1. State of the State in outcomes: Prescription drug overdoses Karin A. Mack, PhD Senior Behavioral Scientist Prescription Drug Overdose Team National Center for Injury Prevention and Control Division of Unintentional Injury Prevention

2. MV Traffic Firearm Poisoning Fall SOURCE: National Vital Statistics System-Mortality (NVSS-M), CDC/NCHS. Injury Deaths by Cause, 1999-2010 - US Age adjusted rate per 100,000 Drug Poisoning

3. <11.011.0 - 13.9>14.0 Age-adjusted rate per 100,000 population 10.0 9.6 7.8 8.6 10.6 6.3 3.4 6.7 7.3 14.0 11.8 11.4 9.6 14.4 13.2 15.0 23.8 11.8 10.9 11.4 19.4 10.7 6.8 12.7 23.6 10.9 12.9 16.9 14.6 16.1 13.0 16.9 15.3 28.9 13.1 17.5 10.4 16.4 17.0 20.7 11.6 VT 9.7 NJ 9.8 CT 10.1 MA 11.0 MD 11.0 NH 11.8 DC 12.9 RI 15.5 DE 16.6 12.5 Death Rates for Drug Overdose by State, 2010 Data: WONDER multiple causes mortality files, age-adjusted death rates for 2010. Deaths whose underlying cause was coded to unintentional (X40-44), intentional (X60-64, X85), or undetermined intent (Y10-14) drug poisoning.

5. Number of deaths by selected drugs involved, US, 1999-2010 CDC/NCHS National Vital Statistics System, CDC Wonder.

6. Specific Drug Involvement in Pharmaceutical Overdose Deaths, United States, 2010 Jones et al Pharmaceutical overdose deaths, United States, 2010. JAMA 2013 and CDC/NCHS NVSS MCOD 2010.

7. Deaths are the tip of the iceberg. For every opioid overdose death in 2010, there were SAMHSA NSDUH, DAWN, TEDS data sets Coalition Against Insurance Fraud. Prescription for Peril. http://www.insurancefraud.org/downloads/drugDiversion.pdf 2007.http://www.insurancefraud.org/downloads/drugDiversion.pdf Substance abuse treatment admissions15 Emergency department visits26 People who meet abuse or dependence criteria115 Past year nonmedical users733

8. Percent change 2000-2010 Treatment admissions for Opioids* >500 300-500 <300 TEDS – Treatment episode data set ICPRS/SAMDHA *This category includes admissions for non-prescription use of methadone, codeine, morphine, oxycodone, hydromorphone, meperidine, opium, and other drugs with morphine-like effects.

9. National Estimates of Misuse/Abuse Drug-related Emergency Department Visits, US 2004 - 2011 Drug Abuse Warning Network http://www.samhsa.gov/data/dawn.aspx#DAWN National Tables

11. Rates of opioid overdose deaths, sales and treatment admissions, US, 1999-2010 Paulozzi, et al. 2011. Vital Signs: Overdoses of Prescription Opioid Pain Relievers --- United States, 1999--2008

12. Preliminary data

14. <17001700-2400>2400 Number of oxycodone scripts per 10,000 persons, US, 2011 Preliminary Data: IMS. Retail.

15. Preliminary data

17. Oxycodone web searches 1. Tampa 2. Seattle 3. Orlando 4. Portland 5. Boston 6. Phoenix 7. Philadelphia 8. Miami 9. New York 10. Atlanta

18. Thank You The findings and conclusions in this report are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.