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12 Month-ending Provisional Number of Drug Overdose Deaths by Drug or Drug Class.” As a result of this re-evaluation, trends for additional states are presented in Figure 2. Differences between final and provisional dataRecent improvements in timeliness and data quality have prompted a re-evaluation of the length of time that data quality requirements have had to be met for states to be included in “Figure 2. Data Quality Measures for All Jurisdictions Percent of records pending investigation Selection of specific states and other jurisdictions to report Cause-of-death classification and definition of drug deaths
Provisional counts are often incomplete and causes of death may be pending investigation (see Technical notes) resulting in an underestimate relative to final counts. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Counts for the most recent final annual data are provided for comparison. Please see the Technical Notes of the dashboard for more information.This data visualization presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System.
Deaths are reported by the jurisdiction in which the death occurred.Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical notes). These counts include all seasons of the year and are insensitive to variations by seasonality. The reported and predicted provisional counts represent the numbers of deaths due to drug overdose occurring in the 12-month periods ending in the month indicated. Map of the percentage changes in provisional drug overdose deaths for the current 12 month-ending period compared with the 12-month period ending in the same month of the previous year, by jurisdiction and (c) the reported and predicted provisional counts of drug overdose deaths involving specific drugs or drug classes occurring nationally and in selected jurisdictions.
For example, the 12-month ending period in June 2017 would include deaths occurring from July 1, 2016, through June 30, 2017. Thus, provisional estimates of drug overdose deaths are reported 6 months after the date of death.Provisional death counts presented in this data visualization are for “12-month ending periods,” defined as the number of deaths occurring in the 12-month period ending in the month indicated. The lag time (i.e., the time between when the death occurred and when the data are available for analysis) is longer for drug overdose deaths compared with other causes of death ( 1). NCHS receives the death records from state vital registration offices through the Vital Statistics Cooperative Program (VSCP).The timeliness of provisional mortality surveillance data in the National Vital Statistics System (NVSS) database varies by cause of death. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. The cutoff date is generally the first Sunday of each month.
Therefore, they should not be considered comparable with final data and are subject to change. Methods to adjust provisional counts have been developed to provide predicted provisional counts of drug overdose deaths ( 2) , accounting for delayed reporting (see Percentage of records pending investigation and Adjustments for delayed reporting).Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12-month ending period. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Counts for the 12-month period ending in the same month of the previous year are shown for comparison.
Opioid overdose deaths are identified by the presence of any of the following MCOD codes: opium (T40.0) heroin (T40.1) natural opioid analgesics (T40.2) methadone (T40.3) synthetic opioid analgesics other than methadone (T40.4) or other and unspecified narcotics (T40.6). Drug categories presented include: heroin (T40.1) natural opioid analgesics, including morphine and codeine, and semisynthetic opioids, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone (T40.2) methadone, a synthetic opioid (T40.3) synthetic opioid analgesics other than methadone, including drugs such as fentanyl and tramadol (T40.4) cocaine (T40.5) and psychostimulants with abuse potential, which includes methamphetamine (T43.6). Drug overdose deaths involving selected drug categories are identified by specific multiple cause-of-death codes. Causes of death for data presented in this report were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual ( 3).Drug overdose deaths are identified using underlying cause-of-death codes from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined). It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on use of the classification. ICD provides the basic guidance used in virtually all countries to code and classify causes of death.
Selection of specific states and other jurisdictions to reportProvisional counts are presented by the jurisdiction in which the death occurred (i.e., the reporting jurisdiction). For example, a death that involved both heroin and fentanyl would be included in both the number of drug overdose deaths involving heroin and the number of drug overdose deaths involving synthetic opioids other than methadone. These new categories, which are a combination of existing categories, are not displayed on the default figure to facilitate ease of display of the main drug categories, but are accessible through the drop-down box that allows for selection of specific drug categories.Drug overdose deaths may involve multiple drugs therefore, a single death might be included in more than one category when describing the number of drug overdose deaths involving specific drugs. Two additional categories were added based on CDC’s Opioid Overdose Indicator Support Toolkit ( 6): drug overdose deaths involving natural, semi-synthetic, or synthetic opioids, including methadone (T40.2–T40.4) drug overdose deaths involving natural and semi-synthetic opioids, and methadone (T40.2–T40.3). Among deaths with an underlying cause of drug overdose, the percentage with at least one drug or drug class specified is defined as that with at least one ICD–10 multiple cause-of-death code in the range T36–T50.8.
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