Trends in Suspected Opioid Overdoses from Emergency Departments in 11 States and DC

ObjectiveThis presentation will provide insight into how the extensive spread of illicitly-manufactured fentanyl impacted opioid overdose rates throughout the Midwest and neighboring states.IntroductionRecent reporting using data from CDC’s National Syndromic Surveillance Program indicates that rates of emergency department (ED) visits involving suspected opioid overdoses increased by 70% in the Midwest from the third quarter (Q3) 2016 (July–September) to the Q3 2017. Large increases in the use and distribution of illicitly-manufactured fentanyl (IMF) and fentanyl analogs, are a key factor driving increased opioid overdose rates in the Midwest and east of the Mississippi River. Fentanyl is a synthetic opioid 50–100 times more potent than morphine. A better understanding of the distribution of changes in opioid overdose rate from Q3 2016 to Q3 2017 within states needed to inform response and prevention efforts.MethodsThe CDC’s Enhanced State Opioid Overdose Surveillance Program currently funds 32 states and Washington DC to increase timeliness of opioid overdose reporting and detect rapid changes in trends. Data from nine states (IL, MD, MO, NC, OH, PA, VA, WI, WV) were analyzed. Midwest states sharing subregional data with CDC were selected to better understand geographic and temporal patterns driving previously reported increases in ED visits involving suspected opioid overdoses from Q3 2016 through Q3 2017. Bordering states (MD, NC, PA, VA, WV) sharing subregional data with CDC were also included to determine trends in states contiguous to the Midwest. State subregions were defined using publicly available state government sources in consultation with state public health departments and were mainly divided by public health districts. . Fifty of 56 possible state subregions across 9 states met two inclusion criteria: 1) reported 25 opioid overdose ED visits per quarter and 2) did not report a change of 50% between any two quarters. Opioid overdoses were defined according to jurisdictional and national definitions that included searches of chief complaint text (e.g., searching for words “opioid” and “overdose”) and ICD-10-CM diagnostic/billing codes. State subregional rates were defined as number of opioid overdoses divided by the total number of ED visits in the state subregion, multiplied by 10,000. Quarterly and yearly percent change in opioid overdose ED visits from Q3 2016 to Q3 2017 were described with a focus on high burden subregions reporting larg