observed among both men and women.

Additionally, this report estimated the percentage of adults who used one or more opioid prescription pain medications (with or without use of non-opioid prescription pain medications) and the percentage who used one ore more non-opioid prescription pain medication (without use of prescription opioids).  In 2015–2018, 5.7% of U.S. adults used prescription opioids and 5.0% used non-opioid prescription pain medications (without prescription opioids) in the past 30 days. Use of one or more prescription opioids and use of non-opioid prescription pain medications (without prescription opioids) were higher among women than men, and increased with age, and were lowest among non-Hispanic Asian adults.  Use of one or more prescription opioids among Hispanic adults was lower than among non-Hispanic white adults.

From 2009–2010 to 2017–2018, there was no significant increase in use of prescription opioids, but use of non-opioid prescription pain medications (without prescription opioids) increased.

Source: National Health and Nutrition Examination Survey, 2015–2018.


Provisional Drug Overdose Death Counts (thru November 2019)

June 17, 2020

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


Provisional Drug Overdose Death Counts (thru September 2019)

April 16, 2020

Provisional data in the United States shows that the reported number of drug overdose deaths occurring in the United States decreased by 0.9% from the 12 months ending in September 2018 to the 12 months ending in September 2019, from 68,421 to 67,839.

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


QuickStats: Percentage of Emergency Department Visits for Pain at Which Opioids Were Given or Prescribed, by Geographic Region of the Hospital — United States, 2005–2017

January 17, 2020

The percentage of emergency department visits for pain at which an opioid was given or prescribed increased from 37.4% in 2005 to 43.1% in 2010 and then decreased to 30.9% in 2017.

A similar pattern was observed in all four regions. Percentages for the Northeast were lower than for the nation as a whole for all years analyzed.

In 2017, the percentage was 21.1% in the Northeast, compared with 32.0% in the Midwest, 32.0% in the South, and 34.7% in the West.

Source: National Center for Health Statistics. National Hospital Ambulatory Medical Care Survey, 2005–2017. https://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm.


Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017

January 8, 2020

Questions for Lead Author Anna Rui, Health Statistician, of “Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017.”

Q: Why did you decide to look at opioid prescribing at emergency department discharges?

AR: There is a large body of research reporting increases in opioid prescription rates from 1999 to 2010 but less is known about how rates have changed from 2010 on, particularly in the emergency department setting, where many patients present with pain symptoms and are likely to receive opioids for treatment. In response to the opioid epidemic, hundreds of local, state, and federal programs were implemented in recent years with the goal of changing prescribing practices. A goal of this report was to evaluate recent trends in opioid prescribing, in order to monitor the effects of public health policy.


Q: How did the data vary by patient/hospital characteristics and in the type of opioids prescribed at discharge?

AR: Variation in the rate of change was found for age, patient residence, and primary expected source of payment. The rate of decrease in the percentage of visits with an opioid prescribed at discharge by younger patients aged 18-44 from both the beginning of the study period (2006-2007) and from the inflection point (2010-2011) to the end of the study period (2016-2017) was the highest across all age groups. Similarly, the percentage of visits by patients living in medium or small metropolitan counties decreased by the highest percentage across the study period among all urban and rural categories. Both Medicaid and self-pay/no charge/charity experienced the highest rate of decrease from 2010-2011 through 2016-2017 whereas the percentage of visits by patients with Medicare that included an opioid prescribed at discharge remained stable across the study period.

In terms of hospital characteristics, among the four regions, the largest decrease in opioids prescribed at discharge from 2006-2007 to 2016-2017 was observed in the Northeast region. Generally, a higher percentage of visits at proprietary (or for-profit) hospital EDs, compared with nonprofit and government hospital EDs, included an opioid prescribed at discharge. Despite the high percentage, the rate of decrease among visits made to proprietary hospital EDs from 2006-2007 through 2016-2017 was modest.

In terms of the type of opioids prescribed, the percentage of opioid mentions with acetaminophen-hydrocodone (e.g., Vicodin) prescribed remained stable through 2012-2013 and decreased starting from 2014-2015. Corresponding to this decrease, the percentage of opioid mentions with tramadol and acetaminophen-codeine, which are known as having a lesser risk of dependence, increased starting in 2014-2015 and continued through 2016-2017.


Q: Was there a specific finding in the data that surprised you?

AR: One finding that surprised me was the magnitude of decrease in the percentage of opioids prescribed from 2010-2011 through 2016-2017 for most of the pain-related diagnoses. For example, the percentage of visits for extremity and back pain decreased by 68.8% and 49.1%, respectively, between 2010-2011 and 2016-2017.


Q: How did you obtain this data for this report?

AR: Restricted data (available from the Research Data Center) collected from the National Hospital Ambulatory Medical Care Survey were used for this report. Masked public use data are available for download from the Ambulatory Health Care Data website (https://www.cdc.gov/nchs/ahcd/datasets_documentation_related.htm)


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

AR: I think the take home message of the report is recent trends show a decrease in the percentage of visits with opioids prescribed at discharge from 2010-2011 through 2016-2017, and this trend was observed for most of the patient and hospital characteristics examined, as well as for most of the pain-related diagnoses prompting the ED visit.