The Midwestern region 

saw opioid overdoses 

increase 70% from July 

2016 through 

September 2017.

Opioid overdoses in 

large cities increased by 

54% in 16 states.

↑70%

↑54% 

↑30%

Opioid overdoses went 

up 30% from July 2016 

through September 2017 

in 52 areas in 45 states.

Want to learn more? 

Visit: www.cdc.gov/vitalsigns

MAR 2018

#vitalsigns

Opioid Overdoses Treated in 

Emergency Departments

Identify opportunities for action

Emergency department (ED) visits for opioid* overdoses rose 30% in all 

parts of the US from July 2016 through September 2017. People who 

have had an overdose are more likely to have another, so being seen in 

the ED is an opportunity for action. Repeat overdoses may be prevented 

with medication-assisted treatment (MAT) for opioid use disorder (OUD), 

which is defined as a problematic pattern of opioid use. EDs can provide 

naloxone, link patients to treatment and referral services, and provide 

health departments with critical data on overdoses. ED data provide an 

early warning system for health departments to identify increases in opioid 

overdoses more quickly and coordinate response efforts. This fast-moving 

epidemic does not stay within state and county lines. Coordinated action 

between EDs, health departments, mental health and treatment providers, 

community-based organizations, and law enforcement can prevent opioid 

overdose and death. 

Health departments can

• Alert communities to rapid increases in overdoses seen in EDs for 

an informed and timely response. 

• Increase naloxone distribution (an overdose-reversing drug) to first 

responders, family and friends, and other community members in 

affected areas, as policies permit. 

• Increase availability of and access to treatment services, including 

mental health services and MAT for OUD.

• Support programs which reduce harms from injecting opioids, 

including those offering screening for HIV and hepatitis B and C, in 

combination with referral to treatment.

• Support the use of the CDC Guideline for Prescribing Opioids for 

Chronic Pain, which encourages using prescription drug monitoring 

programs (PDMPs) to inform clinical practice. 

https://go.usa.gov/xn6uQ

* Opioids include prescription 

pain medications, heroin, and 

illicitly manufactured fentanyl.
From July 2016 through September 2017, opioid overdoses increased for: 

• Men (↑30%) and women (↑24%)

• People ages 25-34 (↑31%), 35-54 (↑36%), and 55 and over (↑32%) 

• Most states (↑30% average), especially in the Midwest (↑70% average)

PROBLEM:

Opioid overdose ED visits continued 

to rise from 2016 to 2017.

SOURCE: CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program, 

16 states reporting percent changes from July 2016 through September 2017.

SOURCE: CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) Program, 16 states reporting percent changes from July 2016 through September 2017.

* From left to right, the categories are: 

1) non-core (non-metro), 2) micropolitan (non-metro), 3) small metro, 4) medium metro, 5) large fringe metro, 6) large central metro.

WI

ME

DE

NC

IL IN OH

WA MT ND MN MI NY

AK

HI TX GA

FL

VT

OK LA MS AL SC

CA AZ KS AR TN VA DC

OR CO

UT

NE MD

ID WY SD IA PA NJ CT

MA RI

NH

NV MO KY WV

NM

Opioid overdoses continued to increase 

in cities and towns of all types.* 

Detecting recent trends in opioid overdose 

ED visits provides opportunities for action 

in this fast-moving epidemic.

SOURCE: CDC’s National Syndromic Surveillance Program, 52 jurisdictions in 45 states reporting. 

Decrease Increase 1 to 24% Increase 25 to 49% Increase 50% or more

Data unavailable

WI

ME

DE

NC

IL IN OH

A MT ND MN MI NY

TX GA

FL

VT

OK LA MS AL SC

CA AZ KS AR TN VA DC

R CO

UT

NE MD

ID WY SD IA PA NJ CT

MA RI

NH

NV MO KY WV

NM

WI

ME

DE

NC

IL IN OH

WA MT ND MN MI NY

AK

HI TX GA

FL

VT

OK LA MS AL SC

CA AZ KS AR TN VA DC

OR CO

UT

NE MD

ID WY SD IA PA NJ CT

MA RI

NH

NV MO KY WV

NM

MORE RURAL MORE URBAN

21% 24% 21%

43%

54%

37% Large and steady 

increases for 

large cities
Local Emergency Department

A rise in opioid overdoses is detected. What now?

• Offer naloxone and training to 

patient’s family and friends, in 

case the patient has another 

overdose.

• Connect patients with hospital 

case managers or peer navigators 

to link them to follow-up 

treatment and services.

• Plan for the increasing number of 

patients with opioid-related 

conditions, including overdose, 

injection-related concerns, and 

withdrawal.

• Increase treatment services, 

including MAT for OUD. 

• Increase and coordinate mental 

health services for conditions 

that often occur with OUD.

Mental Health and Substance

Abuse Treatment Providers

First Responders | Public Safety | Law Enforcement Officers

Community-Based Organizations Local Health Departments

• Alert the community to the rapid increase in opioid 

overdoses seen in emergency departments and inform 

strategic plans and timely responses.

• Ensure an adequate naloxone supply. 

• Increase availability and access to necessary services.

• Coordinate with key community groups to detect and 

respond to any changes in illicit drug use.

• Assist in mobilizing a community response to those 

most at risk. 

• Provide resources to reduce harms that can occur when 

injecting drugs, including ones that offer screening for 

HIV and hepatitis B and C, in combination with referral 

to treatment and naloxone provision.

• Get adequate supply and training for naloxone 

administration.

• Identify changes in illicit drug supply and work 

with state and local health departments to 

respond effectively.

• Collaborate with public health departments and 

health systems to enhance linkage to treatment 

and services.

Community Members

• Connect with organizations 

in the community that 

provide public health 

services, treatment, 

counseling, and naloxone 

distribution.

Coordinated, 

informed efforts 

can better prevent 

opioid overdoses 

and deaths 

Medication-assisted treatment (MAT) for opioid use 

disorder (OUD) can aid in preventing repeat overdoses. MAT 

combines the use of medication (methadone, 

buprenorphine, or naltrexone) with counseling and 

behavioral therapies.

Naloxone is a drug that can reverse the effects 

of opioid overdose and can be life-saving if 

administered in time.

SOURCE: CDC Vital Signs, March 2018. 
THE FEDERAL GOVERNMENT IS

• Tracking overdose trends to better understand and 

more quickly respond to the opioid overdose epidemic.

• Improving access to OUD treatment, such as MAT, and 

overdose-reversing drugs, such as naloxone.

• Educating healthcare providers and the public about 

OUD and opioid overdose, and providing guidance on 

safe and effective pain management.

• Equipping states with resources to implement and 

evaluate safe prescribing practices.

• Coordinating actions to reduce production and 

impacts of the illicit opioid supply in the US

through the High Intensity Drug Trafficking Areas 

(HIDTA) Program.

• Supporting cutting-edge research to improve pain 

management and OUD treatment.

HEALTH DEPARTMENTS CAN

• Alert communities to rapid increases in overdoses 

seen in EDs for an informed and timely response.

• Increase naloxone distribution (an overdose-reversing 

drug) to first responders, family and friends, and

other community members in affected areas, as 

policies permit. 

• Increase availability of and access to treatment 

services, including mental health services and MAT 

for OUD.

• Support programs that reduce harms which can 

occur when injecting opioids, including those 

offering screening for HIV and hepatitis B and C, in 

combination with referral to treatment.

• Support the use of the CDC Guideline for Prescribing 

Opioids for Chronic Pain, which encourages using 

prescription drug monitoring programs (PDMPs) to 

inform clinical practice. 

https://go.usa.gov/xn6uQ

EMERGENCY DEPARTMENTS CAN 

• Develop post-opioid overdose protocols, which 

may include 

` Offering overdose prevention education, naloxone, 

and related training for patients, family members, 

and friends.

` Linking patients to treatment and services in the 

community as needed.

` Starting MAT in the ED.

HEALTHCARE PROVIDERS CAN 

• Prescribe opioids only when benefits are likely to 

outweigh risks.

• Determine a patient’s prescription drug history and level 

of risk by accessing data from their state PDMP.

• Identify mental health, social services, and treatment 

options to provide appropriate care for patients who 

have OUD. 

• Follow the CDC Guideline for Prescribing Opioids for 

Chronic Pain. https://go.usa.gov/xn6uQ

EVERYONE CAN

• Learn about the risks of opioids.

https://go.usa.gov/xn6um

• Learn about naloxone, its availability, and how to use it. 

https://go.usa.gov/xn6uV

• Store prescription opioids in a secure place, out of 

reach of others (including children, family, friends, 

and visitors). 

• Contact SAMHSA’s National Helpline: 1-800-662-HELP 

for anyone who has trouble with opioid use. 

https://go.usa.gov/xn6uw 

CS287946-A

For more information, please contact

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348 | Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: March 6, 2018

www.cdc.gov/vitalsigns

www.cdc.gov/vitalsigns/opioid-overdoses/

WHAT CAN BE DONE