TABLE. Demographics and characteristics of drug overdose deaths involving illicitly manufactured fentanyls,* by geographic region† — State Unintentional Drug Overdose Reporting System, 40 jurisdictions,§ 2020.
| Characteristic | No. (%) |
||||
|---|---|---|---|---|---|
| Northeast | Midwest | South | West | Total | |
|
Among all decedents
| |||||
|
Total
|
10,502
|
7,350
|
12,304
|
3,540
|
33,696
|
|
Gender¶
| |||||
| Male |
7,872 (75.0) |
5,303 (72.1) |
8,816 (71.7) |
2,609 (73.7) |
24,600 (73.0)
|
| Female |
2,630 (25.0) |
2,047 (27.9) |
3,488 (28.3) |
931 (26.3) |
9,096 (27.0)
|
| Unknown/Missing |
0 (—) |
0 (—) |
0 (—) |
0 (—) |
0 (—)
|
|
Age group, yrs¶
| |||||
| Median (IQR) |
40 (32–51) |
39 (31–51) |
39 (31–50) |
33 (26–43) |
39 (31–50)
|
| <15 |
—** |
—** |
13 (0.1) |
21 (0.6) |
47 (0.1)
|
| 15–24 |
623 (5.9) |
636 (8.7) |
971 (7.9) |
750 (21.2) |
2,980 (8.8)
|
| 25–34 |
2,791 (26.6) |
2,052 (27.9) |
3,474 (28.2) |
1,110 (31.4) |
9,427 (28.0)
|
| 35–44 |
2,914 (27.8) |
1,863 (25.4) |
3,379 (27.5) |
833 (23.5) |
8,989 (26.7)
|
| 45–54 |
2,210 (21.0) |
1,474 (20.1) |
2,396 (19.5) |
470 (13.3) |
6,550 (19.4)
|
| 55–64 |
1,620 (15.4) |
1,065 (14.5) |
1,724 (14.0) |
305 (8.6) |
4,714 (14.0)
|
| ≥65 |
338 (3.2) |
250 (3.4) |
345 (2.8) |
50 (1.4) |
983 (2.9)
|
| Unknown/Missing |
—** |
—** |
—** |
—** |
—**
|
|
Race/Ethnicity¶
| |||||
| White, non-Hispanic |
7,297 (70.4) |
4,599 (62.9) |
8,444 (69.2) |
1,905 (54.3) |
22,245 (66.6)
|
| Black, non-Hispanic |
1,622 (15.6) |
2,010 (27.5) |
3,072 (25.2) |
289 (8.2) |
6,993 (20.9)
|
| AI/AN, non-Hispanic |
23 (0.2) |
92 (1.3) |
103 (0.8) |
154 (4.4) |
372 (1.1)
|
| A/OPI, non-Hispanic |
65 (0.6) |
38 (0.5) |
60 (0.5) |
45 (1.3) |
208 (0.6)
|
| Multiple races, non-Hispanic |
49 (0.5) |
63 (0.9) |
71 (0.6) |
60 (1.7) |
243 (0.7)
|
| Hispanic |
1,316 (12.7) |
504 (6.9) |
455 (3.7) |
1,054 (30.1) |
3,329 (10.0)
|
| Unknown/Missing |
130 |
44 |
99 |
33 |
306
|
|
Among decedents with data from coroner or medical examiner reports
| |||||
|
Total
|
9,840
|
7,067
|
10,959
|
3,505
|
31,371
|
|
Drug use history††
| |||||
| Illicit opioids |
2,746 (27.9) |
2,689 (38.1) |
3,695 (33.7) |
915 (26.1) |
10,045 (32.0)
|
| Prescription opioids |
462 (4.7) |
522 (7.4) |
889 (8.1) |
832 (23.7) |
2,705 (8.6)
|
| Unspecified opioids |
657 (6.7) |
389 (5.5) |
473 (4.3) |
223 (6.4) |
1,742 (5.6)
|
| Cocaine |
923 (9.4) |
804 (11.4) |
1,282 (11.7) |
355 (10.1) |
3,364 (10.7)
|
| Methamphetamine |
229 (2.3) |
392 (5.5) |
572 (5.2) |
441 (12.6) |
1,634 (5.2)
|
| Other |
3,684 (37.4) |
2,222 (31.4) |
3,916 (35.7) |
1,150 (32.8) |
10,972 (35.0)
|
|
Route of drug use
§§
| |||||
| Injection |
2,238 (22.7) |
1,691 (23.9) |
3,353 (30.6) |
411 (11.7) |
7,693 (24.5)
|
| No injection reported; snorting, smoking, or ingestion reported |
1,887 (19.2) |
1,865 (26.4) |
2,756 (25.1) |
2,002 (57.1) |
8,510 (27.1)
|
| No injection; snorting |
1,017 (10.3) |
931 (13.2) |
1,520 (13.9) |
835 (23.8) |
4,303 (13.7)
|
| No injection; smoking |
628 (6.4) |
628 (8.9) |
962 (8.8) |
987 (28.2) |
3,205 (10.2)
|
| No injection; ingestion |
467 (4.7) |
774 (11.0) |
914 (8.3) |
1,012 (28.9) |
3,167 (10.1)
|
| No reported route of drug use |
5,708 (58.0) |
3,507 (49.6) |
4,841 (44.2) |
1,087 (31.0) |
15,143 (48.3)
|
|
Evidence of counterfeit pills
|
23 (0.2) |
63 (0.9) |
46 (0.4) |
466 (13.3) |
598 (1.9)
|
|
Documentation of no pulse at first responder arrival¶
|
4,789 (48.8) |
2,832 (40.3) |
7,410 (69.4) |
2,354 (67.8) |
17,385 (56.1)
|
|
Potential bystander present¶
|
4,262 (43.3) |
2,931 (41.5) |
6,053 (55.2) |
2,234 (63.7) |
15,480 (49.3)
|
|
Potential bystander present but no documented overdose response efforts
¶¶
|
2,860 (29.1) |
2,271 (32.1) |
4,212 (38.4) |
1,528 (43.6) |
10,871 (34.7)
|
| Did not recognize abnormalities |
230 (8.0) |
288 (12.7) |
293 (7.0) |
209 (13.7) |
1,020 (9.4)
|
| Recognized abnormalities but not as overdose |
226 (7.9) |
205 (9.0) |
361 (8.6) |
207 (13.5) |
999 (9.2)
|
| Bystander also using drugs or drinking |
223 (7.8) |
284 (12.5) |
416 (9.9) |
110 (7.2) |
1,033 (9.5)
|
| Spatial separation |
1,189 (41.6) |
1,055 (46.5) |
1,860 (44.2) |
901 (59.0) |
5,005 (46.0)
|
| Unaware decedent was using drugs |
231 (8.1) |
370 (16.3) |
635 (15.1) |
330 (21.6) |
1,566 (14.4)
|
|
Drug use witnessed¶
|
644 (6.5) |
612 (8.7) |
1,142 (10.4) |
463 (13.2) |
2,861 (9.1)
|
|
Overdose at home¶
|
6,267 (66.2) |
4,249 (62.6) |
6,068 (61.9) |
2,348 (68.3) |
18,932 (64.2)
|
| Overdose in house or apartment; not own home¶ | 1,200 (12.8) | 1,134 (16.7) | 1,610 (16.3) | 409 (12.0) | 4,353 (14.8) |
Abbreviations: AI/AN = American Indian or Alaska Native; A/OPI = Asian or Other Pacific Islander; IMFs = illicitly manufactured fentanyls; SUDORS = State Unintentional Drug Overdose Reporting System.
* Includes illicitly manufactured fentanyl and fentanyl analogs.
† Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania, Rhode Island, and Vermont; Midwest: Illinois, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, and South Dakota; South: Arkansas, Delaware, District of Columbia, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, Tennessee, Virginia, and West Virginia; West: Alaska, Arizona, Colorado, Hawaii, Montana, Nevada, New Mexico, Oregon, Utah, and Washington.
§ Illinois, Louisiana, Missouri, Pennsylvania, and Washington reported deaths from counties that accounted for ≥75% of drug overdose deaths in the state in 2017, per SUDORS funding requirements; all other jurisdictions reported deaths from the full jurisdiction. Jurisdictions included if data were available for January–June or July–December 2020, or both. Data for July–December 2020 for one state (816 deaths) only included in section for all decedents, because the overall percentage of decedents with a medical examiner or coroner report was <75%, which is the cut-off used in SUDORS for inclusion in analyses of overdose circumstances.
¶ Missing values were excluded from calculations of percentages. Percentages might not sum to 100% because of rounding.
** Data suppressed because cell contained <10 deaths or to prevent calculation of another suppressed cell.
†† Drug use history categories are not mutually exclusive; a decedent could have a documented history of use or misuse of more than one type of drug. Illicit opioid use history includes history of use of IMFs or heroin. Other drug use history includes history of benzodiazepine misuse, history of cannabis use, history of unspecified drug use, and other drug use history (with specific drugs written in).
§§ Route of drug use cannot be directly linked to specific drugs if more than one drug detected and more than one route reported (e.g., if there was evidence of injection and snorting, both would be documented; if more than one drug was detected, it cannot be determined which was injected and which was snorted). Percentages for all rows in this section calculated out of the region total. Categories for no injection/snorting, no injection/smoking, and no injection/ingestion are not mutually exclusive; a death could have evidence of more than one of these routes. Other routes of drug use (transdermal, suppository, sublingual, buccal) were each reported for <0.5% of deaths in each region so these routes were not included but account for why the totals for “injection,” “no injection reported; snorting, smoking, or ingestion reported,” and “no reported route of drug use” do not sum to the regional totals.
¶¶ Reasons for lack of bystander response are presented with percentages calculated out of deaths with evidence of a potential bystander present, but with no evidence that any bystander response was made (e.g., no naloxone administered and no cardiopulmonary resuscitation performed). Reasons for no response are not mutually exclusive; more than one reason could be reported per death.