Data Sources

Notes on data

All the data contained in the Opioid & Health Indicators database are compiled from reputable publicly-available databases. As such, all data are freely available for all non-commercial uses.

In order to estimate data at the level of congressional district, county-level data are aggregated by congressional district. In cases where counties are contained in multiple districts, these estimates will not be completely accurate since no effort is made to proportionately divide counties into congressional districts. For any questions about data methods or acceptable use of data, please contact us.

Indicator definitions

CURES Grant Funding

Funding from the 21st Century Cures Act is provided through the State Targeted Response to the Opioid Crisis Grants administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). These grants will help address the opioid crisis by providing support to states to supplement opioid abuse prevention and treatment activities.

Data source: Department of Health and Human Services. Available at: https://www.hhs.gov/about/news/2017/04/19/trump-administration-awards-grants-states-combat-opioid-crisis.html.

Division of HIV/AIDS Prevention Funding

The Centers for Disease Control and Prevention (CDC) provides leadership in improving public health by working with community, state, national, and international partners in surveillance, research, and prevention and evaluation activities. The Division of HIV/AIDS Prevention (DHAP) is responsible for HIV control activities.

Data source: Centers for Disease Control and Prevention (CDC). Available at: https://www.cdc.gov/nchhstp/stateprofiles/default.htm.

Division of Viral Hepatitis Funding

The Centers for Disease Control and Prevention (CDC) provides leadership in improving public health by working with community, state, national, and international partners in surveillance, research, and prevention and evaluation activities. The Division of Viral Hepatitis (DVH) is responsible for viral hepatitis control activities.

Data source: Centers for Disease Control and Prevention (CDC). Available at: https://www.cdc.gov/nchhstp/stateprofiles/default.htm.

Drug-related Deaths

The total number of deaths from drug poisoning, including both illicit and prescription drugs. Drug poisoning data are from CDC's Detailed Cause of Death data and includes ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14. Data not available for Puerto Rico. All sub-national data representing zero to nine (0-9) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 10 persons. State-level estimates include suppressed values; as such, county and district estimates may not sum to state value.

Data source: Centers for Disease Control and Prevention. Available at: https://wonder.cdc.gov/.

Drug-related Deaths per 100,000

The rate of death from drug poisoning, including both illicit and prescription drugs, per 100,000 population. Drug poisoning data are from CDC's Detailed Cause of Death data and includes ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14. These values are not age-adjusted. Data not available for Puerto Rico. All sub-national data representing zero to nine (0-9) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 10 persons. State-level estimates include suppressed values; as such, county and district estimates may not sum to state value.

Data source: Centers for Disease Control and Prevention. Available at: https://wonder.cdc.gov/.

Estimated Acute Hepatitis C Cases per 100,000

Estimated number of acute (newly diagnosed) cases of hepatitis C in one year, calculated from CDC reported cases, scaled by population. CDC estimates the actual number of acute cases to be 13.9 times the number of reported cases. This estimate does not capture the total number of people living with both acute and chronic hepatitis C, and therefore underrepresents the actual number of cases. According to the U.S. Department of Health and Human Services, acute hepatitis C leads to chronic infection in 75-85% of cases. Hepatitis C reporting to CDC is currently voluntary, undermining the ability to surveil the epidemic and identify potential outbreaks.

Data source: Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/hepatitis/statistics/.

Estimated Cases of Acute Hepatitis C

Estimated number of acute (newly diagnosed) cases of hepatitis C in one year, calculated from CDC reported cases. CDC estimates the actual number of acute cases to be 13.9 times the number of reported cases. This estimate does not capture the total number of people living with both acute and chronic hepatitis C, and therefore underrepresents the actual number of cases. According to the U.S. Department of Health and Human Services, acute hepatitis C leads to chronic infection in 75-85% of cases. Hepatitis C reporting to CDC is currently voluntary, undermining the ability to surveil the epidemic and identify potential outbreaks.

Data source: Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/hepatitis/statistics/.

Facilities Providing Mental Health Services

Number of facilities that provide mental health services. Types of care include crisis intervention teams, psychiatric emergency walk-in services, or mental health treatment. Facilities include hospital inpatient, outpatient, residential, or partial hospitalization/day treatment.

Data source: Substance Abuse and Mental Health Services Administration. Available at: https://www.findtreatment.samhsa.gov.

Facilities Providing Substance Abuse Services

Number of facilities that provide substance abuse services. Types of care include substance abuse treatment, detoxification, transitional housing or halfway houses, prescribing of buprenorphine and/or naltrexone, or SAMHSA-certified Opioid Treatment Programs. Facilities include hospital inpatient, residential, or outpatient.

Data source: Substance Abuse and Mental Health Services Administration. Available at: https://www.findtreatment.samhsa.gov.

Hepatitis C Prevalence per 100,000

Estimated number of persons living with Hepatitis C antibodies, scaled by population. The latest available estimates are from 2010. Data not available for Puerto Rico.

Data source: HepVu. Available at: https://hepvu.org

HIV Prevalence per 100,000

Number of people living with diagnosed HIV per 100,000, among adults and adolescents 13 and older (children represent approximately 0.2% of new HIV infections in any year). All sub-national data representing zero to four (0-4) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data source: CDC. Available at: https://gis.cdc.gov/grasp/nchhstpatlas/main.html.

HOPWA CPD Allocations and Awards

The Housing Opportunities for Persons With AIDS (HOPWA) Program is the only Federal program dedicated to the housing needs of people living with HIV/AIDS. Under the HOPWA Program, HUD makes grants to local communities, States, and nonprofit organizations for projects that benefit low-income persons living with HIV/AIDS and their families.

Data Source: Department of Housing and Urban Development (HUD). Available at: https://www.hudexchange.info/grantees/allocations-awards.

Inpatient Stays Resulting from Opioids per 100,000

Opioid-related rate of inpatient stays per 100,000 population. Inpatient stays include those admitted through the emergency department. Data are from the Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project (HCUP), and the National Inpatient Sample (NIS). The NIS is based on the data collection efforts of data organizations in participating States that maintain statewide data systems and that have partnered with AHRQ. Data from non-Partner States are missing completely from the sampling frame, and data from Partner States are sometimes incomplete because of different State reporting requirements, different State restrictions, or other data omissions. The full list of ICD-10 codes included in the opioid-related stay category are described in greater detail in the data source.

Data source: Healthcare Cost and Utilization Project (HCUP). Available at: https://www.hcup-us.ahrq.gov/.

Jurisdictions that have Completed a CDC Consultation

Since 2016, federal funding from the Department of Health and Human Services (DHHS) can be used to support syringe exchange programs (SEPs). Before these funds may be used for SEPs, each jurisdiction must submit a request to the Centers for Disease Control and Prevention (CDC) demonstrating that they are experiencing or at high risk of experiencing an HIV or hepatitis outbreak related to drug use.

Data Source: Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/hiv/risk/ssps-jurisdictions.html.

New HIV Diagnoses

Number of new HIV diagnoses in one year, among adults and adolescents 13 and older (children represent approximately 0.2% of new HIV infections in any year). All sub-national data representing zero to four (0-4) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data source: CDC. Available at: https://gis.cdc.gov/grasp/nchhstpatlas/main.html.

New HIV Diagnoses per 100,000

Number of new HIV diagnoses per 100,000 in one year, among adults and adolescents 13 and older (children represent approximately 0.2% of new HIV infections in any year). All sub-national data representing zero to four (0-4) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data source: CDC. Available at: https://gis.cdc.gov/grasp/nchhstpatlas/main.html.

Number of 30 Days Supply of Opioids per Part D Enrollee

The number of standardized 30-day supplies of opioids reimbursed by Medicare Part D, per Medicare Part D enrollee. All data used for these values are from the Centers for Medicare & Medicaid Services (CMS). State data on the number of prescriptions come from the Part D Prescriber Summary table, which detail the number of standardized 30-day supplies of each drug billed to Medicare per state. County data were aggregated from the Part D Prescriber Public Use File (PUF), which contains data at the provider-drug level. Providers were matched to their ZIP code by using their unique National Provider Identifier (NPI) in the July 2015 NPPES Data Dissemination. The July 2015 NPPES Data Dissemination was accessed via archive.org, as it is not currently posted publicly as far as we can tell. It is available upon request. The standardized 30-day supply measure was also used at the county level. Part D enrollment data comes from the Medicare Enrollment Dashboard.

Centers for Medicare and Medicaid Services. Available at: Prescribing data:https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/PartD2015.html.
Enrollment data: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html.
NPPES linking data: by request.

Number of People Living with HIV

Number of people living with diagnosed HIV, among adults and adolescents 13 and older (children represent approximately 0.2% of new HIV infections in any year). All sub-national data representing zero to four (0-4) deaths are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data source: CDC. Available at: https://gis.cdc.gov/grasp/nchhstpatlas/main.html.

Number of People with Hepatitis C

Estimated number of persons living with Hepatitis C antibodies. The latest available estimates are from 2010. Data not available for Puerto Rico.

Data source: HepVu. Available at: https://hepvu.org

Opioids prescribed per capita, in morphine mg equivalents (MME)

The amount of opioids prescribed, in morphine milligram equivalents (MME) per population. MME measurement allows for direct comparison of different opioids. The average daily MME per prescription was 48.1 in 2015, and prescriptions for 90 MME per day and up are considered to be "high-dose". This measure is from a recently published Centers for Disease Control and Prevention (CDC) report entitled "Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015" which uses retail prescription data from QuintilesIMS.

Data Source: Centers for Disease Control and Prevention (CDC). Available at: https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm?s_cid=mm6626a4_w.

Percent Needing but Not Receiving Addiction Treatment

Percent of total population aged 12 or older reporting needing but not receiving treatment for illicit drug use in the past year divided by the percent of total population aged 12 or older reporting illicit drug dependence or abuse in the past year. Data are from the National Survey on Drug Use and Health (NSDUH). Data are available at the national, state, and substate region level, with data linked to counties using the "2012-2014 National Survey on Drug Use and Health Substate Region Definitions."

Data source: Substance Abuse and Mental Health Services Administration. Available at: https://www.samhsa.gov/data/population-data-nsduh. Data not available for Puerto Rico.

Percent of Drug Treatment Paid by Medicaid

Percentage of buprenorphine and buprenorphine/naloxone combination prescriptions covered by Medicaid. Data not available for Puerto Rico.

Data source: IMS Institute for Healthcare Informatics. Available at: https://www.imshealth.com/files/web/IMSH%20Institute/Reports/Healthcare%20Briefs/IIHI_Use_of_Opioid_Recovery_Medications.pdf.

Percent of People 12+ Reporting Drug Dependence

Percent of total population aged 12 or older reporting illicit drug dependence or abuse in the past year from the National Survey on Drug Use and Health (NSDUH). Data are available at the national, state, and substate region level, with data linked to counties using the "2012-2014 National Survey on Drug Use and Health Substate Region Definitions." Data not available for Puerto Rico.

Data source: Substance Abuse and Mental Health Services Administration. Available at: https://www.samhsa.gov/data/population-data-nsduh.

Percent of People without Health Insurance

Percent of civilian noninstitutionalized population with no health insurance coverage. Data are from the Selected Economic Characteristics table from the American Community Survey 5-Year Estimates.

Data source: United States Census. Available at: https://factfinder.census.gov.

Percent of Population 12 or Older Reporting Non-medical Use of Pain Relievers

Percent of total population aged 12 or older reporting nonmedical use of pain relievers in the past year from the National Survey on Drug Use and Health (NSDUH). Data are available at the national, state, and substate region level, with data linked to counties using the "2012-2014 National Survey on Drug Use and Health Substate Region Definitions." Data not available for Puerto Rico.

Data source: Substance Abuse and Mental Health Services Administration. Available at: https://www.samhsa.gov/data/population-data-nsduh.

Physicians Licensed to Administer Buprenorphine

Number of physicians authorized to treat opioid dependency with buprenorphine by state. This includes physicians at substance abuse treatment facilities, as well as DATA-certified physicisians.

Substance Abuse and Mental Health Services Administration (SAMHSA). Available at: https://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator.

Population

Population estimates are from the United States Census' Annual Estimates of the Resident Population, all ages. Data are available from American FactFinder.

Data source: United States Census. Available at: https://factfinder.census.gov.

Ryan White Part A Total Funding

The Ryan White HIV/AIDS Program provides a comprehensive system of care that includes primary medical care and essential support services for people living with HIV who are uninsured or underinsured. The Program works with cities, states, and local community-based organizations to provide HIV care and treatment services to more than half a million people each year. Part C funding totals include both Early Intervention Services and Capacity Development Program grants. Part F funding totals include only the Dental Programs. For more information about the Ryan White HIV/AIDS Program, see: https://hab.hrsa.gov/about-ryan-white-hivaids-program/about-ryan-white-hivaids-program.

Data source: Ryan White funding information comes from the Health Resources and Services Administration (HRSA). Funding for the various parts is available at: Part A, Part B , Part C Capacity Development , Part C Early Intervention , Part D , Part F Dental Programs .

Syringe Exchange Program Legality

Indicates whether states have specifically authorized syringe service programs statewide in legislation. States where local units have interpreted state laws to allow syringe access services or where no law prohibits syringe exchange are considered to permit syringe exchange programs. States with pilot programs, those where syringe exchange would require legislative action and/or supportive interpretation of local laws, or those with pending syringe exchange legislation are considered illegal. State laws were gathered from the HIV Prevention Justice Alliance, and compared against current syringe exchange program legislation on state government websites to review accuracy and up-to-date status.

Data source: HIV Prevention Justice Alliance. Available at: http://www.preventionjustice.org/wp-content/uploads/2017/03/TAG-IDU-HIV-and-HCV-prevention-webinar-3.20.17.pdf.

Syringe Exchange Programs

Total number of syringe exchange programs. The directory of syringe exchange programs is aggregated by self-reporting and is therefore unlikely to be a comprehensive and complete list of all syringe exchange programs. Does not include programs that do not distribute syringes.

Data source: North American Syringe Exchange Network. Available at: https://nasen.org/directory.

Third-party Naloxone Prescriptions

Naloxone prescriptions are categorized as legal if pharmacists are allowed to dispense or distribute naloxone without a patient-specific prescription from another medical professional. Laws may allow standing order or protocol order prescriptions, collaborative practice agreements, or pharmacist prescriptive authority. The full text of the relevant laws can be found in the data source. In addition, the dataset has been updated to reflect the passage of MT HB 333.

Data source: The Policy Surveillance Program: A LawAtlas Project. Naloxone Overdose Prevention Laws. Available at: http://lawatlas.org/datasets/laws-regulating-administration-of-naloxone.