This data visualization presents county-level provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. County-level 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. Provisional counts are often incomplete and causes of death may be pending investigation resulting in an underestimate relative to final counts (see Technical Notes). The provisional data presented on the dashboard below include reported 12 month-ending provisional counts of death due to drug overdose by the decedent’s county of residence and the month in which death occurred. Percentages of deaths with a cause of death pending further investigation and a note on historical completeness (e.g. if the percent completeness was under 90% after 6 months) are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical Notes). Counts between 1-9 are suppressed in accordance with NCHS confidentiality standards. Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Technical Notes Nature and Sources of Data Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics (NCHS) as of a specified cutoff date. The cutoff date is generally the first Sunday of each month. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from the 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 and jurisdiction in which the death occurred. 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 due to the time often needed to investigate these deaths (1). 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. For example, the 12 month-ending period in June 2020 would include deaths occurring from July 1, 2019 through June 30, 2020. The 12 month-ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and 12 month-ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Cause of Death Classification and Definition of Drug Deaths Mortality statistics are compiled in accordance with the World Health Organizations (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. 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 regul

This dataset provides model-based provisional estimates of the weekly numbers of drug overdose, suicide, and transportation-related deaths using “nowcasting” methods to account for the normal lag between the occurrence and reporting of these deaths. Estimates less than 10 are suppressed. These early model-based provisional estimates were generated using a multi-stage hierarchical Bayesian modeling process to generate smoothed estimates of the weekly numbers of death, accounting for reporting lags. These estimates are based on several assumptions about how the reporting lags have changed in recent months across different jurisdictions, and the resulting estimates differ from other sources of provisional mortality data. For now, these estimates should be considered highly uncertain until further evaluations can be done to determine the validity of these assumptions about timeliness. The true patterns in reporting lags will not be known until data are finalized, typically 11–12 months after the end of the calendar year. Importantly, these estimates are not a replacement for monthly provisional drug overdose death counts, or quarterly provisional mortality estimates. For more detail about the nowcasting methods and models, see: Rossen LM, Hedegaard H, Warner M, Ahmad FB, Sutton PD. Early provisional estimates of drug overdose, suicide, and transportation-related deaths: Nowcasting methods to account for reporting lags. Vital Statistics Rapid Release; no 11. Hyattsville, MD: National Center for Health Statistics. February 2021. DOI: https://doi.org/10.15620/ cdc:101132

NOTES: Figures include all revisions received from the states and, therefore, may differ from those previously published. Data are provisional and are subject to monthly reporting variation. National data are calculated by summing the number of events reported by state of residence; counts are rounded to the nearest thousand (births and deaths) or hundred (infant deaths). Provisional counts may differ by approximately 2% from final counts, due to rounding and reporting variation. Additionally, the accuracy of the provisional counts may change over time. Data are estimates by state of residence. For discussion of the nature, source, and limitations of the data, see "Technical Notes" of the report, Births, Marriages, Divorces, and Deaths: Provisional Data for 2009. Available from URL: http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_25.htm. Final counts of births, deaths, and infant deaths for previous years can be obtained from http://wonder.cdc.gov. SOURCE: Provisional data from the National Vital Statistics System, National Center for Health Statistics, CDC.

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning from 1999 to 2015. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Estimates should be interpreted with caution. Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year during 1999–2015. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2016 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. 2. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. 2. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning from 1999 to 2015. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Estimates should be interpreted with caution. Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year during 1999–2015. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).

This dataset contains model-based county estimates for drug-poisoning mortality. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2016 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates for 1999-2015 have been updated, and may differ slightly from previously published estimates. Differences are expected to be minimal, and may result from different county boundaries used in this release (see below) and from the inclusion of an additional year of data. Previously published estimates can be found here for comparison.(6) Estimates are unavailable for Broomfield County, Colorado, and Denali County, Alaska, before 2003 (7,8). Additionally, Clifton Forge County, Virginia only appears on the mortality files prior to 2003, while Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. These counties were therefore merged with adjacent counties where necessary to create a consistent set of geographic units across the time period. County boundaries are largely consistent with the vintage 2005-2007 bridged-race population file geographies, with the modifications noted previously (7,8). REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. 2. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html. 3. Rossen LM, Khan D, Warner M. Trends and geographic patterns in drug-poisoning death rates in the U.S., 1999–2009. Am J Prev Med 45(6):e19–25. 2013. 4. Rossen LM, Khan D, Warner M. Hot spots in mortality from drug poisoning in the United States, 2007–2009. Health Place 26:14–20. 2014. 5. Rossen LM, Khan D, Hamilton B, Warner M. Spatiotemporal variation in selected health outcomes from the National Vital Statistics System. Presented at: 2015 National Conference on Health Statistics, August 25, 2015, Bethesda, MD. Available from: http://www.cdc.gov/nchs/ppt/nchs2015/Rossen_Tuesday_WhiteOak_BB3.pdf. 6. Rossen LM, Bastian B, Warner M, and Khan D. NCHS – Drug Poisoning Mortality by County: United States, 1999-2015. Available from: https://data.cdc.gov/NCHS/NCHS-Drug-Poisoning-Mortality-by-County-United-Sta/pbkm-d27e. 7. National Center for Health Statistics. County geog

,This table provides Canadians and researchers with provisional data to monitor weekly death trends by selected grouped causes of death in Canada. Given the delays in receiving the data from the provincial and territorial vital statistics offices, these data are considered provisional. Data in this table will be available by province and territory.,