TABLE 2. Annual number and age-adjusted rate of drug overdose deaths* involving heroin† and synthetic opioids other than methadone,§,¶ by sex, age, race and Hispanic origin,** urbanization level,†† and selected states§§ — United States, 2016 and 2017.
| Decedent characteristic | Heroin |
Synthetic
opioids other than methadone |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2016 |
2017 |
Change from
2016 to 2017¶¶ |
2016 |
2017 |
Change from
2016 to 2017¶¶ |
||||||||
| No. | Rate | No. | Rate | Absolute rate change | % Change in rate | No. | Rate |
No. | Rate | Absolute rate change | % Change in rate | ||
|
All
|
15,469
|
4.9
|
15,482
|
4.9
|
0.0
|
0.0
|
19,413
|
6.2
|
28,466
|
9.0
|
2.8***
|
45.2***
|
|
|
Sex
| |||||||||||||
| Male |
11,752 |
7.5 |
11,596 |
7.3 |
-0.2*** |
-2.7*** |
13,835 |
8.9 |
20,524 |
13.0 |
4.1*** |
46.1*** |
|
| Female |
3,717 |
2.4 |
3,886 |
2.5 |
0.1 |
4.2 |
5,578 |
3.5 |
7,942 |
5.0 |
1.5*** |
42.9*** |
|
|
Age group
(yrs)
| |||||||||||||
| 0–14 |
†††
|
†††
|
†††
|
†††
|
†††
|
†††
|
18 |
†††
|
33 |
0.1 |
†††
|
†††
|
|
| 15–24 |
1,728 |
4.0 |
1,454 |
3.4 |
-0.6*** |
-15.0*** |
1,958 |
4.5 |
2,655 |
6.1 |
1.6*** |
35.6*** |
|
| 25–34 |
5,051 |
11.3 |
4,890 |
10.8 |
-0.5*** |
-4.4*** |
6,094 |
13.6 |
8,825 |
19.5 |
5.9*** |
43.4*** |
|
| 35–44 |
3,625 |
9.0 |
3,713 |
9.1 |
0.1 |
1.1 |
4,825 |
11.9 |
7,084 |
17.3 |
5.4*** |
45.4*** |
|
| 45–54 |
3,009 |
7.0 |
3,043 |
7.2 |
0.2 |
2.9 |
3,872 |
9.1 |
5,762 |
13.6 |
4.5*** |
49.5*** |
|
| 55–64 |
1,777 |
4.3 |
2,005 |
4.8 |
0.5*** |
11.6*** |
2,238 |
5.4 |
3,481 |
8.3 |
2.9*** |
53.7*** |
|
| ≥65 |
275 |
0.6 |
368 |
0.7 |
0.1*** |
16.7*** |
405 |
0.8 |
620 |
1.2 |
0.4*** |
50.0*** |
|
|
Sex and age
group (yrs)
| |||||||||||||
| Male 15–24 |
1,275 |
5.7 |
1,031 |
4.7 |
-1.0*** |
−17.5*** |
1,434 |
6.4 |
1,877 |
8.5 |
2.1*** |
32.8*** |
|
| Male 25–44 |
6,643 |
15.5 |
6,428 |
14.8 |
-0.7*** |
−4.5*** |
8,029 |
18.8 |
11,693 |
27.0 |
8.2*** |
43.6*** |
|
| Male 45–64 |
3,599 |
8.8 |
3,830 |
9.3 |
0.5*** |
5.7*** |
4,116 |
10.0 |
6,524 |
15.8 |
5.8*** |
58.0*** |
|
| Female 15–24 |
453 |
2.1 |
423 |
2.0 |
-0.1 |
−4.8 |
524 |
2.5 |
778 |
3.7 |
1.2*** |
48.0*** |
|
| Female 25–44 |
2,033 |
4.8 |
2,175 |
5.1 |
0.3*** |
6.3*** |
2,890 |
6.8 |
4,216 |
9.8 |
3.0*** |
44.1*** |
|
| Female 45–64 |
1,187 |
2.8 |
1,218 |
2.8 |
0.0 |
0.0 |
1,994 |
4.6 |
2,719 |
6.3 |
1.7*** |
37.0*** |
|
|
Race and
Hispanic origin**
| |||||||||||||
| White, non-Hispanic |
11,631 |
6.3 |
11,293 |
6.1 |
-0.2*** |
−3.2*** |
15,143 |
8.2 |
21,956 |
11.9 |
3.7*** |
45.1*** |
|
| Black, non-Hispanic |
1,899 |
4.5 |
2,140 |
4.9 |
0.4*** |
8.9*** |
2,391 |
5.6 |
3,832 |
9.0 |
3.4*** |
60.7*** |
|
| Hispanic |
1,555 |
2.8 |
1,669 |
2.9 |
0.1 |
3.6 |
1,505 |
2.7 |
2,152 |
3.7 |
1.0*** |
37.0*** |
|
| American Indian/Alaska Native,
non-Hispanic |
131 |
5.0 |
136 |
5.2 |
0.2 |
4.0 |
113 |
4.1 |
171 |
6.5 |
2.4*** |
58.5*** |
|
| Asian/Pacific Islander,
non-Hispanic |
102 |
0.5 |
119 |
0.5 |
0.0 |
0.0 |
134 |
0.6 |
189 |
0.8 |
0.2*** |
33.3*** |
|
|
County
urbanization level††
| |||||||||||||
| Large central metro |
5,507 |
5.3 |
5,820 |
5.6 |
0.3*** |
5.7*** |
6,009 |
5.8 |
8,511 |
8.2 |
2.4*** |
41.4*** |
|
| Large fringe metro |
4,623 |
6.1 |
4,526 |
5.8 |
-0.3*** |
-4.9*** |
6,264 |
8.2 |
8,991 |
11.6 |
3.4*** |
41.5*** |
|
| Medium metro |
3,077 |
4.9 |
2,973 |
4.6 |
-0.3*** |
-6.1*** |
3,978 |
6.3 |
6,254 |
9.8 |
3.5*** |
55.6*** |
|
| Small metro |
990 |
3.7 |
972 |
3.6 |
-0.1 |
-2.7 |
1,270 |
4.7 |
1,878 |
7.0 |
2.3*** |
48.9*** |
|
| Micropolitan (nonmetro) |
860 |
3.6 |
801 |
3.3 |
-0.3 |
-8.3 |
1,228 |
5.0 |
1,860 |
7.7 |
2.7*** |
54.0*** |
|
| Noncore (nonmetro) |
412 |
2.6 |
390 |
2.4 |
-0.2 |
-7.7 |
664 |
4.1 |
972 |
6.0 |
1.9*** |
46.3*** |
|
|
Selected
states§§
| |||||||||||||
|
States with
very good to excellent reporting (n = 27)
| |||||||||||||
| Alaska |
49 |
6.5 |
36 |
4.9 |
-1.6 |
-24.6 |
†††
|
†††
|
37 |
4.9 |
†††
|
†††
|
|
| Connecticut |
450 |
13.1 |
425 |
12.4 |
-0.7 |
-5.3 |
500 |
14.8 |
686 |
20.3 |
5.5*** |
37.2*** |
|
| District of Columbia |
122 |
17.3 |
127 |
18.0 |
0.7 |
4.0 |
129 |
19.2 |
182 |
25.7 |
6.5*** |
33.9*** |
|
| Georgia |
226 |
2.2 |
263 |
2.6 |
0.4 |
18.2 |
277 |
2.7 |
419 |
4.1 |
1.4*** |
51.9*** |
|
| Hawaii |
20 |
1.4 |
10 |
†††
|
†††
|
†††
|
†††
|
†††
|
†††
|
†††
|
†††
|
†††
|
|
| Illinois |
1,040 |
8.2 |
1,187 |
9.2 |
1.0*** |
12.2*** |
907 |
7.2 |
1,251 |
9.8 |
2.6*** |
36.1*** |
|
| Iowa |
47 |
1.7 |
61 |
2.1 |
0.4 |
23.5 |
58 |
2.0 |
92 |
3.2 |
1.2¶¶ |
60.0¶¶ |
|
| Maine |
55 |
4.7 |
76 |
6.2 |
1.5 |
31.9 |
199 |
17.3 |
278 |
23.5 |
6.2*** |
35.8*** |
|
| Maryland |
650 |
10.7 |
522 |
8.6 |
-2.1*** |
-19.6*** |
1,091 |
17.8 |
1,542 |
25.2 |
7.4*** |
41.6*** |
|
| Massachusetts |
630 |
9.5 |
466 |
7.0 |
-2.5*** |
-26.3*** |
1,550 |
23.5 |
1,649 |
24.5 |
1.0 |
4.3 |
|
| Nevada |
86 |
2.9 |
94 |
3.1 |
0.2 |
6.9 |
53 |
1.7 |
66 |
2.2 |
0.5 |
29.4 |
|
| New Hampshire |
34 |
2.8 |
28 |
2.4 |
-0.4 |
-14.3 |
363 |
30.3 |
374 |
30.4 |
0.1 |
0.3 |
|
| New Mexico |
161 |
8.2 |
144 |
7.4 |
-0.8 |
-9.8 |
78 |
4.0 |
75 |
3.7 |
-0.3 |
-7.5 |
|
| New York |
1,307 |
6.5 |
1,356 |
6.8 |
0.3 |
4.6 |
1,641 |
8.3 |
2,238 |
11.3 |
3.0*** |
36.1*** |
|
| North Carolina |
544 |
5.7 |
537 |
5.6 |
-0.1 |
-1.8 |
601 |
6.2 |
1,285 |
13.2 |
7.0*** |
112.9*** |
|
| Ohio |
1,478 |
13.5 |
1,000 |
9.2 |
-4.3*** |
-31.9*** |
2,296 |
21.1 |
3,523 |
32.4 |
11.3*** |
53.6*** |
|
| Oklahoma |
53 |
1.4 |
61 |
1.6 |
0.2 |
14.3 |
98 |
2.5 |
102 |
2.6 |
0.1 |
4.0 |
|
| Oregon |
114 |
2.9 |
124 |
3.0 |
0.1 |
3.4 |
43 |
1.1 |
85 |
2.1 |
1.0*** |
90.9*** |
|
| Rhode Island |
25 |
2.5 |
14 |
†††
|
†††
|
†††
|
182 |
17.8 |
201 |
20.1 |
2.3 |
12.9 |
|
| South Carolina |
115 |
2.5 |
153 |
3.2 |
0.7 |
28.0 |
237 |
5.0 |
404 |
8.5 |
3.5*** |
70.0*** |
|
| Tennessee |
260 |
4.1 |
311 |
4.8 |
0.7 |
17.1 |
395 |
6.2 |
590 |
9.3 |
3.1*** |
50.0*** |
|
| Utah |
166 |
5.6 |
147 |
4.8 |
-0.8 |
-14.3 |
72 |
2.5 |
92 |
3.1 |
0.6 |
24.0 |
|
| Vermont |
45 |
8.7 |
41 |
7.3 |
-1.4 |
-16.1 |
53 |
10.1 |
77 |
13.8 |
3.7 |
36.6 |
|
| Virginia |
450 |
5.5 |
556 |
6.7 |
1.2*** |
21.8*** |
648 |
7.9 |
829 |
10.0 |
2.1*** |
26.6*** |
|
| Washington |
283 |
3.9 |
306 |
4.0 |
0.1 |
2.6 |
93 |
1.3 |
143 |
1.9 |
0.6*** |
46.2*** |
|
| West Virginia |
235 |
14.9 |
244 |
14.9 |
0.0 |
0.0 |
435 |
26.3 |
618 |
37.4 |
11.1*** |
42.2*** |
|
| Wisconsin |
389 |
7.3 |
414 |
7.8 |
0.5 |
6.8 |
288 |
5.3 |
466 |
8.6 |
3.3*** |
62.3*** |
|
|
States with
good reporting (n = 8)
| |||||||||||||
| Arizona |
299 |
4.5 |
334 |
5.0 |
0.5 |
11.1 |
123 |
1.8 |
267 |
4.0 |
2.2*** |
122.2*** |
|
| California |
587 |
1.4 |
715 |
1.7 |
0.3*** |
21.4*** |
355 |
0.9 |
536 |
1.3 |
0.4*** |
44.4*** |
|
| Colorado |
234 |
4.2 |
224 |
3.9 |
-0.3 |
-7.1 |
72 |
1.3 |
112 |
2.0 |
0.7*** |
53.8*** |
|
| Kentucky |
311 |
7.6 |
269 |
6.6 |
-1.0 |
-13.2 |
465 |
11.5 |
780 |
19.1 |
7.6*** |
66.1*** |
|
| Michigan |
727 |
7.6 |
783 |
8.2 |
0.6 |
7.9 |
921 |
9.8 |
1,368 |
14.4 |
4.6*** |
46.9*** |
|
| Minnesota |
149 |
2.8 |
111 |
2.0 |
-0.8*** |
-28.6*** |
99 |
1.9 |
184 |
3.5 |
1.6*** |
84.2*** |
|
| Missouri |
380 |
6.7 |
299 |
5.3 |
-1.4*** |
-20.9*** |
441 |
7.8 |
618 |
10.9 |
3.1*** |
39.7*** |
|
| Texas | 530 | 1.9 | 569 | 2.0 | 0.1 | 5.3 | 250 |
0.9 | 348 | 1.2 | 0.3*** | 33.3*** | |
Source: National Vital Statistics System, Mortality file.
* Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Rates are age-adjusted using the direct method and the 2000 U.S. standard population, except for age-specific crude rates. All rates are per 100,000 population.
† Drug overdose deaths, as defined, that have heroin (T40.1) as a contributing cause.
§ Drug overdose deaths, as defined, that have semisynthetic opioids other than methadone (T40.4) as a contributing cause.
¶ Categories of deaths are not exclusive as deaths might involve more than one drug. Summing of categories will result in more than the total number of deaths in a year.
** Data on Hispanic origin should be interpreted with caution; studies comparing Hispanic origin on death certificates and on census surveys have shown inconsistent reporting on Hispanic ethnicity. Potential race misclassification might lead to underestimates for certain categories, primarily American Indian/Alaska Native non-Hispanic and Asian/Pacific Islander non-Hispanic decedents. https://www.cdc.gov/nchs/data/series/sr_02/sr02_172.pdf.
†† By 2013 urbanization classification (https://www.cdc.gov/nchs/data_access/urban_rural.htm).
§§ Analyses were limited to states meeting the following criteria. For states with very good to excellent reporting, ≥90% of drug overdose deaths mention at least one specific drug in 2016, with the change in drug overdose deaths mentioning at least one specific drug differing by <10 percentage points from 2016 to 2017. States with good reporting had 80% to <90% of drug overdose deaths mention at least one specific drug in 2016, with the change in the percentage of drug overdose deaths mentioning at least one specific drug differing by <10 percentage points from 2016 to 2017. States included also were required to have stable rate estimates, based on ≥20 deaths, in at least two drug categories (i.e., opioids, prescription opioids, synthetic opioids other than methadone, and heroin).
¶¶ Absolute rate change is the difference between 2016 and 2017 rates. Percent change is the absolute rate change divided by the 2016 rate, multiplied by 100. Nonoverlapping confidence intervals based on the gamma method were used if the number of deaths was <100 in 2016 or 2017, and z-tests were used if the number of deaths was ≥100 in both 2016 and 2017. Note that the method of comparing confidence intervals is a conservative method for statistical significance; caution should be observed when interpreting a nonsignificant difference when the lower and upper limits being compared overlap only slightly. Confidence intervals of 2016 and 2017 rates of synthetic opioid-involved deaths in Iowa overlapped only slightly: (1.40, 2.39), (2.36, 3.59).
*** Statistically significant (P-value <0.05).
††† Cells with ≤9 deaths are not reported. Rates based on <20 deaths are not considered reliable and are not reported.