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- 1. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 1 Rowan County Medication and Drug Overdose i NCDHHS, Division of Public Health | November 2020
- 2. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 2 Technical Notes • The fatality data provided here are part of the Vital Registry System of the State Center for Health Statistics (SCHS) and have been used to historically track and monitor the drug overdose burden in North Carolina (NC) using ICD-10 codes. The definitive data on deaths come from the NC Office of the Chief Medical Examiner (OCME). For the most recent data and data on specific drugs, please contact OCME at http://www.ocme.dhhs.nc.gov/annreport/index.shtml. • When calculating rates, higher counts provide greater reliability, therefore years are often grouped. Use caution when interpreting rates for counts between 5-10. Rates are not calculated when counts are between 1-4. • Speaking and technical notes should be read prior to using. If you have questions or concerns about these data, please contact us at SubstanceUseData@dhhs.nc.gov.
- 3. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 3 Rowan County Residents, 2010-2019 0 10 20 30 40 50 60 70 80 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Number of deaths All Intents Unintentional Self-Inflicted Undetermined Assault Technical Notes: Medication and drug overdose: X40-X44, X60-X64, Y10-Y14, X85; Limited to N.C. residents Source: Deaths-N.C. State Center for Health Statistics, Vital Statistics Analysis by Injury Epidemiology and Surveillance Unit County Medication & Drug Overdose Deaths by Intent
- 4. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 4 Rowan County Residents, 2010-2019 Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, Unintentional medication, drug, alcohol poisoning: X40-X45 with any mention of specific T-codes by drug type (Commonly Prescribed Opioids, Heroin, Other Synthetics, Benzodiazepines, Cocaine, Psychostimulants, Antiepileptics and Alcohol). Analysis by Injury Epidemiology and Surveillance Unit *These counts are not mutually exclusive. If the death involved multiple substances it can be counted on multiple lines. Substances* Contributing to Unintentional Overdose Deaths 0 10 20 30 40 50 60 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Number of deaths Commonly Prescribed Opioid Medications Heroin and/or Other Synthetic Narcotics Cocaine Psychostimulants Benzodiazepines Antiepileptics Alcohol
- 5. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 5 Rowan County Resident Population, 2019 Rowan County Resident Unintentional Overdose Deaths, 2019 Rowan County Residents, 2019 Technical Notes: Unintentional Medication and drug overdose: X40-X44; Limited to N.C. residents Source: Deaths-N.C. State Center for Health Statistics, Vital Statistics; Population-NCHS Analysis by Injury Epidemiology and Surveillance Unit County Unintentional Medication & Drug Overdose Deaths Compared to County Population, by Demographics 0% 20% 40% 60% 80% 100% 65+ 55-64 45-54 35-44 25-34 <25 0% 20% 40% 60% 80% 100% Male Female 0% 20% 40% 60% 80% 100% Hispanic White NH* Black NH* AI/AN** NH* Asian NH* Race/Ethnicity Sex Age * Non-Hispanic **American Indian/Alaskan Native
- 6. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 6 2015-2019 Rate of Unintentional Medication & Drug Overdose Deaths Per 100,000 North Carolina Residents, Technical Notes: Rates are per 100,000 N.C. residents; Unintentional medication and drug poisoning: X40-X44 Source: Deaths-N.C. State Center for Health Statistics, Vital Statistics; Population-NCHS Analysis by Injury Epidemiology and Surveillance Unit Rowan 31.6 Rate of Unintentional Medication/Drug Overdose Deaths per 100,000 North Carolina Residents, 2015-2019 Statewide 18.5
- 7. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 7 ^ ^ ^ ^ ^ ^ ^ ^ 4-9 10-14 15-21 22-36 Rate not calculated, <5 deaths ^ Interpret rate with caution, low numbers (5-9 deaths) 2015-2019 Technical Notes: Rates are per 100,000 N.C. residents, Unintentional medication and drug poisoning: X40-X44 and any mention of T40.0 (opium), T40.2 (Other Opioids), T40.3 (Methadone),T40.4 (Other synthetic opioid) and/or T40.6 (Other/unspecified narcotics) Source: Deaths-N.C. State Center for Health Statistics, Vital Statistics; Population-NCHS Analysis by Injury Epidemiology and Surveillance Unit Rate of Unintentional Opioid Overdose Deaths Per 100,000 North Carolina Residents, Rate of Unintentional Opioid Overdose Deaths per 100,000 North Carolina Residents, 2015-2019 Rowan 28.0 Statewide 15.3
- 8. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 8 Counties covered by Syringe Exchange Programs (SEPs) At the end of Year 4 Reporting (June 2020) *Residents from an additional 55 counties (and out of state) traveled to receive services in a SEP target county in N.C. Technical Notes: There may be SEPs operating that are note represented on this map; in order to be counted as an active SEP, paperwork must be submitted to the N.C. Division of Public Health Source: N.C. Division of Public Health, Year 4 SEP Annual Reporting, June 2020 Analysis by Injury Epidemiology and Surveillance Unit SEP Coverage in Rowan County? No
- 9. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 9 2019 One Year’s Estimated Total Lifetime Costs Medical and Work Loss from Medication & Drug Fatalities, All Intents, Technical Note: These estimates only include fatalities and do not include additional costs associated with non-fatal overdoses, treatment, recovery, and other costs associated with this epidemic. Source: Deaths-N.C. State Center for Health Statistics, Vital Statistics, Unintentional medication and drug overdose: X40-X44/Population-National Center for Health Statistics/Economic impact-CDC WISQARS, Cost of Injury Reports, National Center for Injury Prevention and Control, CDC for all medication and drug deaths (any intent), Base year (2010) costs indexed to state 2017 prices. Analysis by Injury Epidemiology and Surveillance Unit Total Medical Costs in Rowan County, 2019 Total Work Loss Costs in Rowan County, 2019 Combined Costs, 2019 Cost per capita in Rowan County, 2019 $298,180 $67,264,648 $67,562,828 $475
- 10. NCDHHS, Division of Public Health | County Overdose Slides | November 2020 10 Questions? SubstanceUseData@dhhs.nc.gov Injury and Violence Prevention Branch NC Division of Public Health www.injuryfreenc.ncdhhs.gov
Editor's Notes
- This slide set was created to provide basic county-level data trends and public health surveillance around the overdose epidemic. These slides are used as a way to provide a basic county-level background on medication and drug overdose deaths by intent, types of substances contributing to unintentional overdose deaths, economic costs, as well as harm reduction efforts. Please read both the speaking and technical notes to ensure that data are presented is a consistent manner.
- For more detailed technical notes on any of the data shared in this slide set, please contact us at SubstanceUseData@dhhs.nc.gov
- This slide displays the trends of the last ten years for medication and drug overdose deaths by intent (unintentional, self-inflicted, assault, and undetermined intents). It also displays all intents summed together. In North Carolina, as in the United States as whole, deaths due to medication/drug overdoses have been steadily increasing since 1999, and the vast majority (90%) of these are unintentional. In 2019, an average of 6 people a day died from medication/drug poisoning in North Carolina (all intents). That number of medication/drug deaths has increased 120%, over the last 10 years (2010-2019). While the number of self-inflicted deaths have remained relatively stable, less than 200 a year, unintentional drug overdoses have continued to rise. Despite a dip from 2017 to 2018, overdose deaths rose in 2019. Opioids, specifically, have contributed to the majority of these deaths. Technical Notes: The data provided here are part of the Vital Registry System of the State Center for Health Statistics and have been used to historically track and monitor the drug overdose burden in NC using ICD10 codes. The definitive data on deaths come from the NC Office of the Chief Medical Examiner (OCME). For the most recent data and data on specific drugs, please contact at OCME at http://www.ocme.dhhs.nc.gov/annreport/index.shtml
- This slide shows the trends of different substances involved in unintentional medication and drug overdose deaths in one county. The epidemic of med/drug overdose is mostly driven by opiates. Historically, prescription opioids (drugs like hydrocodone, oxycodone, morphine) have contributed to an increasing number of medication/drug overdose deaths. In recent years, Statewide, other synthetic narcotics (heroin, fentanyl, and fentanyl analogues*) have resulted in increased deaths, and while there was a decrease in the number of deaths involving heroin and other synthetic narcotics from 2017 to 2018, it increased again in 2019. The number of deaths in North Carolina involving other substances like cocaine, benzodiazepines, alcohol, antiepileptics, and psychostimulants with misuse potential (which includes methamphetamine) continue to rise. These counts are not mutually exclusive. If the death involved multiple substances it can be counted on multiple lines. *Fentanyl analogues are drugs that are similar to fentanyl but have been chemically modified in order to bypass current drug laws. Technical Notes: The data provided here are part of the Vital Registry System of the State Center for Health Statistics and have been used to historically track and monitor the drug overdose burden in NC using ICD10 codes. The definitive data on deaths come from the NC Office of the Chief Medical Examiner (OCME). For the most recent data and data on specific drugs, please contact at OCME at http://www.ocme.dhhs.nc.gov/annreport/index.shtml
- This slide compares the demographic breakdown of drug overdose deaths in a county compared to population estimates for each subgroup in the same county. Groups for which the dark bar is longer than the light bar indicates that the percent of deaths involving that group was greater than the percent of the population accounted for by that group. Statewide, med/drug overdose death rates are highest among males, individuals between 25 and 54 years of age, and non-Hispanic American Indians and Whites.
- This map shades the counties of NC based on their respective unintentional medication/drug overdose death rate. The statewide rate of unintentional medication and drug overdose deaths was 18.5 per 100,000 persons from 2015-2019. This five-year period was used in order to provide greater reliability in county-level rate estimates. In counties with less than five deaths, rates were not calculated. Interpret rates with caution in counties with less than 10 deaths. Technical Notes: The data provided here are part of the Vital Registry System of the State Center for Health Statistics and have been used to historically track and monitor the drug overdose burden in NC using ICD10 codes. The definitive data on deaths come from the NC Office of the Chief Medical Examiner (OCME). For the most recent data and data on specific drugs, please contact at OCME at http://www.ocme.dhhs.nc.gov/annreport/index.shtml
- This map shades the counties of NC based on their respective unintentional opioid overdose death rate. The statewide rate of unintentional opioid-related overdose deaths was 15.3 per 100,000 people (2015-2019). This five-year period was used in order to provide greater reliability in county-level rate estimates. In counties with less than five deaths, rates were not calculated. Interpret rates with caution in counties with less than 10 deaths. Technical Notes: The data provided here are part of the Vital Registry System of the State Center for Health Statistics and have been used to historically track and monitor the drug overdose burden in NC using ICD10 codes. The definitive data on deaths come from the NC Office of the Chief Medical Examiner (OCME). For the most recent data and data on specific drugs, please contact at OCME at http://www.ocme.dhhs.nc.gov/annreport/index.shtml
- Counties shaded in blue were served by at least one Syringe Exchange Program (SEP) as of the end of year 3 annual reporting period in June 2019. Individuals traveled from an additional 38 counties, and out of state, to reach a NC SEP. For additional information on the NC Safer Syringe Initiative visit: https://www.ncdhhs.gov/divisions/public-health/north-carolina-safer-syringe-initiative Technical Notes: There may be SEPs operating that are not represented on this map. In order to be counted as an official SEP, paperwork must be completed with the Division of Public Health. Additional SEPs may have started operating since Year 3 annual reporting ended.
- Average costs for medical costs and work loss costs are based on 2010 prices, then indexed to 2017 prices in North Carolina, as that is the most recent year for which data was available. These figures do not include costs associated with treatment and recovery or other impacts of this epidemic; costs are limited to the cost of one year of overdose fatalities (all intents, all medication/drugs). Costs: based on Fatal Injuries, Both Sexes, All ages, North Carolina, 2017. All Intents. Mechanism: Poisoning. Case Counts: Medication and Drug Overdose deaths, Counties, 2019. All Intents. Per capita cost based on 2019 population.