Nonfatal Overdoses: Heroin
The drug overdose data presented below come from CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) system. CDC has analyzed data from syndromic surveillance of suspected heroin overdoses. Data presented here include percent change estimates in rates of suspected heroin overdoses per 10,000 ED visits. These suspected heroin overdose percent change estimates may change as CDC receives updated data, so estimates should be interpreted with caution.
The map below provides annual percent change estimates in rates of heroin overdoses per 10,000 ED visits for the most recent month of data. The “About This Map” section provides the specific data for the map and also all other annual percent change estimates. The other tables provide annual and monthly percent change estimates overall, by state, and by sex and age group.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual Trends† in Emergency Department Visits for Suspected Heroin Overdose§, January 2018 to January 2020,¶ by OD2A-funded Jurisdiction
| January 2018 to January 2019 | February 2018 to February 2019 |
March 2018 to March 2019 | April 2018 to April 2019 | May 2018 to May 2019 | June 2018 to June 2019 | July 2018 to July 2019 | August 2018 to August 2019 |
September 2018 to September 2019 | October 2018 to October 2019 | November 2018 to November 2019 | December 2018 to December 2019 | January 2019 to January 2020 | Category, January 2019 to January 2020 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of States | 32 | 33 | 35 | 35 | 35 | 35 | 36 | 36 | 36 | 37 | 36 | 36 | 36 | |
| Overall | -5.66 | -3.49 | -8.43 | -2.32 | -6.69 | -3.3 | 0.88 | -0.14 | 1.65 | 1.74 | 5.06 | 5.88 | 15.65 | significant increase |
| State | ||||||||||||||
| Alabama | 6.5 | -35.59 | 2.89 | 25.21 | 20.8 | -9.41 | 7.59 | -6.46 | 18.52 | -0.89 | -37.32 | -23.19 | -7.49 | no significant change |
| Alaska | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Arizona | -0.02 | 12.33 | -6.16 | -17.73 | 10.49 | -25.84 | -18.97 | -36.3 | -23.56 | -26.68 | -40.09 | -43.53 | -29 | significant decrease |
| Arkansas | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| California** | ||||||||||||||
| Colorado | -20.67 | † | 11.48 | 6.66 | -18.03 | -2.05 | -1.61 | -0.22 | -16.57 | -23.49 | 11.3 | -29 | -25.4 | no significant change |
| Connecticut†† | -19.15 | 0.35 | -1.58 | -10.52 | -4.48 | 14.7 | 30.25 | significant increase | ||||||
| Delaware†† | -35.88 | -18.22 | -2.92 | -7.52 | no significant change | |||||||||
| District of Columbia | -41.42 | † | † | † | † | 26.81 | † | 42.26 | † | † | † | † | 91.22 | significant increase |
| Florida | -1.77 | 2.92 | 18.21 | 17.76 | -14.15 | -1 | 5.52 | 15.69 | 71 | 46.79 | 23.16 | 25.11 | 25.25 | significant increase |
| Georgia | 4.57 | -47.14 | -17.57 | -0.37 | 15.45 | -8.55 | 7.99 | 26.65 | 95.44 | 82.24 | 23.23 | -5 | 15.32 | no significant change |
| Hawaii** | ||||||||||||||
| Idaho†† | † | † | † | † | † | † | † | |||||||
| Illinois | 8.38 | -2.46 | -8.03 | 22.14 | 15.9 | 17.21 | 52.4 | 13.01 | 12.66 | -7.25 | 26.94 | 21.44 | 74.14 | significant increase |
| Indiana | -18.05 | -13.78 | -20.48 | -31.46 | -16.86 | 2.28 | 11.61 | 24.37 | -6 | -5.15 | 19.11 | 43.47 | 66.29 | significant increase |
| Iowa** | ||||||||||||||
| Kansas | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Kentucky†† | ||||||||||||||
| Louisiana | -19.63 | -4.19 | -39.4 | -6.22 | 29.4 | 2.35 | 22.99 | 47.05 | 38.46 | 73.74 | 75.24 | 107.19 | 176.39 | significant increase |
| Maine | -52.48 | 13.58 | -58.2 | -34.09 | -7.72 | -8.62 | -46.55 | -41.62 | -6.49 | 11.19 | † | 17.81 | 38.63 | no significant change |
| Maryland†† | -21.31 | -9.18 | -5.24 | 6.62 | -4.61 | 34.72 | 25.77 | -6.2 | -25.33 | |||||
| Massachusetts | -13.57 | -7.33 | -27.71 | -33.62 | -36.89 | -23.41 | -24.38 | -22.58 | -3.4 | 2.15 | -3.51 | 4.5 | -18.71 | significant decrease |
| Michigan | -6.87 | 40.2 | 30.13 | 51.48 | 10.42 | 32.28 | 19.13 | 15.11 | 38.71 | 30.8 | 56.53 | 16.97 | 25.38 | significant increase |
| Minnesota** | ||||||||||||||
| Mississippi†† | † | † | † | † | † | |||||||||
| Missouri | 34.67 | 21.02 | -61.73 | -17.56 | -30.36 | -42.25 | -3.78 | 5.19 | 2.94 | -9.55 | -2.8 | -43.1 | † | |
| Montana | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Nebraska** | ||||||||||||||
| Nevada | -23.29 | -25.49 | 4.21 | -15.23 | -40.93 | -37.82 | -38.14 | 25.53 | -1.55 | -6.63 | 0.02 | -1.82 | 27.56 | no significant change |
| New Hampshire | -33.34 | -42.68 | -43.42 | -34.41 | 15.28 | -30.88 | -50.73 | -42.98 | -46.22 | -35.92 | -44.71 | -24.45 | -39.54 | significant decrease |
| New Jersey | -3.56 | 2.5 | -14.79 | -5.42 | -21.37 | -13.08 | 5.53 | -6.57 | -15.18 | -1.42 | -20.85 | -7.9 | -13.56 | no significant change |
| New Mexico | -5.78 | 36.05 | 2.61 | -17.26 | 24.45 | -12.37 | 12.99 | 63.12 | 37.56 | -14.42 | -4.19 | 7.88 | -13.54 | no significant change |
| New York State | -23.56 | 1.13 | -2.85 | -34.49 | -15.74 | 11.38 | -1.87 | 12.49 | 31.41 | 54.21 | 39.37 | 120.83 | 94.47 | significant increase |
| North Carolina | -26.17 | 7.74 | -2.37 | -9.25 | 10.43 | -10 | -10.4 | -15.24 | -21.78 | -16.36 | -11.75 | -0.07 | 8.57 | no significant change |
| North Dakota§§ | ||||||||||||||
| Ohio | -12.95 | -11.81 | -17.51 | -7.49 | -16.82 | -2.79 | -23.6 | -30.75 | -28.28 | -15.75 | -26.41 | -37.21 | -23.51 | significant decrease |
| Oklahoma** | ||||||||||||||
| Oregon | 30.53 | -15.54 | 18.39 | -0.58 | -5.79 | -6.45 | 12.55 | -14.19 | -48.01 | -1.38 | 37.93 | -10.79 | -4.47 | no significant change |
| Pennsylvania | -16 | -15.34 | -25.93 | -16.39 | -29.6 | -25.38 | -37.55 | -12.13 | -33.44 | -14.78 | -13 | -11.09 | -1.69 | no significant change |
| Puerto Rico** | ||||||||||||||
| Rhode Island†† | † | -17.12 | † | † | † | † | † | † | † | † | † | † | ||
| South Carolina†† | ||||||||||||||
| South Dakota | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Tennessee | 31.1 | 28.08 | 1.31 | 51.69 | 35.84 | 1.71 | 29.19 | -7.05 | 19.73 | 7.43 | 17.27 | -17.77 | -22.98 | significant decrease |
| Texas§§ | ||||||||||||||
| Utah | 36.55 | 7.28 | 38.49 | -1.31 | 49.21 | 2.98 | 20.15 | -8.64 | 11.44 | 44.76 | 5.62 | -56.81 | -31.79 | no significant change |
| Vermont | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Virginia | -4.96 | -28.13 | -28.08 | -8.05 | 2.85 | 20.68 | -4.87 | 10.75 | 5.73 | 26.89 | 12.53 | 6.8 | 25.19 | no significant change |
| Washington | 8.07 | -20.41 | 8.31 | -19.61 | 11.85 | 14.55 | -4.47 | 11.46 | 4.66 | 2.28 | -28.8 | 6.62 | -11.08 | no significant change |
| West Virginia†† | 76.8 | 44.43 | 98.07 | significant increase | ||||||||||
| Wisconsin†† | -24.84 | 39.87 | -17.23 | -11.64 | 131.61 | 80.72 | 24.98 | 27.46 | ||||||
| Wyoming§§ |
* See DOSE System page.
† To account for changes occurring across time, annual trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Annual change, controlling for seasonal effects, was estimated as the change from the final month of previous year to the final month of the current year (e.g., January 2018 to January 2019). Significance testing was conducted using chi-square tests. Data table provides the annual rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.
§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.
¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.
** The state/territory does not share data from syndromic surveillance systems for DOSE.
†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.
§§ State does not participate in OD2A DOSE ED data sharing.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Monthly Trends† in Emergency Department Visits for Suspected Heroin Overdose§, January 2018 to January 2020,¶ by OD2A-funded Jurisdiction
| January 2018 to February 2018 | February 2018 to March 2018 | March 2018 to April 2018 | April 2018 to May 2018 | May 2018 to June 2018 | June 2018 to July 2018 | July 2018 to August 2018 | August 2018 to September 2018 | September 2018 to October 2018 | October 2018 to November 2018 | November 2018 to December 2018 | December 2018 to January 2019 | January 2019 to February 2019 | February 2019 to March 2019 | March 2019 to April 2019 | April 2019 to May 2019 | May 2019 to June 2019 | June 2019 to July 2019 | July 2019 to August 2019 | August 2019 to September 2019 | September 2019 to October 2019 | October 2019 to November 2019 | November 2019 to December 2019 | December 2019 to January 2020 | Category, December 2019 to January 2020 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (35 states) | (35 states) | (36 states) | (36 states) | (36 states) | (36 states) | (36 states) | (36 states) | (36 states) | (35 states) | (36 states) | (36 states) | (36 states) | (37 states) | (38 states) | (38 states) | (39 states) | (39 states) | (41 states) | (41 states) | (41 states) | (41 states) | (41 states) | (41 states) | ||
| Overall | 3.68 | 7.63 | -2.24 | 11.18 | 5.38 | -5.11 | 5.23 | -9.05 | -3.98 | -5.47 | -6.66 | -6.67 | 5.26 | 4.02 | 5.15 | 6.53 | 8.72 | -0.82 | 4.73 | -8.34 | -2.62 | -4.03 | -6.57 | 2.73 | no significant change |
| State | |||||||||||||||||||||||||
| Alabama | 15.85 | -13.63 | -0.72 | -13.98 | 28.5 | -1.67 | 9.26 | -26.49 | 33.97 | 32.63 | -30.46 | -0.6 | -29.94 | 37.97 | 20.82 | -17.02 | -3.64 | 16.79 | -5.01 | -6.87 | 12.03 | -16.12 | -14.78 | 19.72 | no significant change |
| Alaska | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Arizona | 22.59 | 0.26 | 13.15 | -12.46 | 27.01 | -1.08 | -7.24 | 1.19 | -1.22 | -30.3 | 8.29 | -6.62 | 37.74 | -16.24 | -0.8 | 17.57 | -14.75 | 8.08 | -27.08 | 21.43 | -5.25 | -43.05 | 2.07 | 17.41 | no significant change |
| Arkansas | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| California** | |||||||||||||||||||||||||
| Colorado | † | † | 2.22 | 6.99 | 7.86 | 15.46 | -23.14 | 27.95 | -11.71 | -9.13 | 9.32 | -26.97 | 20.88 | 7.51 | -2.2 | -17.78 | 28.9 | 15.98 | -22.05 | 6.98 | -19.03 | 32.19 | -30.26 | -23.26 | no significant change |
| Connecticut†† | -3.04 | -3.02 | 8.86 | -22.95 | -19.89 | -4.49 | 13.18 | -1.82 | 3.75 | 21.4 | 7.64 | -11.08 | 20.33 | -4.88 | -1.03 | -17.75 | -3.8 | 8.46 | no significant change | ||||||
| Delaware†† | -33.11 | 12.03 | -24.73 | -15.99 | 32.94 | -0.07 | 21.74 | 7.53 | -2.52 | 16.16 | -20.66 | -13.41 | -14.68 | 33 | -28.3 | significant decrease | |||||||||
| District of Columbia | -34.62 | † | † | † | -1.84 | 21.85 | -10.83 | † | † | † | † | † | † | † | † | † | † | † | † | 3.59 | 22.84 | 15.96 | -57.12 | 86.01 | significant increase |
| Florida | -6.63 | -9.88 | 7.49 | 26.76 | 3.37 | -8.19 | -3.01 | -24.41 | 13.63 | 12.32 | -4.22 | 0.73 | -2.17 | 3.51 | 7.08 | -7.6 | 19.2 | -2.14 | 6.33 | 11.73 | -2.46 | -5.76 | -2.7 | 0.84 | no significant change |
| Georgia | 5.13 | 8.66 | 13.88 | -25.33 | 38.95 | -17.83 | 2.15 | -33.6 | 14.78 | 11.74 | 12 | -3.24 | -46.85 | 69.44 | 37.65 | -13.48 | 10.06 | -2.96 | 19.8 | 2.46 | 7.03 | -24.44 | -13.65 | 17.46 | no significant change |
| Hawaii** | |||||||||||||||||||||||||
| Idaho†† | † | † | † | † | † | † | † | ||||||||||||||||||
| Illinois | 22.71 | 4.4 | -13.67 | 21.43 | 2.04 | -14.55 | 33.2 | -7.07 | 14.78 | -23.6 | -0.4 | -14.39 | 10.44 | -1.57 | 14.65 | 15.22 | 3.2 | 11.1 | -1.23 | -7.36 | -5.5 | 4.55 | -4.71 | 22.77 | significant increase |
| Indiana | 7.92 | 11.8 | -7.24 | 8.67 | 0.94 | -12.32 | 0.2 | 20 | -0.93 | -19.79 | -21.87 | 1.97 | 13.54 | 3.12 | -20.05 | 31.82 | 24.19 | -4.32 | 11.65 | -9.3 | -0.03 | 0.72 | -5.88 | 18.19 | no significant change |
| Iowa** | |||||||||||||||||||||||||
| Kansas | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Kentucky†† | 19.01 | -5.64 | -23.32 | 24.6 | 1.52 | 5.55 | |||||||||||||||||||
| Louisiana | -3.48 | 65.86 | -13.06 | -25.57 | 31.6 | -4.9 | -5.63 | 5.33 | -24.11 | 8.67 | 11.28 | -32.05 | 15.06 | 4.92 | 34.53 | 2.71 | 4.09 | 14.28 | 12.83 | -0.82 | -4.77 | 9.61 | 31.56 | -9.35 | no significant change |
| Maine | -21.74 | 57.41 | -18.7 | -1.35 | -5.53 | 21.72 | 1.48 | -26.73 | -22.16 | 39.91 | -3.64 | -46.39 | 87.04 | -42.07 | 28.2 | 38.11 | -6.45 | -28.81 | 10.84 | 17.36 | -7.44 | † | † | -36.92 | significant decrease |
| Maryland†† | 19.57 | -3.03 | 4.68 | -15.88 | 15.63 | -18.57 | 4.05 | -10.7 | 13.9 | 11.9 | 9.23 | -5.36 | 3.45 | 15.01 | -2.86 | -33.41 | -9.33 | -11.02 | -8.21 | 10.03 | no significant change | ||||
| Massachusetts | 10.81 | 12.52 | -0.09 | 12.82 | -3.96 | -8.73 | -4.77 | -21.6 | -3.57 | 4.88 | -0.55 | -6.56 | 18.8 | -12.23 | -8.25 | 7.25 | 16.56 | -9.88 | -2.5 | -2.18 | 1.97 | -0.93 | 7.7 | -27.31 | significant decrease |
| Michigan | -6.32 | 9.1 | -12.22 | 31.31 | -3.54 | -3.11 | 2.78 | -8.67 | 1.53 | -12.09 | 6.11 | -4.84 | 41.01 | 1.27 | 2.19 | -4.28 | 15.55 | -12.75 | -0.69 | 10.06 | -4.26 | 5.2 | -20.71 | 2 | no significant change |
| Minnesota** | |||||||||||||||||||||||||
| Mississippi†† | † | † | † | † | † | † | † | ||||||||||||||||||
| Missouri | -11.57 | 110.8 | -51.35 | 47.23 | 8.54 | -13.93 | 22.97 | -45.84 | 33.07 | 20.85 | 7.78 | -6.47 | -20.53 | -33.33 | 4.79 | 24.36 | -9.98 | 43.41 | 34.42 | -47 | 16.93 | 29.86 | -36.9 | † | |
| Montana | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Nebraska** | |||||||||||||||||||||||||
| Nevada | 50.01 | -30.9 | -1.72 | 43.27 | 10.55 | 1.75 | -38.2 | -8.13 | 14.08 | -33.01 | 19.89 | -10.19 | 45.71 | -3.35 | -20.06 | -0.17 | 16.38 | 1.22 | 25.41 | -27.95 | 8.19 | -28.23 | 17.69 | 16.68 | no significant change |
| New Hampshire | -6.94 | 31.28 | -22.54 | -24.69 | 26.34 | -4.48 | 11.09 | -19.41 | 3.59 | 26.7 | -34.36 | 0.47 | -19.98 | 29.58 | -10.2 | 32.36 | -24.25 | -31.91 | 28.58 | -24 | 23.43 | 9.32 | -10.3 | -19.59 | no significant change |
| New Jersey | -7.59 | 16.55 | 2.28 | 25.65 | -9.63 | -6.66 | 20.43 | 4.29 | -17.27 | 1.75 | -16.05 | -6.93 | -1.79 | -3.1 | 13.52 | 4.46 | -0.1 | 13.33 | 6.62 | -5.33 | -3.85 | -18.31 | -2.32 | -12.65 | no significant change |
| New Mexico | -9.79 | 56.74 | 12.77 | 15.2 | -14.96 | -1.58 | -11.55 | 18.22 | -17.65 | -19.1 | 4.14 | -15.53 | 30.25 | 18.22 | -9.07 | 73.28 | -40.12 | 26.9 | 27.69 | -0.3 | -48.76 | -9.43 | 17.26 | -32.3 | no significant change |
| New York State | -3.76 | 20.85 | 23.5 | -3.86 | -6.99 | 23.29 | 9.34 | -21.46 | -18.42 | 7.19 | -33.55 | -3.26 | 27.33 | 16.09 | -16.72 | 23.65 | 22.95 | 8.62 | 25.34 | -8.25 | -4.26 | -3.13 | 5.29 | -14.81 | significant decrease |
| North Carolina | -8.34 | 13.58 | -8.6 | 2.94 | 24.05 | -14.58 | 7.08 | 6.33 | -20.77 | 4.71 | -20.16 | -5.68 | 33.75 | 2.93 | -15.04 | 25.25 | 1.1 | -14.95 | 1.29 | -1.87 | -15.28 | 10.47 | -9.59 | 2.48 | no significant change |
| North Dakota§§ | |||||||||||||||||||||||||
| Ohio | 4.02 | 12.67 | -6.11 | 16.26 | -4.68 | 21.21 | 9.73 | -18.92 | -11.96 | -5.72 | -1.41 | -19.1 | 5.38 | 5.39 | 5.29 | 4.54 | 11.39 | -4.73 | -0.54 | -16.02 | 3.42 | -17.66 | -15.87 | -1.46 | no significant change |
| Oklahoma** | |||||||||||||||||||||||||
| Oregon | 33.07 | -15.5 | 28.55 | 16.07 | 4.38 | -12.06 | 1.79 | 41.97 | -44.99 | -20.03 | 25.99 | 5.84 | -13.9 | 18.46 | 7.95 | 9.99 | 3.65 | 5.8 | -22.4 | -13.98 | 4.34 | 11.85 | -18.52 | 13.34 | no significant change |
| Pennsylvania | -4.99 | 19.56 | 11.2 | 2.9 | 14.84 | 4.5 | -4.99 | 0.22 | -20.92 | -8.55 | -16.11 | -6.76 | -4.24 | 4.6 | 25.53 | -13.37 | 21.72 | -12.55 | 33.69 | -24.09 | 1.25 | -6.64 | -14.28 | 3.1 | no significant change |
| Puerto Rico** | |||||||||||||||||||||||||
| Rhode Island†† | 8.55 | -21.07 | 44.38 | -13.08 | -18.18 | 18.31 | 7.71 | -3.8 | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |||
| South Carolina†† | -20.35 | 20.56 | 36.85 | -43.29 | 17.9 | 17.81 | -20.08 | -0.91 | no significant change | ||||||||||||||||
| South Dakota | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | ||||
| Tennessee | -10.76 | 15.53 | -23.45 | 12.92 | 54.48 | -20.76 | 7.29 | -23.57 | 7.97 | 8.78 | 3.77 | 20.21 | -12.81 | -8.61 | 14.62 | 1.12 | 15.67 | 0.64 | -22.81 | -1.54 | -3.11 | 18.74 | -27.23 | 12.6 | no significant change |
| Texas§§ | |||||||||||||||||||||||||
| Utah | 16.66 | 9.73 | -4.89 | -28.33 | 47.85 | -19.01 | 33.47 | -16.59 | -4.06 | 7.44 | 51.49 | -24.83 | -8.35 | 41.65 | -32.23 | 8.37 | 2.04 | -5.51 | 1.49 | 1.75 | 24.62 | -21.61 | -38.05 | 18.71 | no significant change |
| Vermont | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |
| Virginia | 27.96 | -3.8 | 21.8 | 16.49 | -11.8 | -12 | 16.26 | 2.8 | -26.73 | 11.41 | -19.29 | -10.97 | -3.22 | -3.73 | 55.72 | 30.3 | 3.49 | -30.63 | 35.35 | -1.86 | -12.06 | -1.2 | -23.4 | 4.36 | no significant change |
| Washington | 3 | -8.4 | 32.13 | -10.27 | 6.06 | -0.52 | -8.81 | -9.49 | 15.49 | 13.31 | -16.02 | 0.94 | -24.14 | 24.65 | -1.93 | 24.84 | 8.62 | -17.04 | 6.4 | -15.01 | 12.87 | -21.11 | 25.75 | -15.82 | no significant change |
| West Virginia†† | -20.66 | -6.59 | 9.98 | 30.96 | 21.93 | 17.99 | -2.83 | -3.82 | 14.33 | -21.81 | 16.82 | 17.95 | -35.18 | 28.11 | no significant change | ||||||||||
| Wisconsin†† | 15.8 | 15.52 | -16.24 | 58.15 | -13.27 | -43.32 | 34.08 | 5.78 | -3.51 | 55.88 | -6.41 | -7.41 | 48.57 | 4.62 | -26.85 | -1.59 | 10.05 | -12.06 | 15.58 | no significant change | |||||
| Wyoming§§ |
* See DOSE System page.
† To account for changes occurring across time, annual trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Annual change, controlling for seasonal effects, was estimated as the change from the final month of previous year to the final month of the current year (e.g., January 2018 to January 2019). Significance testing was conducted using chi-square tests. Data table provides the annual rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.
§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.
¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.
** The state/territory does not share data from syndromic surveillance systems for DOSE.
†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.
§§ State does not participate in OD2A DOSE ED data sharing.
CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) System:* Annual and Monthly Percent Changes† in Suspected Heroin Overdoses§, January 2018 to January 2020¶ by Sex and Age Group
| Yearly Percent Change | Monthly Percent Change | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| January 2018 to January 2019 |
February 2018 to February 2019 |
March 2018 to March 2019 | April 2018 to April 2019 |
May 2018 to May 2019 |
June 2018 to June 2019 | July 2018 to July 2019 | August 2018 to August 2019 |
September 2018 to September 2019 | October 2018 to October 2019 | November 2018 to November 2019 | December 2018 to December 2019 | January 2019 to January 2020 | Category, January 2019 to January 2020 | January 2018 to February 2018 | February 2018 to March 2018 | March 2018 to April 2018 | April 2018 to May 2018 | May 2018 to June 2018 | June 2018 to July 2018 | July 2018 to August 2018 | August 2018 to September 2018 | September 2018 to October 2018 | October 2018 to November 2018 | November 2018 to December 2018 | December 2018 to January 2019 | January 2019 to February 2019 | February 2019 to March 2019 | March 2019 to April 2019 | April 2019 to May 2019 | May 2019 to June 2019 | June 2019 to July 2019 | July 2019 to August 2019 | August 2019 to September 2019 | September 2019 to October 2019 | October 2019 to November 2019 | November 2019 to December 2019 | December 2019 to January 2020 | Category, December 2019 to January 2020 | ||
| ( 32 States ) | ( 33 States ) | ( 35 States ) | ( 35 States ) | ( 35 States ) | ( 35 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 37 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 35 States ) | ( 35 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 35 States ) | ( 36 States ) | ( 36 States ) | ( 36 States ) | ( 37 States ) | ( 38 States ) | ( 38 States ) | ( 39 States ) | ( 39 States ) | ( 41 States ) | ( 41 States ) | ( 41 States ) | ( 41 States ) | ( 41 States ) | ( 41 States ) | ||||
| Sex | ||||||||||||||||||||||||||||||||||||||||
| Male | -8.56 | -4.38 | -5.92 | -2.03 | -8.53 | -3.87 | 1.36 | 1.38 | 1.43 | 0.81 | 5.41 | 8.28 | 18.39 | significant increase | 1.51 | 6.26 | -0.13 | 11.03 | 3.6 | -5.11 | 5.2 | -7.97 | -4.82 | -4.63 | -7.74 | -7.77 | 6.77 | 5.06 | 5.01 | 4.74 | 8.33 | 0.64 | 5.79 | -8.76 | -3.84 | -1.61 | -6.34 | 1.49 | no significant change | |
| Female | 0.16 | -2.65 | -13.71 | -4.15 | -2.6 | -3.1 | -1.12 | -4.74 | 1.27 | 3.23 | 3.1 | 0.13 | 9.41 | significant increase | 8.54 | 9.68 | -6.25 | 9.47 | 9.55 | -5.26 | 5.33 | -11.45 | -1.67 | -6.88 | -4.57 | -3.24 | 1.65 | 1.9 | 4.74 | 9.65 | 8.69 | -3.97 | 2.05 | -6.99 | 0.86 | -9.15 | -6.91 | 6.77 | significant increase | |
| Age group | ||||||||||||||||||||||||||||||||||||||||
| 0-14 | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | † | |||
| 15-24 | -20.58 | -9.73 | -27.96 | -19.35 | -25.25 | -12.25 | -25.45 | -10.78 | -26.91 | -10.46 | -10.9 | -12.19 | -2.58 | no significant change | -1.37 | 15.19 | -6.29 | 11.22 | 0.24 | -7.31 | -7.84 | 2.09 | -12.72 | -1.36 | -3.53 | -10.52 | 9.16 | -2.74 | 5.13 | 4.04 | 16.51 | -20.05 | 11.24 | -17.38 | 8.41 | -1.9 | -7.33 | 0.76 | no significant change | |
| 25-34 | -11.61 | -5.39 | -7.66 | -3.53 | -13.98 | -8.1 | -3.99 | -7.27 | 0.42 | 1.02 | 1.24 | 0.24 | 1.73 | no significant change | 3.08 | 2.86 | -3.64 | 11.32 | 0.03 | -5.6 | 6.83 | -11.4 | -0.36 | -1.09 | -5.08 | -7.38 | 8.06 | 3.32 | 2.48 | -1.51 | 6.74 | -2.54 | 3.34 | -4.73 | 0.67 | -2.61 | -5.13 | -5.64 | significant decrease | |
| 35-54 | -2.4 | -6.05 | -4.77 | 4.53 | 7.07 | 3.21 | 9.79 | 8.54 | 11.54 | 6.99 | 13.48 | 14.63 | 29.97 | significant increase | 11.13 | 3.58 | -4.49 | 5.99 | 8.76 | -7.62 | 7.32 | -6.48 | 0.12 | -7.18 | -1.79 | -12.81 | 6.97 | 5.1 | 5.13 | 9.96 | 3.71 | -0.6 | 7.34 | -4.87 | -2.37 | -3.17 | -2.15 | -0.01 | no significant change | |
| 55 and up | 14.33 | 10.89 | 18.47 | 17.32 | 7.37 | 11.13 | 23.76 | 13.91 | 12.73 | 9.05 | 25.8 | 26.72 | 51.07 | significant increase | 0.76 | 5 | 2.94 | 28.1 | 1.35 | -5 | 12.93 | -5.34 | -6.96 | -7.34 | -13.94 | 0.84 | 3.21 | 10.87 | 2.34 | 17.79 | 5.48 | 6.98 | 4.04 | -7.68 | -8.44 | 2.48 | -14.42 | 21.06 | significant increase | |
* See DOSE System page.
† To account for changes occurring across time, annual trends for the rate of ED visits involving suspected drug overdoses (e.g., ED visits involving drug overdoses divided by total ED visits and multiplied by 10,000) were analyzed by U.S. state. Annual change, controlling for seasonal effects, was estimated as the change from the final month of previous year to the final month of the current year (e.g., January 2018 to January 2019). Significance testing was conducted using chi-square tests. Data table provides the annual rate changes by state. Bolded estimates indicate statistically significant results. Rates are suppressed when based on <20 overdoses; for more information, please see: Healthy People 2010 Criteria for Data Suppressionpdf icon.
§ The syndrome definitions used by jurisdictions draw from multiple fields within emergency department (ED) data. Please see more information on the DOSE System tab or CDC’s March 2018 Vital Signs.
¶ The following are several important caveats to consider when interpreting the data presented: (1) Data sent from facilities to health departments may be delayed or may stop for a period of time. When facilities begin sharing data again, information about visits during the lapse may never be shared; (2) For syndromic data, information from ~70% of visits arrive within 48 hours as the chief complaint of the visit. However, the chief complaint field may be incomplete. As updates to visits arrive weeks later, relevant overdose discharge diagnosis codes or revised chief complaint text may be received. Therefore, rates may change over time as the visit records are completed and new drug overdose visits are identified; (3) Because these data are not finalized based on toxicological results, they are not considered confirmed cases, but “suspected” overdoses. Data collected from syndromic surveillance should not be interpreted or represented as exact counts; and (4) Data likely represent an undercount, given inaccuracies in coding and missing chief complaint information.
** The state/territory does not share data from syndromic surveillance systems for DOSE.
†† The funded jurisdiction did not provide CDC enough months of data to calculate all percent change cells.
§§ State does not participate in OD2A DOSE ED data sharing.
