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CDC Publications

Featured Article

photo of a need and a bottle of fentanyl

Underlying Factors in Drug Overdose Deaths

In 2015, drug overdoses accounted for more than 52,000 deaths in the United States. Preliminary data from CDC indicate that drug overdoses increased between 2015 and 2016—by more than 20%. This increase is being driven by overdoses related to illicit fentanyl (i.e., synthetic opioids). Since 2010, overdose deaths involving heroin and illicit opioids including fentanyl have increased more than 200%. These findings underscore the need to continue efforts to address and prevent this public health problem.

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Journal Articles





  • Haegerich, T.M., Paulozzi, L., Manns, B., & Jones, C. J. (2014). What we know and don’t know about state and system level policy strategies to prevent prescription drug overdose. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2014.10.001.
  • Jones C, Paulozzi L, Mack K. Sources of prescription opioid pain relievers by frequency of past-year nonmedical use: United States, 2008–2011. JAMA Int Med 2014; 174(5):802-803.
  • Baumblatt JA, Wiedeman C, Dunn J, Schaffner W, Paulozzi L, Jones T. High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Int Med 2014;174(15):796-801.
  • Paulozzi L, Zhang K, Jones C, Mack K. Risk of adverse health outcomes with increasing duration and regularity of opioid therapy. J Am Board Fam Med 2014;27:329-338.


  • Sauber-Schatz, EK. Mack KA, Diekman ST, Paulozzi LJ. Associations between pain clinic density and distributions of opioid pain relievers, drug-related deaths, hospitalizations, emergency department visits and neonatal abstinence syndrome in Florida. Drug Alc Depend 2013;
  • Logan J, Liu Y, Paulozzi LJ, Zhang K, Jones C. Opioid prescribing in emergency departments: the prevalence of potentially inappropriate prescribing and misuse. Med Care 2013; doi:10.1097.
  • Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers – United States, 2002-2004 and 2008-2010. Drug Alc Depend 2013. Available at:
  • Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical overdose deaths, United States, 2010. JAMA 2013;309:657-659.




Related Publications

Annual Surveillance Report

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Annual Surveillance Report of Drug-Related Risks and Outcomes – United States, 2017 [PDF – 2MB]

Summarizes the latest information available for various health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. This report covers latest data available on rates of opioid prescribing, substance use disorder, nonfatal hospitalizations and emergency department visits, and overdose deaths. National information, and some state information, is presented to serve as a resource to help address the ongoing national problem of drug abuse, addiction, and overdose.

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Highlights from the Annual Surveillance Report of Drug-Related Risks and Outcomes – United States, 2017 [PDF – 5 MB]

Presentation available for download, and includes highlights of the data, maps, tables, and charts from the first Annual Surveillance Report of Drug-Related Risks and Outcomes – United States, 2017.  Citation when using resources from this presentation [Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2017. Accessed [date] from ]

CDC Health Alert Network (HAN) Advisories

CDC Grand Rounds

NCHS Data Publications

Other Publications

  • A promising strategy for addressing the U.S. opioid overdose epidemic is improving the use of prescription drug monitoring programs (PDMPs). The Substance Abuse and Mental Health Services Administration (SAMHSA) funded nine states to better integrate PDMP data into health systems and to initiate and increase interstate data sharing. The project was called PDMP Electronic Health Records (EHRs) Integration and Interoperability Expansion (PEHRIIE) and funded Florida, Illinois, Indiana, Kansas, Maine, Ohio, Texas, Washington, and West Virginia from 2012 to 2016. CDC conducted a process and outcome evaluation of the program; and in collaboration with Brandeis University, used a comparative case study to describe the implementation process, identify successes and challenges, and explore the program’s effects on the stated goals.

  • Created by the Department of Health and Human Services’ Behavioral Health Coordinating Committee Subcommittee on Prescription Drug Abuse, this publication is a review of current federal initiatives and literature focused on ensuring the safe use of prescription drugs with the potential for abuse and the treatment of prescription drug dependence. The report includes identified opportunities to enhance programmatic and policy efforts as well as future research on prescription drug abuse and overdose in the U.S. (This publication was developed pursuant to Section 1122 of the Food and Drug Administration Safety and Innovation Act of 2012 (FDASIA).)

  • References [PDF – 93 KB]
    Prescription Painkiller Overdoses is one in a series of issue briefs highlighting key public health issues and important, science-based policy actions that can be taken to address them. Through this publication, CDC supports state-based efforts to reduce prescription drug abuse while ensuring patients have access to safe, effective pain treatment. The publication includes information about deaths and emergency department visits resulting from prescription painkiller overdoses, overdose trends, the most common drugs involved, and the regions and populations most severely affected. Recommendations on how health care providers, private insurance providers, and state and federal agencies can work to prevent unintentional drug overdoses are also included.

  • To assess the knowledge, response, and planning regarding prescription drug misuse and overdose, in late 2007 the Association of State and Territorial Health Officials (ASTHO) and CDC conducted interviews with state and territorial health officials and other senior leaders in nine states (Arkansas, Florida, Indiana, Kentucky, Montana, North Carolina, Oklahoma, Utah, and West Virginia). The resulting report, Prescription Drug Overdose: State Health Agencies Respond, outlines the state perceptions, partnerships, recommendations, policies, and other issues that are fundamental to understanding and responding to drug misuse.

MMWR Articles







Guides and Meeting Reports

Prescription Behavior Surveillance System Data Briefs

Increase in overdose deaths involving synthetic opioids other than methadone linked to increase in supply of fentanyl in PBSS states [PDF – 512 KB]

From 2010 to 2015, annual overdose deaths involving opioids in the United States increased by nearly 57%, with a notable rise in deaths attributed to synthetic opioids other than methadone. A new Prescription Behavior Surveillance System (PBSS) Issue Brief compares trends in synthetic opioid overdose deaths in five states. The data show a close association between rising synthetic opioid overdose deaths and the rising availability of illicitly manufactured fentanyl.

Geographic Patterns in Neonatal Abstinence Syndrome and Prescription Opioids in Kentucky [PDF – 809K]

Data released by the Commonwealth of Kentucky examines the relationship between rates of Neonatal Abstinence Syndrome (NAS) in various regions of the state versus risky opioid prescribing behaviors observed in these same regions. In the wake of the ongoing opioid epidemic, NAS has greatly increased nationwide, more than tripling from 2004 to 2013. Findings in Kentucky reveal a close association between NAS and high opioid prescribing rates in the preceding year among women of childbearing age.

Patient Risk Measures for Controlled Substance Prescriptions in Washington, 2013 [PDF – 877K]

An analysis of Washington prescription drug monitoring program (PDMP) data revealed that multiple provider episodes (MPEs) vary by age group and class of prescription drug. Opioids and opioid combinations had the highest number of days of overlapping prescriptions, and eight opioids had a mean daily dosage greater than 120 morphine milligram equivalents (MME). Findings indicate that MPEs, overlapping prescription, and mean daily dosages over 100 MMEs are patient risk factors to look for in PDMP data.

Maine’s PDMP data was analyzed to examine several patient risk measures for prescription drug misuse, abuse and overdose. Patients aged 35-54 had the highest rate of MPEs, and opioids were the drug class most frequently involved with MPEs. However, the rate of MPEs declined from 2010 to 2014, and this coincided with an increase in prescribing of buprenorphine, widely used in treating opioid dependence.