Nonfatal Drug Overdoses Treated in Emergency Departments — United States, 2016–2017

Abstract

In 2017, drug overdoses caused 70,237 deaths in the United States, a 9.6% rate increase from 2016 (1). Monitoring nonfatal drug overdoses treated in emergency departments (EDs) is also important to inform community prevention and response activities. Analysis of discharge data provides insights into the prevalence and trends of nonfatal drug overdoses, highlighting opportunities for public health action to prevent overdoses. Using discharge data from the Healthcare Cost and Utilization Project's (HCUP) Nationwide Emergency Department Sample (NEDS), CDC identified nonfatal overdoses for all drugs, all opioids, nonheroin opioids, heroin, benzodiazepines, and cocaine and examined changes from 2016 to 2017, stratified by drug type and by patient, facility, and visit characteristics. In 2017, the most recent year for which population-level estimates of nonfatal overdoses can be generated, a total of 967,615 nonfatal drug overdoses were treated in EDs, an increase of 4.3% from 2016, which included 305,623 opioidinvolved overdoses, a 3.1% increase from 2016. From 2016 to 2017, the nonfatal overdose rates for all drug types increased significantly except for those involving benzodiazepines. These findings highlight the importance of continued surveillance of nonfatal drug overdoses treated in EDs to inform public health actions and, working collaboratively with clinical and public safety partners, to link patients to needed recovery and treatment resources (e.g., medication-assisted treatment). The 2017 HCUP NEDS data set is a nationally representative, stratified sample of ED visits from nonfederal, hospitalbased EDs in 36 U.S. states and the District of Columbia.* Hospital discharge data represent the reference standard in nonfatal overdose surveillance and allow generation of population-level estimates to examine rate changes over time. Using 2016 and 2017 NEDS data, six drug overdose indicators were classified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) discharge diagnosis codes: 1) all-drugs, 2) all opioids, 3) nonheroin opioids, 4) heroin, 5) benzodiazepines, and 6) cocaine. All diagnosis fields were searched for initial encounter † visits for intent (i.e., unintentional, intentional self-harm, assault, and *

Nonfatal Drug and Polydrug Overdoses Treated in Emergency Departments — 29 States, 2018–2019

“…From 2018 to 2019, rates of suspected nonfatal overdoses involving opioids, cocaine, and amphetamines treated in EDs increased, and those involving benzodiazepines decreased. Despite the decline in nonfatal benzodiazepine-involved overdoses, benzodiazepines were identified in 12.2% of nonfatal overdoses treated in EDs during 2017 (1). Benzodiazepines were also one of the most common drug classes identified in overdose deaths, ¶ ¶ ¶ ¶ likely because of co-use with opioids (3).…”

“…Benzodiazepines were also one of the most common drug classes identified in overdose deaths, ¶ ¶ ¶ ¶ likely because of co-use with opioids (3). Increases in overdose rates involving other drugs highlight the complicated nature of and challenges associated with addressing the evolving U.S. drug overdose epidemic (1). Deaths involving ¶ ¶ ¶ ¶ https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_12-508.pdf.…”

“…The U.S. drug overdose epidemic continues to cause substantial morbidity and mortality. In 2017, 967,615 nonfatal drug overdoses were treated in emergency departments (EDs), a 4.3% increase from 2016 in all overdoses and a 3.1% increase in opioid-involved overdoses (1). During 2017 and 2018, syndromic surveillance revealed that 37.2% of overdoses treated in EDs in 18 states involved multiple drugs (2).…”

Benzodiazepines reported in NFLIS-Drug, 2015 to 2018

“…NFLIS-Drug data show that the estimated total benzodiazepine reports decreased by 14% between 2015 and 2018, and the number of benzodiazepine prescriptions decreased by 18% between 2015 and 2018. A decrease in benzodiazepines can be seen around this time through nonfatal drug overdoses that were treated in emergency departments [ 33 ]. Although NFLIS-Drug data and IQIVIA Launch data showed a decrease in benzodiazepines, there are still issues of concern due to misuse and abuse, co-prescribing or concurrent use with other substances, and the emergence of designer benzodiazepines [ 34 ].…”

HIV detection by an emergency department HIV screening program during a regional outbreak among people who inject drugs

“…PWID present to EDs at a higher rate than the general population and for reasons often associated with IDU, such as overdose and injection-related infections [ 20 , 21 ]. In 2017, there were nearly one million ED visits for non-fatal overdose in the United States [ 22 ]. Because EDs have ready access to the PWID population, they may be uniquely poised to identify PWID with undiagnosed HIV.…”