Extramural research and non-research funding in the National Center for Injury Prevention and Control (NCIPC) are key mechanisms for meeting the mission to prevent overdose and substance use-related harms. Along with research conducted by CDC, extramural funding supports rigorous research to address Overdose Prevention Research Priorities. CDC public health news, press releases, government public health news, medical and disease news, story ideas, photos. View the Stimulant Guide below to find answers to emerging questions about stimulants in the context of the overdose epidemic in the United States. View the DOSE and SUDORS data dashboards to see the most up-to-date data on overdoses. For more overdose, injury, and violence data sources, visit Data Statistics, and Reporting.
- Although persons who use opioids have reported increasing stimulant co-use to maintain workplace productivity and alertness, occupational patterns of co-involvement in fatal overdose have not been systematically investigated.
- The National Institute for Occupational Safety and Health has developed the Workplace Supported Recovery (WSR) initiative, which guides employers in bolstering the employment and retention of persons with substance use disorders and in facilitating access to treatment (4).
- Changes in the illicit drug supply, the continued threats from illegal fentanyl and other synthetic opioids, a rise in stimulant use, and the use of multiple drugs at one time are all making substance use deadlier than ever.
- Cocaine-involved death rates increased among both sexes and among persons aged ≥15 years, non-Hispanic whites (whites), non-Hispanic blacks (blacks), and Hispanics.
- All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest.
- Finally, this analysis was exploratory, with no guiding hypotheses; therefore, these findings should be considered hypothesis-generating and warrant confirmation.
Three waves of opioid overdose deaths
Try to keep the person awake and breathing and lay the person on their side to prevent choking. Opioid Use Disorder (OUD), sometimes referred to as «opioid dependence» or «opioid addiction,» is a problematic pattern of opioid use that causes significant impairment or distress. OUD is a medical condition that can affect anyone – regardless of race, sex, income level, or social class. Like many other medical conditions, evidence-based treatments are available for OUD, but seeking treatment remains stigmatized.
Opportunity: Insights for prevention and response efforts
Overall, we found that rates of overdose ED visits involving cocaine and psychostimulants with an opioid increased in recent years, as did those involving psychostimulants without opioids. Overdose deaths involving cocaine and psychostimulants increased in the past several years with and without opioids. Of particular note, these increases occurred across a broad range of demographic groups and geographic areas, underscoring the dynamic and evolving overdose crisis in the United States. From 2016 to 2017, death rates involving cocaine and psychostimulants increased across age groups, racial/ethnic groups, county urbanization levels, and multiple states.
Learn more about CDC’s overdose prevention strategic priorities
Non-fatal drug overdoses were analyzed in SAS version 9.4 (SAS Institute Inc., Cary, NC, USA) using SAS survey procedures (PROC SURVEYFREQ) to account for the NEDS sampling design. Deaths involving synthetic opioids (largely illicitly made fentanyl) and stimulants (such as cocaine and methamphetamine) have increased in recent years. In this exploratory analysis of multiple cause of death data from 2022, occupations and industries with higher percentages of psychostimulant involvement in synthetic opioid overdose deaths tended to be physically demanding, whereas those with higher percentages of cocaine involvement tended to be less so. The death rate involving psychostimulants without opioids also increased from 2016 to 2017 (23.0%), from 1.3 to1.6.Rates increased among both sexes,most age groups, all regions except the Northeast and all urbanization levels. The largest absolute (0.9) and relative (65.5%) increases in rates by urbanization level were in small metro areas. While the largest relative increase by region was in the Midwest (39.2%), the largest absolute increase was in the West (0.6).
Nonfatal Drug and Polydrug Overdoses Treated in Emergency Departments — 29 States, 2018–2019
Additionally, we support the Drug-Free Communities (DFC) Program, which is the nation’s leading effort to support communities working to prevent youth substance use. The DFC program has been a central component of our nation’s youth substance use prevention strategy, and it provides funding and support to community coalitions to prevent and reduce youth substance use. DFC coalitions are uniquely situated to leverage historical knowledge and the unique needs and assets in their communities to address youth substance use by requiring comprehensive prevention planning with an emphasis on community level change.
More than 3 out of 5 overdose deaths involved at least one potential opportunity to link people to care before an overdose or to implement life-saving actions when an overdose occurred. These opportunities can be targeted to both prevent overdoses and improve response to overdoses to prevent deaths. †† For overdoses of opioids combined with other drugs, the sum of the bars for “Opioid without other drug” and for “Opioid and other drug” are the percentage totals for opioid-involved overdoses. 49.9%, and 34.6% of suspected unintentional and undetermined intent drug overdoses among persons aged 15–24, 25–34, 35–54, and ≥55 years, respectively. In 2019, opioids were involved in 40.2% of all suspected drug overdoses treated in EDs, including 28.7%, 56.9%, 49.9%, and 34.6% of overdoses among persons aged 15–24, 25–34, 35–54, and ≥55 years, respectively (Figure). In 2019, 23.6% of overdoses involving cocaine, 17.1% involving amphetamines, and 18.7% involving benzodiazepines also involved opioids.
Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential — United States, 2003–2017
Results and project successes will determine the impact of this program and inform future state and national efforts in preventing prescription drug overdoses. Drug overdose deaths, as defined, that have psychostimulants with abuse potential (T43.6) and heroin (T40.1) as a contributing cause. Drug overdose deaths, as defined, that have psychostimulants with abuse potential (T43.6) and any opioid (T40.0, T40.1, T40.2, T40.3, T40.4 or T40.6) as a contributing cause. The rate of cocaine overdose ED visits without opioids decreased 13.6% from 2015 to 2016, from 6.9 to 5.9.
- Rates of cocaine- and psychostimulant-involved overdose ED visits with any opioid were relatively low, and while increasing from 2015 to 2016, they did not increase as dramatically as death rates involving cocaine and psychostimulants with opioids.
- In 2017, 967,615 nonfatal drug overdoses were treated in emergency departments (EDs), a 4.3% increase from 2016 in all overdoses and a 3.1% increase in opioid-involved overdoses (1).
- The death rate involving psychostimulants without opioids also increased from 2016 to 2017 (23.0%), from 1.3 to1.6.Rates increased among both sexes,most age groups, all regions except the Northeast and all urbanization levels.
- Irrespective of whether an opioid, stimulant, or both contributed to death, decedents filled more opioid (67.7%, 74.1%, and 63.9%, respectively) than stimulant (10.6%, 11.6%, and 13.4%, respectively) prescriptions preceding death.
All intents (unintentional, suicide, assault and undetermined), diagnoses (not just principal) and encounters (initial, subsequent and sequelae) were included. Amphetamine and other psychostimulant codes were combined to create one variable for psychostimulants to ensure consistency with fatal overdose codes that only designate psychostimulant and donot differentiate amphetamines. One way CDC is working to address drug overdoses is to advance overdose prevention in communities across the country.
Connection to Other Drug Overdose Funding Efforts
First, overdose case definitions relied on discharge diagnosis codes, which were missing in 20.3% of ED visits available in NSSP for the 29 states analyzed. Improvements in submission of discharge diagnosis codes might have influenced the changes observed. However, in stimulant overdose drug overdose cdc injury center all included states, visits with valid discharge diagnosis codes increased 5.3% from 2018 to 2019. Second, discharge diagnosis codes might be used inconsistently by hospitals and providers, which could result in misclassification. Third, comprehensive toxicology testing of patients experiencing overdose rarely occurs in overdose ED visits (10), which might have underestimated polydrug overdoses.
By urban-rural status, counties in medium metro areas experienced the largest absolute rate increase (1.3 per 100,000) in 2017, whereas the largest relative rate increase occurred in micropolitan counties (57.9%). The Midwest Census region had the largest relative rate increase (43.6%), whereas the highest 2017 rate was in the Northeast (7.0 per 100,000). Death rates involving cocaine increased in 15 states, with the largest relative increases in Wisconsin (84.6%) and Maryland (72.0%), and the largest absolute rate increases in Ohio (3.9) and Maryland (3.6). Drug overdose deaths were identified based on ICD-10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide) or Y10–Y14 (undetermined intent).
The highest percentages of cocaine- (35.0%), amphetamine- (21.1%), and benzodiazepine-involved (23.6%) overdoses that also involved opioids occurred among persons aged 25–34 years. Changes in rates of polydrug overdoses predominantly comprised those co-involving opioids and amphetamines (37.3% relative increase; 0.4 per 100,000 absolute increase) (Table 2). Relative and absolute rate increases for overdoses co-involving opioids and amphetamines were experienced by both females (32.7%; 0.2) and males (38.3%; 0.6) and all age groups except persons aged 45–54 years. Relative and absolute rate increases were identified in the Northeast (116.3%; 0.4), South (33.3%; 0.4), and West (26.7%; 0.7) Census regions. Relative and absolute increases in rates of overdoses co-involving opioids and amphetamines occurred among persons living in urban counties (54.1%; 0.5). Medical personnel, emergency departments, first responders, public safety officials, mental health and substance use treatment providers, community-based organizations, public health, and members of the community all bring awareness, resources, and expertise to address this complex and fast-moving epidemic.
From 2016 to 2017, the death rate involving cocaine without opioids increased 23.3%, from 0.9 to 1.1. Rates also increased among both sexes, most age groups, all regions and all urbanization levels except for non-core counties. The Midwest witnessed the largest absolute (0.4) and relative (43.7%) regional increases.
Drowning prevention
CDC’s Comprehensive Suicide Prevention Program (CSP) funds 24 programs to implement and evaluate a comprehensive public health approach to suicide prevention. Funding also supports near real-time collection of emergency department data for suicide attempts and suicidal ideation. Suicide is a serious public health problem that can have long-lasting effects on individuals, families, and communities. The CDC Injury Center uses data, research, and partnerships to identify and implement effective suicide prevention strategies to foster healthy and resilient communities across the United States. ††† The unit of analysis was ED visits, not individual patients, and the absence of unique patient identifiers prevents linking ED visits across individual patients to determine the proportions treated in the ED during a single visit versus multiple visits. As an example, a patient treated for nonfatal overdoses in June 2018, October 2018, and March 2019, will reflect three individual ED visits included in the data, analyzed as distinct ED visits.
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