Drug-Involved Overdose Deaths
In the U.S., there were 67,367 drug overdose deaths reported in 2018, 4.1% fewer deaths than in 2017.
- The age-adjusted rate declined by 4.6% to 20.7 per 100,000 standard population.1 The decline follows an increasing trend in the rate from 6.1 in 1999 to 21.7 in 2017.
- Opioids were involved in 46,802 (a rate of 14.6) overdose deaths in 2018—nearly 70% of all overdose deaths.
- Deaths involving synthetic opioids other than methadone (including fentanyl and fentanyl analogs) continued to rise with more than 28,400 (a rate of 9.9) overdose deaths in 2018.
- The number of deaths involving prescription opioids declined to 14,975 (a rate of 4.6) in 2018 and those involving heroin dropped to 14,996 (a rate of 4.7).2
In Texas, opioid-involved overdose deaths totaled 1,402 (a rate of 4.8) in 2018.
- Deaths involving synthetic opioids other than methadone (mainly fentanyl and fentanyl analogs) remained steady with 358 (a rate of 1.2) reported deaths in 2018 (Figure 1).
- Deaths involving heroin or prescription opioids also remained level with a respective 668 (a rate of 2.3) and 547 (a rate of 1.9) deaths in 2018.3
In 2018, Texas providers wrote 47.2 opioid prescriptions for every 100 persons—the lowest rate in the state since 2006 when data became available. The average U.S. rate in the same year was 51.4.4
Neonatal Abstinence Syndrome (NAS)/Neonatal Opioid Withdrawal Syndrome (NOWS)
NAS or NOWS may occur when a woman uses opioids during pregnancy. To date, there is no standard in NAS/NOWS provider and hospital coding practices.5 As a result, there is variability in the rates reported by states.
- The national incidence rate of NAS/NOWS in 2016 was 7 cases per 1,000 hospital births.6-7
- The highest rates were reported among American Indian/Alaska Native (15.9 per 1,000 births) and White Non-Hispanic (10.5 per 1,000 births) individuals.
- In 2016, hospital costs for NAS/NOWS births totaled $572.7 million, after adjusting for inflation.8
- The incidence rate of NAS/NOWS in Texas in 2017 was 2.5 cases per 1,000 hospital births and is the most recent data available.6-7
New HIV Diagnoses9 and Prevalence Attributed to Injection Drug Use (IDU)
- U.S. New Diagnoses: In 2017, 9.7% (3,690) of the 38,226 new HIV diagnoses were attributed to IDU. Among males, 8.6% (2,655) of new diagnoses were transmitted via IDU or male-to-male sexual contact and IDU. Among females, 14.2% (1,035) of new diagnoses were transmitted via IDU.10
- U.S. Prevalence: In 2017, more than 1 million Americans were living with a diagnosed HIV infection—a rate of 367.7. Among males, 16.4% (125,274) contracted HIV from IDU or male-to-male sexual contact and IDU. Among females, 20.8% (49,288) were living with HIV attributed to IDU.10
- State New Diagnoses: Of the new HIV diagnoses in 2017, 4,358 occurred in Texas—a rate of 18.9. Among males, 8.5% of new HIV diagnoses were attributed to IDU or male-to-male sexual contact and IDU. Among females, 13.3% were attributed to IDU (Figure 2).10
- State Prevalence: In 2017, 88,099 persons were living with a diagnosed HIV infection in Texas—a rate of 382.9. Of those, 14.5% of male cases were attributed to IDU or male-to-male sexual contact and IDU. Among females, 18.3% were living with HIV attributed to IDU.10
Hepatitis C (HCV) Incidence and Prevalence Attributed to IDU11
- U.S. Incidence: In 2017, there were an estimated 44,700 new cases of acute HCV. Among case reports that contained information about IDU, 86.6% indicated IDU prior to onset of acute, symptomatic HCV.12
- U.S. Prevalence: An estimated 2.4 million Americans are living with HCV (based on 2013-2016 annual average).12
- State Incidence: There were approximately 35 new cases of acute HCV (a rate of 0.1) reported in Texas in 2017.10
- State Prevalence: In Texas, there are an estimated 205,500 persons living with HCV (a rate of 1,020 based on 2013-2016 annual average).13
- Rates are age-adjusted per 100,000 standard population unless otherwise noted.
- Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2018. NCHS Data Brief, no 356. Hyattsville, MD: National Center for Health Statistics. 2020.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2018 on CDC WONDER Online Database released in 2020. Data are from the Multiple Cause of Death Files, 1999-2018, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. (2020 February 14) Retrieved from http://wonder.cdc.gov/mcd-icd10.html
- Centers for Disease Control and Prevention. U.S. Opioid Prescribing Rate Maps. (2019, October 3). Retrieved from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html
- Lind JN, Ailes EC, Alter CC, et al. Leveraging Existing Birth Defects Surveillance Infrastructure to Build Neonatal Abstinence Syndrome Surveillance Systems—Illinois, New Mexico, and Vermont, 2015–2016. MMWR Morb Mortal Wkly Rep 2019;68:177–180.
- Healthcare Cost and Utilization Project (HCUP). Neonatal Abstinence Syndrome (NAS) Among Newborn Hospitalizations. (2019, December 12) Retrieved from https://www.hcup-us.ahrq.gov/faststats/nas/nasquery.jsp?
- Comparisons with earlier estimates are difficult because of the ICD-10-CM transition in 2015.
- Strahan AE, Guy Jr. GP, Bohm M, et al. Neonatal Abstinence Syndrome Incidence and Health Care Costs in the United States, 2016. JAMA Pediatrics. 2020;174(2):200-202.
- The term refers to people diagnosed with HIV infection, regardless of the stage of disease at diagnosis.
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) AtlasPlus. (2020, January 30). Retrieved from https://gis.cdc.gov/grasp/nchhstpatlas/main.html.
- Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
- Centers for Disease Control and Prevention. Surveillance for Viral Hepatitis—United States, 2017. 2019, November 14. Retrieved from https://www.cdc.gov/hepatitis/statistics/2017surveillance/index.htm
- HepVu. Local Data: Texas. Retrieved from https://hepvu.org/state/Texas/