The NEDS transition from ICD-9-CM to ICD-10-CM/PCS codes probably affected comparisons between overdose ED visits from 2015 to 2016 and also precluded us from performing comparisons in earlier years. To minimize the transition’s impact, we included all overdose intents since the transition modified coding guidelines, and previous analyses of overdose data have shown drastic differences across the transition by intent 25–27. We also conducted sensitivity analyses comparing the fourth quarter of 2015 to the fourth quarter of 2016, both of which used ICD-10-CM codes, and found similar results (data not shown). Because of the time lag in NEDS data, we were unable to compare the exact most recent years in both ED and mortality data. Finally, there is overlap in the involvement of synthetic opioid- and heroin-involved overdose deaths presented in Table 4 (e.g. deaths involving cocaine and heroin do not exclude deaths involving cocaine, heroin and synthetic opioids).
About Overdose Prevention
Relative and absolute rates of opioid-involved overdoses increased among persons living in both urban (13.6%; 16.9) and rural counties (10.1%; 6.1), as did rates of amphetamine-involved overdoses (21.7%; 1.3, urban and 20.8%; 1.9, rural). Number and age-adjusted ratesa of cocaine and psychostimulant overdose deaths with synthetic opioids other than methadone and heroin, by sex, age, Census region and level of urbanization—United States, 2016 and 2017. NEDS transitioned from using International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) diagnosis codes to International Classification of Diseases, 10th revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) on 1 October 2015. For non-fatal drug overdoses, ICD-9-CM codes were used to classify drug overdoses for 2006–14 and the first three quarters of 2015. These included codes for cocaine, amphetamine, other psychostimulants and opioids (Supporting information, Table S1).
For Public Health Professionals
Stigma can be a major barrier to how well prevention and treatment programs work amid the opioid crisis. When we act early, we can prevent illegal substance use, including illegal opioids, and misuse of prescription medications, like opioids, that can lead to substance use disorders. See the full list of strategies in CDC’s Evidence-Based Strategies for Preventing Opioid Overdose (PDF – 40 page). Each featured strategy includes why the strategy works, when it works best, a trailblazer example, and supporting research. Potential opportunities to link people to care or to implement life-saving actions were present for more than 3 in 5 people who died from drug overdose.
Quick Facts: Cocaine
Rates of overdoses involving opioids, cocaine, and amphetamines increased 9.7%, 11.0%, and 18.3%, respectively, and the rate of benzodiazepine-involved overdoses decreased 3.0%. Overdoses co-involving opioids and amphetamines increased from 2018 to 2019, overall, in both sexes, and in most age groups. In 2019, 23.6%, 17.1%, and 18.7% of overdoses involving cocaine, amphetamine, and benzodiazepines, respectively, also involved opioids. Expanding overdose prevention, treatment, and response efforts is needed to reduce the number of drug and polydrug overdoses.
Identifying emergency department visits and overdose deaths with and without opioids
This also underscores the importance of naloxone access not onlyamong individuals knowingly using opioids, but also among individuals using other illicit drugs that might be contaminated with IMF 16. In 2017, among 70,237 drug overdose deaths that occurred in the United States, 13,942 (19.8%) involved cocaine, representing a 34.4% increase from 2016 (Table). Nearly three fourths (72.7%) of cocaine-involved deaths in 2017 also involved opioids.
- Rates also increased among both sexes, most age groups, all regions and all urbanization levels except for non-core counties.
- In contrast to mortality data, cocaine overdose ED visits without an opioid decreased 13.6% from 2015 to 2016.
- 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.
- The resources come from two new Overdose Data to Action (OD2A) funding opportunities and fill a longstanding gap in funding for local communities by specifically supporting city, county, and territorial health departments.
Expanding coverage to include all ED visits in the United States would help further identify certain population characteristics and geographic regions that should be prioritized for prevention, treatment, and response efforts. The increases observed in polydrug overdose rates highlight the complexity of the overdose epidemic and the need to intervene more rapidly before nonfatal polydrug overdoses increase further or result in fatal overdoses. EDs provide an opportunity to intervene and link persons into treatment, harm reduction services, and other community-based programs. While increases in cocaine-involved deaths in the United States from 2006 seem to be driven by opioids, particularly synthetic opioids, increases in non-fatal and fatal overdoses involving psychostimulants are occurring with and without opioids. During 2015–2016, age-adjusted cocaine-involved and psychostimulant-involved death rates increased by 52.4% and 33.3%, respectively. Illicitly manufactured fentanyls, heroin, cocaine, or methamphetamine (alone or in combination) were involved in nearly 85% of drug overdose deaths in 24 states and the District of Columbia during January–June 2019.
- If a person who has had an overdose is seen in the ED, there is an opportunity to help prevent a repeat overdose by linking an individual to care that can improve their health outcomes.
- In 2019, 23.6% of overdoses involving cocaine, 17.1% involving amphetamines, and 18.7% involving benzodiazepines also involved opioids.
- CDC is headquartered in Atlanta and has experts located throughout the United States and the world.
- For non-fatal drug overdoses, ICD-9-CM codes were used to classify drug overdoses for 2006–14 and the first three quarters of 2015.
Rates also decreased among both sexes, most age groups, all regions except the West and in large central metro (−30.0%) and non-metro counties micropolitan (−23.4%) and non-core (−36.6%). The West wasthe only region to experience an increase, although the absolute increase was small (0.2). Number and age-adjusted ratesa of cocaine and psychostimulant overdose emergency department visits with and without opioids, by sex, age, Census region and level of urbanization—United States, 2015 and 2016. Data on non-fatal drug overdoses for 2006–16 were obtained from the Healthcare Cost and Utilization Project’s Nationwide Emergency Department Sample (NEDS) 10. NEDS is an annual stratified sample of billing records that is weighted to produce nationally representative estimates of non-federal, hospital-based emergency department (ED) visits in the United States.
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.
Opioid-involved overdose deaths1
Continued increases in stimulant-involved deaths require expanded surveillance and comprehensive, evidence-based public health and public safety interventions. In 2017, a total of 967,615 nonfatal drug overdoses were treated in U.S. emergency departments (EDs); polydrug ED-treated overdoses increased from 2017 to 2018. ED visits for psychostimulant overdose without an opioid also increased from 2015 to 2016. The West has historically had higher methamphetamine use rates 17, and experienced particularly large increases in ED visits for psychostimulant overdose from 2015 to 2016. This is probably attributable to a shift in production of methamphetamine by Mexican cartels in recent years after a decline in US domestic production following laws limiting access to methamphetamine precursors, pseudoephedrine, phenylpropanolamine and ephedrine 18,19.
However, the increasing mortality resulting from stimulant use warrants further analysis, including a longer history of PA PDMP data, enhanced monitoring as new data become available, and investigation of risk factors outside of controlled substance prescribing. In addition, some persons who use opioids have reported that they also use stimulants to compensate for the effects of synthetic opioids (e.g., fentanyl), thereby improving alertness and their ability to function, and this polysubstance use also warrants further exploration (8). Occupations and industries with higher percentages of cocaine involvement were those often considered to be less physically strenuous. Occupations with the highest percentages of synthetic opioid-involved overdoses involving cocaine were healthcare support (34.2%); community and social services (33.5%); business and financial (31.6%); legal (31.5%); and protective services (30.5%). Deaths involving cocaine and opioids increased more than cocaine deaths without an opioid from 2016 to 2017, suggesting that the opioid overdose epidemic is contributing to recent increases in cocaine-involved deaths. Data from 2016 to 2017 on psychostimulant-involved deaths with and without opioids also point to increasing opioid involvement.
This fast-moving epidemic does not distinguish among age, sex, or state or county lines. If a person who has had an overdose is seen in the ED, there is an opportunity to help prevent a repeat overdose by linking an individual to care that can improve their health outcomes. Pre-overdose opioid prescribing is a risk marker for fatal overdose from opioids alone, stimulants alone, or both; pre-overdose stimulant prescribing might not be a risk marker for fatal overdose attributable to stimulants. Identifying risk factors specific to stimulant misuse could better guide development of harm reduction practices stimulant overdose drug overdose cdc injury center to prevent fatal stimulant-related overdoses. Non-research funding is used to support drug overdose surveillance and programmatic efforts by funding jurisdictions comprised of state, territorial, county, and city health departments through Overdose Data to Action (OD2A).
Drug overdose deaths, as defined, that have psychostimulantswith abuse potential (T43.6) and do not have an opioid (T40.0, T40.1, T40.2, T40.3, T40.4 or T40.6) as a contributing cause. Stimulants include methamphetamine, cocaine, crack cocaine, and amphetamines, such as medications prescribed for the treatment of ADHD. Timely data help improve coordination and promote readiness among health departments, community members, healthcare providers, public health, law enforcement, and government agencies, for regional or multiple state overdose increases. Ways to prevent opioid overdose are to improve opioid prescribing, reduce exposure to opioids, prevent illegal opioid use and prescription opioid misuse, and treat opioid use disorder. There are strategies that can help prevent overdose and support the health and well-being of communities. § ICD-10 multiple cause of death code T43.6, poisoning by psychostimulants with abuse potential, includes poisoning by substances such as methamphetamine, amphetamine, methylphenidate, and MDMA and excludes poisoning by cocaine.
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