Table 1.

Select surveillance systems for monitoring the opioid epidemic

Topic	Name and owner of system	Brief description
Fatal overdoses	National Vital Statistics System (NVSS) CDC National Center for Health Statistics	• Certified vital registration information on deaths using death certificates from medical examiners/coroners.
Fatal and non-fatal overdoses	Enhanced State Opioid Overdose Surveillance (ESOOS) CDC National Center for Injury Prevention & Control	• Syndromic surveillance system to detect sharp increases or decreases innon-fatal opioid overdoses at the state level using data from emergency department visits and/or EMS transports. Leverages the CDC National Syndromic Surveillance program and other state-based platforms. Some states capture naloxone administration. • Death certificates and medical examiner/coroner reports on risk factors for unintentional and undetermined opioid-related overdose deaths (e.g., route of administration, recent discharge for residential treatment or prison, recent arrest, recent relapse using opioid-related drugs, whether bystanders were present when the overdose occurred, mental health conditions, presence of adulterated drugs, and patterns in polysubstance drug use). Detailed toxicology information identifying the type of drug involved in death. Uses the State Unintentional Drug Overdose Reporting System (SUDORS).
Drug use	National Survey on Drug Use and Health (NSDUH) Substance Use and Mental Health Services Administration (SAMSHA)	• National survey of a representative sample of up to 70,000 household members 12 years or older that provides estimates of substance use in the USA conducted annually. Includes information on alcohol, tobacco and drug use, abuse and dependence, as well as demographic and other data.
Drug use in youth	Youth Risk Behavioral Surveillance System Centers for Disease Control and Prevention	• Conducts biannual, nationally representative surveys in high schools including use of alcohol, marijuana, prescription drugs, and injection drug use; many states conduct population-based surveys using the same or slightly modified data collection instruments.
Prescribing patterns	IMS Health Quintiles	• IMS Health provides estimates of the numbers of prescriptions dispensed in each state based on a sample of pharmacies, which dispense over 85% of retail prescriptions in the USA. Prescriptions, including refills, dispensed at retail pharmacies and paid for by commercial insurance, Medicaid, Medicare, or cash are available.
Prescribing patterns and medical claims	MarketScan Truven Health Analytics	• The MarketScan Multi-State Medicaid database is a weighted and nationally representative sample from 31 million enrollees from 11 geographically dispersed states and contains standardized, fully integrated, enrollee-level de-identified claims across inpatient, outpatient, and prescription drug services for both fee-for-services and capitation plans. • The MarketScan commercial claims database contain standardized, enrollee-level claim information across inpatient, outpatient, and prescription drug services and is weighted to be representative of the roughly 175 million people with employer-sponsored insurance in the USA. • Both the commercial claims and Medicaid databases include the following information on pharmaceutical claims: drug name, date dispensed, therapeutic class, national drug code, quantity dispensed, and days of supply.
Prescribing patterns	Prescription Behavioral Surveillance System (PBSS) CDC, Food and Drug Administration, Bureau of Justice Assistance, Brandeis Center of Excellence on PDMPs	• PBSS collects data from participating state Prescription Drug Monitoring Programs (PDMPs). PDMPs were originally created primarily as a tool for law enforcement to identify patients, prescribers, or dispensers engaged in illegal activities such as drug diversion. More recently, they became sources of information for prescribers on the prescription histories of their patients. • PBSS represents an additional use of PDMP data for public health surveillance. PBSS uses de-identified data from participating states’ PDMPs to measure trends in controlled substance prescribing and dispensing as well as indicators of medical and non-medical use, diversion, and inappropriate prescribing and dispensing.
Drug distribution	Automation of Reports and Consolidated Orders System (ARCOS) Drug Enforcement Agency	• A mandatory reporting system that allows the US DEA to monitor certain controlled substances from the point of manufacture to the point of sale. ARCOS data represent the amount of controlled substances legitimately distributed at the retail level. The number of grams of each monitored substance distributed to pharmacies, practitioners, hospitals, teaching institutions, and narcotics treatment programs in each state is available.
Drug seizure	National Forensic Laboratory Information System (NFLIS) Drug Enforcement Agency	• Systematically collects drug identification results from drug cases submitted for analysis to forensic laboratories.
HIV/AIDS	National HIV Surveillance System National HIV Behavioral Surveillance System Centers for Disease Control and Prevention	• The National HIV Surveillance System systematically collects data and produces annual reports of HIV diagnoses, estimated HIV incidence, mortality, and other HIV indicators on national, state, and selected local jurisdictions levels, stratified by demographic and behavioral factors, including injection drug use. • The National HIV Behavioral Surveillance System is conducted in > 20 cities with groups at high risk for HIV infection, alternating every third year among persons who inject drugs, heterosexuals, and men who have sex with men. This system collects demographic, behavioral, health care, and other information from participants.
Viral hepatitis	National Hepatitis Surveillance System Centers for Disease Control and Prevention	• Routinely collects information from health departments regarding case reports of acute and chronic hepatitis B and C infection, as well as all cases of hepatitis A infection. The majority of cases of acute HCV infection in the nation are attributable to injection drug use.

Italicized text indicates the organization responsible for the data collection system