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Data Handbook

Technical Notes Supporting information and technical notes about data processing, including the coding of deaths and non-fatal cases, suppression of counts, and statistical differences.

Data Definitions Definitions for Dashboard indicators including a brief description of the indicator, list of codes used, and limitations for each data source (Deaths, Morbidity, and Prescriptions).

Resource Links Links to information on the opioid epidemic and California’s approach, as well as additional data-related resources and websites.

Updates Important Dashboard data updates and feature announcements.

Publications Data Publications Supplemental Publications and Data Briefs featuring California opioid- and other drug-related data.

Welcome to the California Opioid Overdose Surveillance Dashboard

This Dashboard provides data on state and local level drug-related overdose outcomes for California, including deaths, emergency department visits, and hospitalizations, as well as opioid and select other drug prescription data. Data are available through collaboration with the Office of Statewide Health Planning and Development (OSHPD), the Center for Health Statistics and Informatics (CHSI), and the Department of Justice prescription drug monitoring program, Controlled Utilization Review and Evaluation System (CURES).

Any Opiod-Related Overdose Deaths

Total Population, Prelim. 2018 Age-Adjusted Rate per 100,000 Residents

Opioid Prescriptions (excl bup)

Total Population Age-Adjusted Rate per 1,000 Residents

Opioid Prescriptions (excl bup)

Amphetamine-Related Deaths now Equal to Opioid-Related Deaths

View California Data Insights

Data last updated on: 06/23/2020

Deaths: 2006 - Q3 2019*
ED Visits: 2006 - 2019
Hospitalizations: 2006 - Q2 2019*
Prescriptions: 2008 - Q1 2019*
*Note: Quarterly 2019 data are only available for viewing in the time trend box on the California and county dashboards

View all updates

Technical Notes

Supporting information and technical notes about data processing

Cause-of-Death Classification

Mortality statistics are compiled in accordance with World Health Organization (WHO) regulations, which specify that WHO member nations classify and code causes of death in accordance with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD).

ICD is the foundation for the identification of health trends and statistics globally, and the international standard for reporting diseases and health conditions (e.g. the poisoning categories used on this Dashboard). Additionally, the ICD provides the rules used to select the underlying cause of death from the multiple causes of death that may be reported on a single death certificate.

Causes of death for data presented on this Dashboard were coded according to the 10th revision of ICD (ICD-10). See the Data Dictionary for specific ICD-10 codes used for each data indicator.

For more information about ICD visit the WHO

Principle diagnosis & External cause classification

Morbidity (ED visits & hospitalization) statistics are compiled in accordance with the Centers for Medicare and Medicaid Services and the National Center for Health Statistics guidelines for coding and reporting using the International Classification of Diseases, Clinical Modification (current revision, ICD-10-CM).

The Clinical Modification is a morbidity classification published by the United States for classifying diagnoses and reason for visits in all health care settings. Both ICD-9-CM and ICD-10-CM are based on the respective ICD-9 and ICD-10 statistical classifications of disease for mortality coding published by the World Health Organization.

Morbidity data presented on this Dashboard were coded according to the ICD-9-CM and ICD-10-CM codes described in the Data Dictionary. Data prior to October 2015 are coded using ICD-9-CM. As of October 1, 2015 (fourth quarter), ICD-10-CM replaced ICD-9-CM and all subsequent morbidity data has been coded using ICD-10-CM.

See the Data Dictionary for specific ICD-10 codes used for each data indicator.

For more information on the transition from ICD-9-CM to ICD-10-CM

For more specific information about ICD-10-CM

Population denominators

Population estimates used for computing rates originate from the bridged-race population data available on the Centers for Disease Control and Prevention (CDC) WONDER (Wide-ranging Online Data for Epidemiologic Research). CDC WONDER

Bridged-race population estimates are produced by the U.S. Census Bureau in collaboration with the National Center for Health Statistics (NCHS) and released by NCHS. The population estimates used in this Dashboard are based on intercensal (between 2000 & 2010) and postcensal (between 2011 forward) estimates. Changes in rates between years may reflect differences between population estimates.

Quarterly rates are based on the population estimates for midpoint of the year containing the quarter. Rates for 12-month periods are based on the average of population estimates for each of the included quarters.

Note: In an effort to provide timely data, the California Department of Public Health creates population estimates for the current year using data obtained from the California Department of Finance (DOF) population estimates. These population estimates are used until the final estimates created by CDC are made available, usually in July of the following year (e.g. for 2017, population estimates were used until the CDC estimates were released in late July of 2018). DOF Population Estimates

Suppression of Counts

Counts are available at both the state and county level. However, given the Dashboard also presents indicators by selected demographic groups, counts for some combinations of time, geography, and demographic categories are either fully suppressed, or partially suppressed for counts less than six cases.

For more information about data de-identification and suppression of counts see: California Opioid Overdose Surveillance Dashboard Data Suppression

Computing rates

Crude Rates: Mortality and morbidity rates are on an annual basis per 100,000 estimated population.

Prescription Rates: Rates based on prescription data are on an annual basis per 1,000 estimated population, except for Milligrams of Morphine Equivalents (MMEs), which are estimated per resident.

Age-Adjusted Rates: Age-adjusted rates are used to compare relative risks over time or between geographic areas. However, they should be viewed as relative indexes rather than as actual measures of risk. All age-adjusted rates were computed by the direct method; that is, by applying age-specific death rates to the United States standard population (relative age distribution of year 2000 projected population of the United States).

Rate estimates are subject to sampling error and are less reliable when based on small counts. We encourage you to examine the confidence intervals when presented. Formulas used in the computation of rates in this application, and associated standard errors and confidence intervals, can be found at the following webpage: Rate Algorithms

Statistical differences

Statistical differences presented within this Dashboard are based on independent rates and conservative approaches. We determined whether a significant difference exists between rates by comparing the respective 95% confidence intervals for both rates.

As a conservative statistical test, we consider the differences not significant if the intervals overlap. For example, if we compared mortality rates for two consecutive years, and found Year 1 had an interval of 12.3-15.7 and the interval for Year 2 was 14.5-16.3, we would conclude there is no significant difference between the two rates.

Note: The smaller the number of events upon which the rate is based, the larger the confidence interval will be. Therefore, two rates based on small counts are less likely to be different.

Previous Note

Next Note

TERMS

Publications

Data Publications About Opioid-Related Issues in California

Injury and Violence Prevention Branch

Patterns of Opioid-Related Overdose Deaths in California, 2011-2017 California continues to face a serious public health crisis with the dynamic and rapidly changing opioid epidemic having substantial health and economic impacts. This brief describes opioid-related overdose deaths over time, and demographic differences among different types of opioid overdoses. DOWNLOAD PDF

Counting Opioid Overdose Deaths Among American Indians Using Different Definitions The conventional public health surveillance method of counting opioid-related overdose deaths among American Indians and Alaska Natives ("AI/ANs") relies on a racial classification that counts only single-race AI/ANs. This brief describes different ways of counting AI/AN populations. DOWNLOAD PDF

Other Publications featuring California Data

Suspected Heroin Overdoses in US Emergency Departments, 2017-2018 From American Journal of Public Health (AJPH) LINK TO ABSTRACT

Help

Frequently Asked Questions and Select Help Topics

Understanding the Data

What can these data tell me?

The information provided on the Dashboard can help drive/support prevention and surveillance activities in your communities.
The Dashboard contains/presents/provides four administrative datasets: ED visit data, patient discharge data (hospitalizations), death certificate data, and prescription data
Data can be viewed at the state, county, and ZIP Code level. The county dashboard allows users to view their chosen county in relation to either another county or California
Both crude and age-adjusted rates are provided. Depending on the indicator and geography (CA vs. County level) selected, rates can be stratified by total population, sex, age, and race/ethnicity.

What is the source of these datasets?

ED visit data from the Office of Statewide Health Planning and Development (OSHPD)
Patient Discharge data (hospitalizations) from OSHPD
Death certificate data from CDPH Center for Health Statistics and Informatics (CHSI)
Prescription data from the Department of Justice Controlled Substance Utilization Review and Evaluation System (CURES), California's Prescription Drug Monitoring Program (PDMP

How are the data processed?

Data files are processed and prepared in SAS analytic software by the Dashboard team at CDPH.
Data quality checks are in place throughout the process to ensure the accuracy of indicators. All data are thoroughly checked by a team of research scientists and epidemiologists prior to publishing on the Dashboard.

For information about processing data see Technical Notes and for information on individual indicators see Data Definitions.

What do these terms mean: Age-adjusted rate, crude rate, prescription rate?

Crude Rate: Rates allow for fairer comparisons between geographies with different population totals. Crude rates also account for the total burden of a health outcome to a community. This statistic is calculated as the number of events (numerator) divided by the population at risk (denominator). The population at risk is “a term applied to all those whom an event could have happened, whether it did or not.”.
Age-Adjusted Rate: Age adjusting rates is a way to make fairer comparisons between groups with different age distributions. For example, a county having a higher percentage of elderly people may have a higher rate of death or hospitalization than a county with a younger population, merely because the elderly are more likely to die or be hospitalized. (The same distortion can happen when comparing races, genders, or time periods.) Age adjustment can make the different groups more comparable. A "standard" population distribution is used to adjust death and hospitalization rates. The age-adjusted rates are rates that would have existed if the population under study had the same age distribution as the "standard" population. Therefore, they are summary measures adjusted for differences in age distributions.
Prescription Rate: All prescription drug measures are based on counts of either prescriptions or residents meeting some criteria (i.e. taking 100+ MMEs of prescription opioids), divided by the population and multiplied by 1,000. Please note that prescription drug indicators are per 1,000 residents unless otherwise noted.

What is ICD-10-CM?

The U.S. developed ICD-10-CM, a Clinical Modification for medical diagnoses, based on World Health Organization’s International Classification of Diseases External 10th Revision (ICD-10), which was implemented for mortality coding and classification from death certificates in the U.S. in 1999.
On October 1, 2015, ICD-10-CM replaced the Ninth Revision (ICD-9-CM) for coding hospital discharge and emergency department visit records, including drug overdoses

For more information about ICD-10-CM see: ICD-10-CM Primer
For more information on the transition from ICD-9-CM to ICD-10-CM see: International Classification of Diseases, (ICD-10-CM/PCS) Transition – Background

Analyze & Report

Can I download the data for my own analysis?

Each Dashboard view (Geographic Distribution, Time Trend, and Demographic Breakdown) allows the user to download the currently selected data as a .csv file
Each tab view on the dashboard will download a dataset specific to that view:

For indicators by county (on the California Dashboard) or ZIP Code (on County Dashboards) - Geographic distribution
For indicators over time - Time trend
For indicators by a selected demographic (e.g., Age or Sex) - Demographic breakdown

Note: Some data will not be available or will be suppressed in downloded county .csv files due to data privacy rules for small counts.

How do I use the dashboard to view data for a specific topic or indicator?

The settings panel on the right side of each Dashboard view (Geographic Distribution, Time Trend, and Demographic Breakdown), allows users to select data visualization options including data source, year, and indicator. See Using the Dashboard help topic for more information.

Are there any pregenerated reports?

The Data Insights tab on the California and County dashboards contains data snapshots that can be downloaded.

Using the Dashboard

As a dashboard user, you can view state and county data in a variety of ways. We recommend exploring the various data indicators and visualization options to better understand how best to customize the data for your needs. <br> There are two dashboards available for use. Both the California Dashboard and the County Dashboard (links available in the sidebar) display data by county or zip code.

Look for the following when navigating the site:

Collapses or 'hides' the sidebar. For some screen sizes (i.e. 1078x768), collapsing the side bar may improve viewing of the dashboard. If not, we recommend adjusting your browser window.

Settings: Each Dashboard view has an analytic focus and is customizable by making changes in the Settings panel on the right side of the dashboard page. Settings include:

Data Source
Year to display (all graphs default to the most current year of data)
Data Indicator (review the Data Definitions page for more information about indicators)

Population type: total population or selected demographic group(s)

Type of rate to display (crude or age-adjusted)

Clicking, Hovering, Scrolling, & Dragging
All Dashboard maps, graphs, and charts are dynamic, which means they respond to clicking, hovering, scrolling, or dragging:

Maps will display data values for a selected area when clicked, zoom by scrolling (or by using the zoom buttons), and move by dragging. You can reset the map view by clicking [INSERT the target icon] on the maps.
Graphs respond to clicking and dragging and graphs can be reset by double-clicking. Axes can be moved by dragging up and down or side to side. You can also click and drag on a graph to zoom in on a specific section. Hovering your mouse over graph lines will display data values.
Charts respond to clicking and dragging and can be reset by double-clicking. Axes can be moved by dragging up and down or side to side. You can also click and drag on a chart to zoom in on a specific section. Hovering your mouse over bars will display data values.

Data Definitions

Select an indicator from below for a brief description, list of codes used, and limitations for each data source

Mortality Indicator Definitions - Death Certificates

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

Mortality Indicator:

Numerator Data Source

2016 and later: Death certificate data are from the California Comprehensive Death File (CCDF) provided by CDPH, Center for Health Statistics and Informatics (CHSI).

2006-2015: Death certificate data are from CDPH CHSI Multiple Cause of Death file (MCOD).
The National Center for Health Statistics (NCHS) codes all causes of death according to the International Classification of Diseases, 10th revision (ICD-10) for mortality using the literal cause of death text from death certificates.

Denominator

State and County Denominator: Denominators are midyear populations for the calendar year under surveillance. Midyear state and county populations were based upon CDC WONDER Bridge-Race Population Estimates, and are produced by the U.S. Census Bureau in collaboration with NCHS.
CDC WONDER Bridge-Race Population Estimates

Zip Code Denominator: Population estimates for Zip Code Tabulation Areas (ZCTAs) were based on two different data sources: American Community Survey five-year estimates and the 2010 Census. Estimates were obtained by using the US Census Bureau's data dissemination platform (previously American FactFinder). Data.census.gov

Note: Population estimates for the current year are created using data obtained from the California Department of Finance. These population estimates are used until the final estimates created by CDC WONDER are made available, usually in July of the following year (e.g. final population estimates for 2017 were released by the CDC in late July 2018). DOF Population Estimates

Measure of Frequency

Measures of frequency for the Dashboard include crude and age-adjusted rates available as annual rates, annualized quarterly rates, or 12-month moving averages. Age adjusted rates are standardized by the direct method to the year 2000 standard U.S. population.

Note: For 12-month moving averages, the 12-months ending in the fourth quarter of a given year represents the annual rate.

For the Time Trend table, under the Quarter column and the Q4 row for each year (e.g. 2018 Q4, 2017 Q4, 2016 Q4), the annual rate and count for that year can be found in the 12-Month Moving Avg. column for that row.

Period for Case Definition

The period for case definition is the calendar quarter and year based on the date of death.

Limitations

Drug overdose deaths represent only a small proportion of the overall burden of drug misuse, dependence, and overdose.

Dashboard indicators are not mutually exclusive, and an individual death certificate may have both prescription drugs and illicit drugs listed as the cause of death. For example, a death certificate that lists hydrocodone, heroin, benzodiazepines, and cocaine overdose as the cause of death will be counted in all the following mortality indicators: all drugs, any opioid, prescription opioids, heroin, benzodiazepines, and cocaine.

Indicators based on ICD-10 codes found in death data are limited by the quality and completeness of the reported causes of death from death certificates. ICD-10 codes are assigned by the National Center for Health Statistics (NCHS) and are based on the literal causes of death written on death certificates. NCHS ICD-10

The completeness of cause-of-death coding is also affected by the length of overdose investigations. Death investigations may require weeks or months to complete and while investigations are being conducted, deaths may be assigned a pending status on the death certificate (ICD-10 underlying cause code R99, ‘Ill-defined and unknown cause of mortality').

Analysis of the percentage of death certificates with an underlying cause of death of R99 by age, over time, and by jurisdiction should be conducted to determine potential impact of incomplete underlying causes of death on drug overdose death indicators.

Morbidity Indicator Definitions: Emergency Department Visits & Hospitalizations

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

Morbidity Indicator:

Numerator Data Source

ED visit data and patient discharge data provided by the California Office of Statewide Health Planning and Development (OSHPD).

Q4 2015-Present: Morbidity data coded using ICD-10-CM

Q3 2015 and earlier: Morbidity data coded using ICD-9-CM

*For more information about the transition from ICD-9-CM to ICD-10-CM see Non-Fatal Injury Classification in Technical Notes.

Measure of Frequency

Period for Case Definition

The period for case definition is the calendar quarter and year based on the date of the ED visit or the date of discharge from the hospital.

Limitations

Poisoning injuries that result in ED visits or hospitalizations represent only a portion of the overall burden of drug overdoses.
Indicators are selected from valid principal diagnosis codes for ICD-10-CM (or the first-listed valid external cause for ICD-9-CM codes) and not on any mention of a drug overdose diagnosis code.
The ICD-10-CM codes used by the Dashboard may represent provisional codes provided by the CDC. The sensitivity and specificity of these indicators may vary by quarter, year, hospital location, and drug type.

Note: The accuracy of indicators based on ICD-9-CM or ICD-10-CM codes found in ED visit and hospital discharge data is limited by the completeness and quality of reporting and coding. The overall completeness of external cause coding should be reviewed in conjunction with the indicator.

Prescription Drug Indicator Definitions

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

PDMP Indicator:

Numerator Data Source

California Department of Justice, Controlled Substance Utilization Review and Evaluation System (CURES), California's Prescription Drug Monitoring Program (PDMP).

Denominator

Measure of Frequency

Measures of frequency for the Dashboard include crude and age-adjusted rates available as annual rates, annualized quarterly rates, or 12-month moving averages. Age adjusted rates are standardized by the direct method to the year 2000 standard U.S. population.

Note: For 12-month moving averages, the 12-months ending in the fourth quarter of a given year represents the annual rate.
For the Time Trend table, under the Quarter column and the Q4 row for each year (e.g. 2018 Q4, 2017 Q4, 2016 Q4), the annual rate and count for that year can be found in the 12-Month Moving Avg. column for that row.

Period for Case Definition

The period for case definition is the calendar quarter and year based on the date the prescription was filled.

Limitations

Dashboard indicators are limited to data on prescriptions for California residents in CURES, California's Prescription Drug Monitoring Program (PDMP).
Indicators do not capture whether the dispensed medications were taken as prescribed or taken by the patient to whom they were prescribed. Additionally, indicators do not capture any drugs used outside of medical care or medications prescribed or dispensed in other states to California residents.

The accuracy of indicators based on PDMP data is limited by the completeness and quality of the data. Indicators at the patient level also depend on specific PDMP procedures for determining which prescriptions belong to the same patient. Prescriptions captured by a PDMP will vary based on the schedule of controlled substances (schedules II-IV) required to be reported to the PDMP.

The requirements for pharmacies to enter data into CURES varies depending on the organization, as some are not required to report to CURES (e.g., Veterans Affairs, or Indian Health Services), which will affect the number of prescriptions captured.

Note: Methods used to identify and match/link unique patients within a PDMP vary by completeness and accuracy. Additionally, rescheduling and upscheduling of specific drugs (e.g., tramadol and hydrocodone) will affect trends over time.

INDICATORS

Privacy Policy

Title of the Page

Pursuant to Government Code Section 11019.9, all departments and agencies of the State of California shall enact and maintain a permanent privacy policy, in adherence with the Information Practices Act of 1977 (Civil Code Section 1798 et seq.), that includes, but not necessarily limited to, the following principles:

Personally identifiable information may only be obtained through lawful means.
The purposes for which personally identifiable data are collected shall be specified at or prior to the time of collection, and any subsequent use of the data shall be limited to and consistent with the fulfillment of those purposes previously specified.
Personal data may not be disclosed, made available, or otherwise used for a purpose other than those specified, except with the consent of the subject of the data, or as required by law or regulation.
Personal data collected shall be relevant to the purpose for which it is needed.
The general means by which personal data is protected against loss, unauthorized access, use, modification, or disclosure shall be posted, unless the disclosure of those general means would compromise legitimate agency objectives or law enforcement purposes.

Each department shall implement this privacy policy by:

Designating which position within the department or agency is responsible for the implementation of and adherence to this privacy policy;
Prominently posting the policy physically in its offices and on its Internet website, if any;
Distributing the policy to each of its employees and contractors who have access to personal data;
Complying with the Information Practices Act (Civil Code Section 1798 et seq.), the Public Records Act (Government Code Section 6250 et seq.), Government Code Section 11015.5, and all other laws pertaining to information privacy, and
Using appropriate means to successfully implement and adhere to this privacy policy.
If you have any questions or comments about the information presented here, please contact the Privacy Office at: Privacy@cdph.ca.gov.

Resource Links

General Information

California Department of Public Health (CDPH)
California's Approach to the Opioid Epidemic

Opioid News and Data
Opioid-Related News, Data Updates, and Action Notices for California

Overdose Prevention Initiative (OPI)
CDPH Overdose Prevention Initiative

MAT Expansion
California Department of Health Care Services (DHCS) Medication Assisted Treatment (MAT) Expansion Project

Injury and Violence Prevention Branch
California Injury and Violence Prevention

Data Information

CDPH EpiCenter
California Injury Data Online Query

CDPH Center for Health Statistics and Informatics (CHSI)
Vital Records (Death) Data

Office of Statewide Health Planning and Development (OSHPD)
ED Visit and Hospitalization Data

Department of Justice (DOJ) - CURES 2.0
Prescription Data

PDMP TTAC
Brandeis Prescription Drug Monitoring Program Training and Technical Assistance Center

CDC WONDER
Population Data

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Updates

Dashboard data updates and feature announcements in chronological order

July 6, 2020

Full Year 2019 Preliminary Death Data Preliminary fourth quarter (October-December) 2018 mortality data are now available on the dashboard completing the full year of 2019. These data are now available for viewing on the California and County dashboards. Caution: Not all 2019 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

June 23, 2020

Full Year 2019 ED Visit Data Fourth Quarter Emergency Department Visit data are now available on the dashboard completing the full year of 2019. ED data for 2019 are now available for viewing on the Geographic Distribution and Demographic Breakdown boxes in addition to the Time Trend box.

May 27, 2020

Third Quarter 2019 Preliminary Death Data Preliminary third quarter (July - September) 2019 mortality trend data from CHSI (Center for Health Statistics and Informatics) including estimated number of fentanyl deaths, are now available. The preliminary data are only available in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.

Preliminary First & Second Quarter 2019 Mortality Trend Data Preliminary first and second quarter (January - March & April -June) 2019 mortality trend data, have been updated to reflect the most recent death file available from CHSI. The updated preliminary data are only available in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.
Note: Overall 2019 trends, including estimated number of fentanyl deaths, may have changed due to the resolution of pending cases. The updated preliminary data are only available in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.
Caution: Not all 2019 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

Amphetamine Mortality Indicator Name The name for the indicator “Amphetamine-Related Overdose Deaths” has been changed to “Psychostimulant with Abuse Potential-Related Overdose Deaths” to more accurately reflect the ICD-10 mortality code used to create the indicator. The data displayed by the indicator remains the same: acute poisoning deaths involving psychostimulants with abuse potential (e.g. methamphetamine or MDMA). For information on this indicator, please visit the Data Definitions page.

Race/Ethnicity Labels The labels for race/ethnicity have been updated to provide more descriptive information about the race/ethnicity categories used on the Dashboard. The underlying definitions for each group have not changed and all data displayed by these categories remains the same.

April 27, 2020

Third Quarter 2019 ED Trend Data Third quarter (July - September) 2019 Emergency Department visit data trend data from OSHPD are now available on the dashboard. These data are only available for viewing in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.

First & Second Quarter 2019 Hospitalization Trend Data First and second quarter (January - June) 2019 Hospital discharge trend data from OSHPD are now available. These data are only available for viewing in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.

January 16, 2020

NEW INDICATORS! Cannabis ED visits & Hospitalizations
ED visit and hospitalization data for cannabis-related overdose are now available on the dashboard starting in 2015. To view cannabis data, select other drug indicators from the settings ( ) panel of each dashboard visualization box (Geographic Distribution, Time Trend, and Demographic Breakdown) by selecting the 'Other Drugs' radio button and select cannabis fron the dropdown menu.

January 13, 2020

First and Second Quarter 2019 ED Trend Data

First and second quarter (January - June) 2019 Emergency Department Visit data are now available on the dashboard. These data are only available for viewing in the Time Trend box.

Preliminary First and Second Quarter 2019 Mortality Trend Data

Preliminary first and second quarter (January - June) 2019 mortality trend data including estimated number of fentanyl deaths, are now available. These data are only available for viewing in the Time Trend box.

Caution: Not all 2019 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved. These preliminary data are only available in the Time Trend box and are not displayed on other boxes or quick stats because full year 2019 data are not yet available.

First Quarter 2019 (CURES) Prescription Trend Data

First quarter (January - March) 2019 opioid prescription data from the Department of Justice (DOJ) CURES database are now available. These data are only available for viewing in the Time Trend box.

Full Year 2018 Death Data Mortality Data for 2018 have been updated to reflect the official 2018 California Comprehensive Master Death File from CHSI (Center for Health Statistics and Informatics). Updates to 'pending' cases in the preliminary file used previously has resulted in changes to death numbers, including number of fentanyl deaths, previously published on the dashboard.

Note: Overall 2018 trends, including estimated number of fentanyl deaths, have changed due to the resolution of pending cases.

August 14, 2019

Full Year 2018 Preliminary Death Data Preliminary fourth quarter (October-December) 2018 mortality data are now available on the dashboard completing the full year of 2018. These data are now available for viewing on the Geographic Distribution and Demographic Breakdown boxes in addition to the Time Trend box. Caution: Not all 2018 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

Full Year 2018 Prescription Data Fourth quarter CURES prescription data are now available on the dashboard completing the full year of 2018. These data are now available for viewing on the Geographic Distribution and Demographic Breakdown boxes in addition to the Time Trend box.

Full Year 2018 Morbidity (Hospitalization) Data Second and third quarter (July - December) 2018 Hospital discharge trend data from OSHPD are now available on the dashboard completing the full year of 2018. These data are now available for viewing on the Geographic Distribution and Demographic Breakdown boxes in addition to the Time Trend box.

Population Data for 2018 Population Data for 2018 has been updated to use current CDC Wonder data. Due to the updated population, rates for indicators may have changed. In an effort to provide the most timely data possible, the California Department of Public Health creates population estimates for the most current year (e.g., 2018) using data obtained from the Department of Finance Population Estimates. These population estimates are used until the final estimates created by CDC are made available, usually in July of the next year.

July 25, 2019

NOTICE OF CORRECTION - County Age-Adjusted Rates by Ethnicity An error has been discovered in the previously reported county race/ethnicity age-adjusted rates for morbidity and mortality indicators in the 6/18/2019 update. The issue has been corrected and no other age-adjusted rates were affected. We apologize for any inconvenience.

June 18, 2019

Any Opioid Combined with Other Drugs Indicators

New any opioid combined with other drug mortality indicators are now available:
- Any Opioid and Benzodiazepines, 2006-2017
- Any Opioid and Amphetamines, 2006-2017
- Any Opioid and Cocaine, 2011-2017

Other Drug Indicators

New indicators for other drugs are now available. Dashboard users can now select other drug indicators from the settings ( ) panel of each dashboard visualization box (Geographic Distribution, Time Trend, and Demographic Breakdown) by selecting the 'Other Drugs' radio button.
- Deaths related to Amphetamines and Cocaine, 2006-2017
- Hospitalizations related to Amphetamines, 2006-2017
- Hospitalizations related to Cocaine, 2011-2017
- ED Visits related to Amphetamines, 2006-2018
- ED Visits related to Cocaine, 2011-2018

Full Year 2018 ED Visit Data

Fourth Quarter Emergency Department Visit data are now available on the dashboard completing the full year of 2018. These data are now available for viewing on the Geographic Distribution and Demographic Breakdown boxes in addition to the Time Trend box.

Preliminary Third Quarter 2018 Mortality Trend Data

Preliminary third quarter (July - September) 2018 mortality trend data including estimated number of fentanyl deaths, are now available.

Preliminary First & Second Quarter 2018 Mortality Trend Data

Preliminary first and second quarter (January -June) 2018 mortality trend data, have been updated to reflect the most recent death file available.

Caution: Not all 2018 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

Note: Overall 2018 trends, including estimated number of fentanyl deaths, may have changed due to the resolution of pending cases. The updated preliminary data are only available in the Time Trend box and are not displayed on other boxes or quick stats because full year 2018 data are not yet available.

2006-2017 Morbidity and Mortality Data

Morbidity and mortality data for the years 2006-2017 has been updated and in some cases, revised. Some indicator counts and rates may have changed slightly, however overall trends remain the same.
Morbidity indicators data using ICD-10-CM coding (Fourth quarter 2018 - present) have been updated to only include initial encounter emergency department visits or hospitalizations.

April 6, 2019

New Feature! Data Publications We are excited to announce the new Data Publications page, which can now be found in the left-hand sidebar. You will find our March 2019 data brief titled 'Patterns of Opioid-Related Overdose Deaths in California, 2011-2017' in this section.

March 26, 2019

Third Quarter 2018 CURES Trend Data Third quarter (July - September ) 2018 opioid prescription data from the Department of Justice (DOJ) CURES database are available in the trend line graph and table (upper right corner box on State & County Dashboard pages).

NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available.

First and Second Quarter 2018 CURES Trend Data Prescription counts for the first and second quarters (January-June) of 2018 have been updated using the latest available oral morphine milligram equivalent (MME) conversion factors from the Centers for Disease Control and Prevention. This update may affect counts or rates for first and second quarters of 2018 posted previously on the Dashboard. For more information on MME conversion please visit: https://www.cdc.gov/drugoverdose/resources/data.html

February 11, 2019

Third Quarter 2018 Morbidity (ED) Trend Data Third quarter (July - September) 2018 Emergency Dept. discharge trend data from OSHPD are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages).
NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available.

Preliminary Second Quarter 2018 Mortality Trend Data

Preliminary second quarter (April - June) 2018 mortality trend data including estimated number of fentanyl deaths, are now available.

Preliminary First Quarter 2018 Mortality Trend Data

Preliminary first quarter (January - March)2018 mortality trend data, have been updated to reflect the most recent death file available.

Caution: Not all 2018 deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.
NOTE: Overall 2018 trends, including estimated number of fentanyl deaths, may have changed due to the resolution of pending cases. The updated preliminary data are now available in the trend line graph and corresponding table (upper right corner box on State & County Dashboard pages). These data are not displayed on maps or quick stats because full year 2018 data are not yet available.

First & Second Quarter 2018 Morbidity (Hosp.) Trend Data

first and second quarter (January - June) 2018 Hospital discharge trend data from OSHPD are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages) NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available.

2015-2017 Hospital Discharge Data

Due to coding changes, hospital discharge data for 2015-2017 have been updated. This update may affect counts or rates for 2015-2017 posted previously on the Dashboard.

November 30, 2018

Second Quarter 2018 CURES Trend Data Second quarter (April - June) 2018 opioid prescription data from the Department of Justice (DOJ) CURES database are available in the trend line graph and table (upper right corner box on State & County Dashboard pages).

NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available. 11/30/2018 Preliminary First Quarter Mortality
Preliminary first quarter (January - March) 2018 mortality trend data, have been updated to reflect the most recent death file available from CHSI (Center for Health Statistics and Informatics). Overall trends, including estimated number of fentanyl deaths, may have changed due to the resolution of pending cases. The updated preliminary data are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages).

Caution: Not all deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

November 30, 2018

Second Quarter 2018 Morbidity (ED) Trend Data
Second quarter (April - June) 2018 morbidity Data - Emergency Dept. discharge trend data from OSHPD are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages)

NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available.

October 3, 2018

Final Mortality Data for 2017
Mortality Data for 2017 have been updated to reflect the official 2017 California Comprehensive Master Death File from CHSI (Center for Health Statistics and Informatics). Updates to 'pending' cases in the preliminary file used previously has resulted in changes to death numbers, including number of fentanyl deaths, previously published on the dashboard.

Preliminary First Quarter 2018 Mortality Trend Data

Preliminary first quarter (January - March) 2018 mortality trend data, including estimated number of fentanyl deaths, are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages).
Caution: Not all deaths may be recorded at this time, which may result in an undercount until all cases are included and 'pending' cases are resolved.

First Quarter 2018 Morbidity Trend Data

First quarter (January - March) 2018 morbidity data - Emergency Dept. discharge trend data from OSHPD are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages)

First Quarter 2018 CURES Trend Data

First quarter (January - March) 2018 opioid prescriptions data from the Department of Justice (DOJ) CURES database are now available in the trend line graph and table (upper right corner box on State & County Dashboard pages).

NOTE: Data for 2018 are only available on trend line graph and corresponding table and not displayed on maps or quick stats because full year 2018 data are not yet available.

2017 Morbidity Data - Hospital In-Patient Discharge

Full year 2017 morbidity data - OSHPD hospital in-patient discharge data now available.

Population Data for 2017 Population Data for 2017 has been updated to use current CDC Wonder data. In an effort to provide the most timely data possible, the California Department of Public Health creates population estimates for the most current year (e.g., 2018) using data obtained from the Department of Finance Population Estimates. These population estimates are used until the final estimates created by CDC are made available, usually in July of the next year.

Bug Fixes - Thank you for reporting issues!

Bug in Demographic Indicators table had been fixed

June 13, 2018

NOTICE OF CORRECTION - Fentanyl-related Deaths The California Department of Public Health (CDPH) has discovered an error in the previously reported number of 2017 fentanyl-related overdose deaths reported on the Opioid Overdose Dashboard. The correct number of fentanyl-related overdose deaths is 373, exactly one-half of the originally reported number of 746. No other indicators or years of data represented on the Dashboard are affected. There remains a substantial one-year increase in the number of fentanyl-related deaths (57% increase from 2016) which is an example of this dynamic and growing public health issue. We apologize for any inconvenience.

April 27, 2018

NEW 2017 CURES Data NEW 2017 Opioid Prescriptions data from Department of Justice (DOJ) CURES database.

NEW 2017 Mortality and Morbidity Data

PRELIMINARY 2017 Mortality data - including fentanyl-related fatalities based on text search of death certificates; Caution: Not all 2017 deaths may be recorded yet, which may result in a undercount until all cases are included and 'pending' cases are resolved.
NEW 2017 Emergency Department data from OSHPD

2017 Population Data 2017 Population estimates are created using both CDC Wonder and the California Department of Finance population data because CDC Wonder doesn't have 2017 population estimates available.

March 14, 2018

Updated 2016 Mortality & Morbidity Data

FINALIZED 2016 Mortality Data - including fentanyl-related fatalities
NEW 2016 Emergency Department data from OSHPD
NEW 2016 Hospitalization (i.e. In-Patient) data from OSHPD

November 3, 2017

NEW Downloadable State Snapshot Report Under the State Dashboard link in the sidebar, you will see a new State Report button. Clicking this button will generate a downloadable snapshot report of selected dashboard indicators. The new report is based on the last 12 quarters, and will automatically update as new data is released. Please email with feedback on this new feature.

County-level Data Download Function UPDATE Downloading indicator trends over time can be found using the time-plots on the County Dashboards. When you compare a selected county with the state or another county, the comparison area will now be included in the downloadable .csv file.

NEW Help Feature In the upper right corner of the Dashboard, a new help function is available for select pages. On the home page, and State and County dashboard pages it will walk you through the various features of that page. Give it a try and take the tour!

October 11, 2017

NEW Preliminary Fentanyl Overdose Indicator A new, preliminary fentanyl overdose indicator is now available on the dashboard. Importantly, this indicator is based on a text search of death certificates and likely represents an undercount of actual fentanyl deaths in California. As a preliminary indicator , it may be subject to updates and may change as our text search algorithm continues to evolve. Please check the Data Definitions page for more details.

NEW Downloadable County Snapshot Reports Under the County Dashboard link in the sidebar, you will see a new County Report button. Clicking this button will generate a downloadable snapshot report of selected dashboard indicators. The new reports are based on the last 12 quarters, and will automatically update as new data is released. Please email with feedback on this new feature.

August 18, 2017

2016 Prescription Drug Indicator UPDATE Due to an unforseen issue, we had to update our 2016 prescription drug data released on 8/4/2017. Buprenorphine was unintentionally included in our data used to create multiple indicators. The issue primarily affected MME calculations, as buprenorphine is a strong opioid. Please review indicators to see how this update may have affected rates in your area.

2016 PRELIMINARY Mortality Data Available The dashboard now includes preliminary mortality data for 2016. Rates and counts may change when final 2016 data are released . Morbidity data is still unavailable for 2016.

August 4, 2017

2016 Prescription Drug Data Available The dashboard now includes prescription drug data for 2016.

April 21, 2017

Buprenorphine Indicator Update An an issue with our buprenorphine measure - a key indicator of MAT expansion - was brought to our attention. The indicator has subsequently been updated.

March 27, 2017

********ALL NEW DATA*********

Everything you thought you could learn from the Dashboard has changed!
New 2015 data at the state, county, and zip code level!
New quarterly and annual rates!
Counts available for the first time at the state and county levels!
Examine indicators by sex, age, or race/ethnicity!

January 4, 2017

New Data Exploration Tools Two new tools have been added for exmaining indicator co-occurance at the county level. The County Bivariate Map and Bubble Plot allow for the display of multiple indicators simultaneously. You can find the new tools under the Explore link in the sidebar.

December 28, 2016

Bug Fixes - Thank you for reporting issues!

Maps now include a title and outlines for easier viewing.
Bug in % Change Bar Graph has been fixed.
Broken links to CDPH and Program websites fixed.
Headers added to data downloads.
County name and Zip Codes added to Rank Bar Graphs.
Principle Diagnosis Code typo for Heroin has been fixed.

November 9, 2016

New Dashboard Video Tutorials Available! The Using the Dashboard now has six videos demonstrating the basics of dashboard use, including how to customize the displays and download data. Maximize them on your screen for the best viewing experience. Each video is 3-4 minutes.

November 1, 2016

California Opioid Overdose Surveillance Dashboard Version 2 is released Changes include:

'California Quick Stats' (high-level counts of featured indicators) and 'Dashboard Updates' info-box.
New 'Using the Dashboard' page that will provide instructions and tutorials on use.
Larger maps and graphs.
Downloadable data for each graph.
Revised rate change table.

October 5, 2016

2015 CURES data are now available at the state and county levels only. The data are from CURES 2.0 and reflect unduplicated counts of patients. All CURES 1.0 data have been removed, which included zip code level prescription drug data. CURES 1.0 data included duplicated patient counts and was only available up to 2013. Zip code level prescription drug data will be available soon.

September 22, 2016

Califronia Opioid Overdose Surveillance Dashboard goes live

Previous Update

Next Update

Data Handbook

Welcome to the California Opioid Overdose Surveillance Dashboard

Any Opiod-Related Overdose Deaths

Total Population, Prelim. 2018 Age-Adjusted Rate per 100,000 Residents

Opioid Prescriptions (excl bup)

Total Population Age-Adjusted Rate per 1,000 Residents

Amphetamine-Related Deaths now Equal to Opioid-Related Deaths

Data last updated on: 06/23/2020

California

Settings

Amphetamine-Related Deaths now Equal to Opioid-Related Death

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SUPPORTING DATA

Amphetamine-Related Deaths now Equal to Opioid-Related Death

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SUPPORTING DATA

Notable Differences in Opioid Overdoses and Opioid Prescriptions by Sex

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SUPPORTING DATA

California Opioid Overdose Snapshot: 2015-Q4 to 2018-Q3

Stimulant Overdose, Synthetic Opioid/Fentanyl, and Opioid Overdose: 2015-Q4 to 2018-Q3

Prescribing and Treatment: 2015-Q4 to 2018-Q3

Opioid Prescriptions (excluding buprenorphine)

Treatment

NOTABLE DATA INSIGHTS

Settings

Bivariate Map

Technical Notes

Supporting information and technical notes about data processing

Cause-of-Death Classification

Principle diagnosis & External cause classification

Population denominators

Suppression of Counts

Computing rates

Statistical differences

TERMS

Publications

Data Publications About Opioid-Related Issues in California

Injury and Violence Prevention Branch

Other Publications featuring California Data

Help

Frequently Asked Questions and Select Help Topics

Understanding the Data

Analyze & Report

Using the Dashboard

TOPICS

Data Definitions

Select an indicator from below for a brief description, list of codes used, and limitations for each data source

Mortality Indicator Definitions - Death Certificates

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

Numerator Data Source

Denominator

Measure of Frequency

Period for Case Definition

Limitations

Morbidity Indicator Definitions: Emergency Department Visits & Hospitalizations

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

Numerator Data Source

Measure of Frequency

Period for Case Definition

Limitations

Prescription Drug Indicator Definitions

Indicator definitions were modeled after the CDC Prevention for States Indicator Support Toolkit

Numerator Data Source

Denominator

Measure of Frequency

Period for Case Definition

Limitations

INDICATORS

Privacy Policy

Title of the Page

Resource Links

General Information

Data Information