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

Age-adjusted Drug Poisoning Deaths per 100,000 (Modeled)

Estimated rate of death from drug poisoning, including both illicit and prescription drugs, per 100,000 U.S. standard population for 2000. Only available at county level. For state data, see drug deaths per 100,000. Estimates come from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) Data Visualization Gallery. The data are binned below 30 deaths per 100,000 in bins of size 1.9, and counties with estimated rates over 30 are coded as "30+". It should be noted that these data are estimates, and are drawn from a model designed to generate stable estimates of death rates where data are sparse due to small population size. Specific county values should be interpreted with caution, and the actual measure of drug deaths per 100,000 should be preferred where available. More information on the estimation procedure available at the link below.

Data Source: Centers for Disease Control's National Center for Health Statistics Data Visualization Gallery.

Available at: https://www.cdc.gov/nchs/data-visualization/drug-poisoning-mortality/

CDC 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

Available at: https://www.cdc.gov/nchhstp/stateprofiles/default.htm

CDC 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

Available at: https://www.cdc.gov/nchhstp/stateprofiles/default.htm

CDC National Center for Injury Prevention and Control 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 CDC’s National Center for Injury Prevention and Control (NCIPC) supports research and prevention activities related to opioid overdose, violence, motor vehicle safety, and other sources of injury and disability. NCIPC funding represented here is limited to two categories related to opioids: Illicit Opioid Use Risk Factors and Opioid Prescription Drug Overdose.

Data Source: Centers for Disease Control and Prevention

Available at: https://wwwn.cdc.gov/fundingprofilesapp/FundingProfiles/FundingQuery

Distance to Nearest SSP

Distance to a facility. The geographic distance is calculated in miles using haversine equation between each ZIP code tabulation area (ZCTA) without a facility and the nearest ZCTA containing such a facility. County estimates are averages of the ZCTAs contained in that county. Syringe services program locations are taken from the North American Syringe Exchange Network (NASEN) and does not include programs that do not distribute syringes.

Based on analysis originally published at CROI: 220 Vulnerable Counties: One Year Later

Data Source: amfAR Analysis

Available at: http://opioid.amfar.org/indicator/num_SSPs

Distance to Nearest Substance Abuse Facility providing MAT

Distance to a facility. The geographic distance is calculated in miles using haversine equation between each ZIP code tabulation area (ZCTA) without a facility and the nearest ZCTA containing such a facility. County estimates are averages of the ZCTAs contained in that county. Facilities locations are taken from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) and is limited to facilities that report providing at least one form of medication-assisted treatment.

Based on analysis originally published at CROI: 220 Vulnerable Counties: One Year Later

Data Source: amfAR Analysis

Available at: http://opioid.amfar.org/indicator/SMAT_fac

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. This includes both opioid and non-opioid drug poisonings, since the CDC reports that due to variable levels of completeness on death certificates only 28 states have high enough quality of data to report drug-specific poisoning data. 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. This includes both opioid and non-opioid drug poisonings, since the CDC reports that due to variable levels of completeness on death certificates only 28 states have high enough quality of data to report drug-specific poisoning data. 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

Emergency Department Visits Resulting from Opioids per 100,000

Rate of opioid-related emergency department visits per 100,000 population. Emergency department visits include all visits regardless of whether they result in admission. 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: Agency for Healthcare Research and Quality.

Available at: https://www.hcup-us.ahrq.gov

enumerations.Med_SA_HIV_fac

indicator.long-Med_SA_HIV_fac

Data Source: indicator.source-Med_SA_HIV_fac

Available at: indicator.link-Med_SA_HIV_fac

enumerations.SA_HIV_fac

indicator.long-SA_HIV_fac

Data Source: indicator.source-SA_HIV_fac

Available at: indicator.link-SA_HIV_fac

Estimated Acute Hepatitis C Cases per 100,000

Estimated number of acute (newly diagnosed) cases of hepatitis C in one year, per 100,000 population, 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 CDC, acute hepatitis C leads to chronic infection in 75-85% of cases. Hepatitis C has been a nationally notifiable diseases since 1994, yet not all states report usable data and no HCV data are available at the county level, 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 CDC, acute hepatitis C leads to chronic infection in 75-85% of cases. Hepatitis C has been a nationally notifiable diseases since 1994, yet not all states report usable data and no HCV data are available at the county level, 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 All Medication Assisted Treatments

Number of substance abuse treatment facilities offering all three MAT services (Buprenorphine, Methadone, Naltrexone). Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. To qualify as providing all three MAT services, facilities must have declared that methadone, buprenorphine, and naltrexone are included in their programs. These include facilities coded with: At least one of: BM (Buprenorphin maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification); At least one of: DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time); and at least one of: VTRL (Extended-release, injectable naltrexone). Of note, N-SSATS facilities can also be coded as UBN (Prescribes/administers buprenorphine and/or naltrexone). Some facilities do report as UBN but do not individually report offering either buprenorphine or naltrexone. These facilities are included in substance abuse facilities offering any MAT, but are excluded here. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing All Medication Assisted Treatments and Accepting Medicaid

Number of substance abuse treatment facilities offering all three MAT services (Buprenorphine, Methadone, Naltrexone) and accept Medicaid. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. To qualify as providing all three MAT services, facilities must have declared that methadone, buprenorphine, and naltrexone are included in their programs. These include facilities coded with: At least one of: BM (Buprenorphin maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification); At least one of: DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time); and at least one of: VTRL (Extended-release, injectable naltrexone). Of note, N-SSATS facilities can also be coded as UBN (Prescribes/administers buprenorphine and/or naltrexone). Some facilities do report as UBN but do not individually report offering either buprenorphine or naltrexone. These facilities are included in substance abuse facilities offering any MAT, but are excluded here. Medicaid accepting facilities are identified from key code MD (Medicaid) in the N-SSATS data. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing at Least Two Different Forms of Medication Assisted Treatment

Number of substance abuse treatment facilities offering at least two forms of medication assisted treatment (MAT). Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Treatment programs that offer any two of the medications used in the treatment of substance abuse disorders (methadone, buprenorphine, or naltrexone) are included. These include facilities coded with at least two different services: Buprenorphine - BM (Buprenorphine maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification); Methadone - DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time); and/or Naltrexone - VTRL (Extended-release, injectable naltrexone). Facilities coded as UBN (Prescribes/administers buprenorphine and/or naltrexone) that do not individually report either buprenorphine or naltrexone are only included if the facility also offers one of the Methadone codes. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing at Least Two Different Forms of Medication Assisted Treatment and Accepting Medicaid

Number of substance abuse treatment facilities offering at least two forms of medication assisted treatment (MAT) and accept Medicaid. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Treatment programs that offer any two of the medications used in the treatment of substance abuse disorders (methadone, buprenorphine, or naltrexone) are included. These include facilities coded with at least two different services: Buprenorphine - BM (Buprenorphine maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification); Methadone - DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time); and/or Naltrexone - VTRL (Extended-release, injectable naltrexone). Facilities coded as UBN (Prescribes/administers buprenorphine and/or naltrexone) that do not individually report either buprenorphine or naltrexone are only included if the facility also offers one of the Methadone codes. Medicaid accepting facilities are identified from key code MD (Medicaid) in the N-SSATS data. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing Mental Health Services

Number of facilities that provide mental health services. Data from The National Mental Health Services Survey (N-MHSS) - an annual survey of U.S. facilities offering mental health services facilities. 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.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-MHSS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://www.samhsa.gov/data/mental-health-facilities-data-nmhss/reports

Facilities Providing Mental Health Services and Accepting Medicaid

Number of facilities that provide mental health services. Data from The National Mental Health Services Survey (N-MHSS) - an annual survey of U.S. facilities offering mental health services facilities. 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. Medicaid accepting facilities are identified from key code MD (Medicaid) in the N-MHSS data.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-MHSS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://www.samhsa.gov/data/mental-health-facilities-data-nmhss/reports

Facilities Providing Some Medication Assisted Treatment

Number of substance abuse treatment facilities offering any form of medication assisted treatment (MAT). Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Treatment programs that offers at least one medication used in the treatment of substance abuse disorders (methadone, buprenorphine, or naltrexone) are included. These include facilities coded with any of the following: BM (Buprenorphin maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification), DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time), UBN (Prescribes/administers buprenorphine and/or naltrexone), VTRL (Extended-release, injectable naltrexone). Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing Some Medication Assisted Treatment and Accepting Medicaid

Number of substance abuse treatment facilities offering any form of medication assisted treatment (MAT) and accept Medicaid. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Treatment programs that offers at least one of the medication used in the treatment of substance abuse disorders (methadone, buprenorphine, or naltrexone) are included. These include facilities coded with any of the following: BM (Buprenorphin maintenance), BMW (Buprenorphine maintenance for a pre-determined time), BU (Buprenorphine used in treatment), BUM (Buprenorphine maintenance (<2016)), DB (Buprenorphine detoxification), DM (Methadone detoxification), METH (Methadone), MM (Methadone maintenance), MMW (Methandone maintenance for pre-determined time), UBN (Prescribes/administers buprenorphine and/or naltrexone), VTRL (Extended-release, injectable naltrexone). Medicaid accepting facilities are identified from key code MD (Medicaid) in the N-SSATS data. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Facilities Providing Substance Abuse Services

Number of facilities that provide substance abuse services. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. 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 for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Hepatitis C Prevalence per 100,000

Estimated number of persons living with Hepatitis C antibodies, scaled by population. A positive Hepatitis C antibody test means that a person has ever been exposed to the virus, and includes the 15-20% of people infected with HCV that spontaneously clear the virus without treatment. Since this measure includes both current and historic cases of HCV, it is likely to be overestimate the current prevalence. The latest available estimates are from 2010, and therefore do not reflect the tripling in acute HCV infections from 2010-2015. Data not available for Puerto Rico.

Data Source: HepVu. Emory University, Rollins School of Public Health.

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) persons are suppressed.

Data Source: Centers for Disease Control and Prevention

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

HOPWA 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

Available at: https://www.hudexchange.info/grantees/allocations-awards/?params=%7B%22limit%22%3A20%2C%22COC%22%3Afalse%2C%22sort%22%3A%22%22%2C%22min%22%3A%22%22%2C%22years%22%3A%5B%5D%2C%22dir%22%3A%22%22%2C%22grantees%22%3A%5B%5D%2C%22state%22%3A%22%22%2C%22programs%22%3A%5B8%5D%2C%22max%22%3A%22%22%7D

Inpatient Stays Resulting from Opioids per 100,000

Rate of opioid-related inpatient stays per 100,000 population. Inpatient stays are all formally-admitted hospital stays, and 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: Agency for Healthcare Research and Quality.

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

Law Enforcement Seizures of Fentanyl

The total number of drug seizures that were tested by forensic laboratories and reported to contain fentanyl to the Drug Enforcement Agency's (DEA) National Forensic Laboratory Information System (NFLIS) in a calendar year (currently only available for 2015 and 2016). The NFLIS collects drug chemistry analysis results, as well as other related information, from cases analyzed by state, local and federal forensic laboratories. These laboratories analyze substances secured in law enforcement operations across the country.

Data Source: DEA National Drug Threat Assessment (NDTA), 2016 and 2017

Available at:

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) diagnoses are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data Source: Centers for Disease Control and Prevention

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) diagnoses are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data Source: Centers for Disease Control and Prevention

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. A standardized 30-day supply is bottom coded at 1, and top coded at 12. This means efforts to reduce the number of doses per prescription are not well captured by this measure. However, as the state-level data do not contain the actual days' supply, the 30-day supply measure was used for consistency. 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 but is available upon request. The standardized 30-day supply measure was also used at the county level, although days' supply, a more accurate measure of the volume prescribed, is available in the Prescriber PUF. Part D enrollment data comes from the Medicare Enrollment Dashboard.

Data Source: Centers for Medicare and Medicaid Services.

Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/PartD2016.html

Number of People Living with Diagnosed 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) persons are suppressed. Corresponding sub-national denominator population figures are also suppressed when the population represents fewer than 5 persons.

Data Source: Centers for Disease Control and Prevention

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. A positive Hepatitis C antibody test means that a person has ever been exposed to the virus, and includes the 15-25% of people infected with HCV that spontaneously clear the virus without treatment. Since this measure includes both current and historic cases of HCV, it is likely to be overestimate the current prevalence. The latest available estimates are from 2010, and therefore do not reflect the tripling in acute HCV infections from 2010-2015. Data not available for Puerto Rico.

Data Source: HepVu. Emory University, Rollins School of Public Health.

Available at: https://hepvu.org

Opioid Prescriptions per 100 Persons

The number of opioid prescriptions dispensed, per 100 U.S. residents. This measure uses IQVIA data from pharmacies which dispense nearly 90% of all retail prescriptions in the US. It includes prescriptions paid for by commercial insurance, Medicaid, Medicare, or cash or equivalent. Cough and cold formulations containing opioids and buprenorphine products typically used to treat opioid use disorder are excluded, and IQVIA data does not include methadone dispensed through methadone maintenance treatment programs.

Data Source: Centers for Disease Control and Prevention

Available at: https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

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 by accounting for differing potencies. 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. County-level data were shared privately by CDC.

Data Source: Centers for Disease Control and Prevention

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." Sub-state data should be interpreted with caution. 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 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 the 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

Percent of Substance Abuse Facilities that Offer Both HIV Testing and HCV Screening

Percent of substance abuse facilities that report offering both HIV testing and hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT and Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Percent of Substance Abuse Facilities that Offer HCV Screening

Percent of substance abuse facilities that report offering Hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Percent of Substance Abuse Facilities that Offer HIV Testing

Percent of substance abuse facilities that report offering HIV testing. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

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

Providers Licensed to Administer Buprenorphine

Number of providers (including RNs and PAs) authorized to treat opioid dependency with buprenorphine. This includes providers at substance abuse treatment facilities, as well as DATA-certified providers. The national number is updated weekly from SAMHSA's Physician and Program Data webpage. State and county providers counts represented here are limited to those providers that have chosen to be publicly identified on SAMHSA's treatment locator and are therefore lower than the national total when summed.

Data Source: Substance Abuse and Mental Health Services Administration

Available at: https://findtreatment.samhsa.gov/locator

Ryan White 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. Find more information about the Ryan White HIV/AIDS Program here.

Data Source: Health Resources and Services Administration.

Available at:

SAMHSA FR-CARA Funding

The First Responders - Comprehensive Addiction and Recovery Act Cooperative Agreement (FR-CARA) program is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). This program trains and provides resources to first responders and other key community sectors to admister the opioid overdose reversing drug naloxone.

Data Source: Department of Health and Human Services

Available at: https://www.samhsa.gov/grants-awards-by-state

SAMHSA MAT-PDOA Funding

The Targeted Capacity Expansion: Medication Assisted Treatment - Prescription Drug and Opioid Addiction (MAT-PDOA) grant program is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). This program provides funding to states to build medication assisted treatment (MAT) capacity, and to provide MAT and recovery services that are 'accessible, effective, comprehensive, coordinated, and evidence-based.'

Data Source: Substance Abuse and Mental Health Services Administration (SAMHSA)

Available at: https://www.samhsa.gov/grants-awards-by-state

SAMHSA Opioid State Targeted Response 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/2018/04/18/hhs-provides-states-second-installment-grant-awards-combat-opioid-crisis.html

SAMHSA PDO Funding

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths are administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). This program aims to train first responders and other key community sectors on the prevention of prescription drug/opioid overdose-related deaths, and to purchase and distribute naloxone to first responders.

Data Source: Department of Health and Human Services

Available at: https://www.samhsa.gov/grants-awards-by-state

SAMHSA State Opioid Response Grants

State Opioid Response Grants program is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). This program aims to address the opioid crisis by increasing access to medication-assisted treatment (MAT) using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) (including prescription opioids, heroin, and illicit fentanyl and fentanyl analogs).

Data Source: Department of Health and Human Services

Available at: https://www.samhsa.gov/sites/default/files/grants/pdf/sorfoafinal.6.14.18.pdf

State Good Samaritan Laws

Indicates whether states have enacted "Good Samaritan" laws, which provide legal protections for people who call for help when they witness an overdose. Some states provide protection from parole or probation violations. State Good Samaritan laws vary as to whether they provide protection from arrest, charge, prosecution, or another type of protection.

Data Source: Prescription Drug Abuse Policy System

Available at: http://pdaps.org/datasets/good-samaritan-overdose-laws-1501695153

State Medicaid Coverage of Methadone for Treatment

Indicates whether states reported Medicaid coverage of methadone. Methadone is a medication used to treat Opioid Use Disorder (OUD), and has been shown to decrease the probability of overdose death, as well as lower rates of infectious disease. State Medicaid programs that do not cover methadone make it more difficult for patients to get treatment for their OUD.

Data Source: Kaiser Family Foundation

Available at: https://www.kff.org/medicaid/state-indicator/states-reporting-medicaid-coverage-of-medication-assisted-treatment-mat-drugs/

Substance Abuse Facilities Offering Both HIV Testing and HCV Screening

Number of substance abuse facilities that report offering both HIV testing and hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT and Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Facilities Offering Both HIV Testing and HCV Screening and Accepting Medicaid

Number of substance abuse facilities that report offering both HIV testing and hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT and Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Medicaid accepting facilities are identified from key code MD in the N-SSATS facilities catalog. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Facilities Offering HCV Screening

Number of substance abuse facilities that report offering hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Facilities Offering HCV Screening and Accepting Medicaid

Number of substance abuse facilities that report offering hepatitis C screening. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. Hepatitis C screening facilities are identified from key code SHC in the N-SSATS facilities catalog starting in 2016. Medicaid accepting facilities are identified from key code MD in the N-SSATS facilities catalog. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Facilities Offering HIV Testing

Number of substance abuse facilities that report offering HIV testing. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT in the N-SSATS facilities catalog starting in 2016. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Facilities Offering HIV Testing and Accepting Medicaid

Number of substance abuse facilities that report offering HIV testing. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. HIV testing facilities are identified from key code HIVT in the N-SSATS facilities catalog starting in 2016. Medicaid accepting facilities are identified from key code MD in the N-SSATS facilities catalog. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

Substance Abuse Services Facilities Accepting Medicaid

Number of facilities that provide substance abuse services and accept Medicaid. Data are from The National Survey of Substance Abuse Treatment Facilities (N-SSATS) - an annual survey of U.S. facilities offering treatment services for alcohol and drug abuse. 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. Medicaid accepting facilities are identified from key code MD in the N-SSATS facilities catalog. Data for the most recent year are downloaded from https://findtreatment.samhsa.gov/. Data for prior years are sourced from published facility directories.

Methodology Change: Note that as of August 10, 2018, there has been a methodology change. Previously, data were presented for the year of the N-SSATS Directory, which presents the results of the N-SSATS survey collected during the previous year. Data are now reflective of the year the N-SSATS survey was administered. Data for the current year remain those taken from SAMHSA's treatment locator.

Data Source: Substance Abuse and Mental Health Services Administration.

Available at: https://wwwdasis.samhsa.gov/dasis2/nssats.htm

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 to the North American Syringe Exchange Network (NASEN) 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. Syringe exchange programs wishing to be identified in the database should contact NASEN to be added to the file.

Data Source: North American Syringe Exchange Network.

Available at: https://nasen.org/directory

Unemployment Rate

Unemployment rate, from the Bureau of Labor Statistics (BLS) Local Area Unemployment Statistics (LAUS) program. Rates are annual averages.

Data Source: Bureau of Labor Statistics Local Area Unemployment Statistics

Available at: https://www.bls.gov/lau

Vulnerable County Rank

vulnerable_rank. In 2016, the CDC identified 220 counties at risk of experiencing an outbreak of HIV and/or hepatitis C among people that inject drugs. These represent only the top 5% of counties in the nation based on 6 factors assessed. The article abstract is available here.

Data Source: Centers for Disease Control and Prevention

Available at: https://www.ncbi.nlm.nih.gov/pubmed/27763996