This is an overview of data presented on this dashboard. The Injury & Violence Prevention Program (IVPP) uses other data sources outlined here: IVPP Data Glossary

State Unintentional Drug Overdose Reporting System (SUDORS)

Data come from death certificate information, medical examiner or coroner reports, and forensic toxicology results entered into the State Unintentional Drug Overdose Reporting System (SUDORS). Jurisdictions report occurrent drug overdose deaths (i.e., all overdose deaths that occurred within the jurisdiction regardless of decedent residence).

The number of deaths, and corresponding rates, in SUDORS might not match the number and rate in CDC’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) or the death data on this dashboard.

For national SUDORS data, visit the CDC SUDORS Dashboard: Fatal Drug Overdose Data Dashboard.

Emergency Department and Hospital Stays

Health care information on this dashboard is administrative discharge data (emergency department and hospital visits) from the Hospital Association of Oregon (HAO). (link to data source)

Discharge data include hospital and emergency department (ED) visit information. Hospitals and EDs report data to HAO on visits when there is a charge for services. This information includes diagnoses, medical care received, and demographic information of the patient (examples: age, sex, race and ethnicity). Hospital and ED discharge data do not overlap. If a patient goes to an ED first and then is admitted to the hospital, their information will be reported in the hospital discharge data only.

Hospital discharge data include information for hospital visits that were at least 24 hours long. This information does not include outpatient and ED visits. This information has been available since 2000. The diagnosis classifications changed in October 2015, so information after date this cannot be compared directly to earlier information. It takes six months for this data to become available.

Emergency Department discharge data includes information for ED visits. This information has been available since 2018 and takes six months for this data to become available.

Death/Mortality

Death data on this dashboard are available from the Oregon Center for Health Statistics. (CHS) (link to data source)

Death certificates are registered with CHS. Death certificates are completed and signed by a physician, physician’s assistant, nurse practitioner, or medical examiner. The data reported on this dashboard represents drug overdose deaths to Oregon residents who died in Oregon. Oregon began collecting this data in 1903 and is finalized 10 to 11 months after the end of the calendar year.

All Overdose:
Includes any reported drug-related overdose (examples: poisoning by drugs, medications, and biological substances regardless of intention, unintentional, self-harm, harm to others, undetermined, etc.). Note: Categories are not mutually exclusive and therefore the ‘All Overdose’ category will not equal the sum of every category combined.

Any Opioid:
Includes any opioid-related overdose regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.1X-T40.4X and T40.6X]

Benzodiazepine:
Includes any benzodiazepine-related overdose, such as alprazolam, chlordiazepoxide, clorazepate, etc., regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T42.4X: Benzodiazepine]

Fentanyl:
Includes any fentanyl related overdose regardless of intention for hospitalization and emergency department only using a new ICD-10 CM code implemented in October 2020 (unintentional, self-harm, harm to others, undetermined, etc.) [ICD-10-CM: T40.41X: Fentanyl]

Heroin:
Includes any heroin-related overdose regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.1X: Heroin]

Methadone:
Includes any methadone-related overdose regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.3X: Methadone]

Natural & Semi-Synthetic Opioids:
Includes ‘natural’ opioids, non-synthetic opioids, and/or opioids not specified, like codeine. This includes overdoses regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.2X: Natural/Semi-Synthetic Opioids]

Stimulant:
Includes any stimulant-related overdose, such as amphetamines, methamphetamines, cocaine, etc., regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). Note: an ICD-10 CM methamphetamine code for hospitalization and emergency department data was implemented October 2022 and will be reported as it becomes available. [ICD-10: T40.5X: Cocaine & T43.6X: Stimulants]

Synthetic Opioid:
Includes any synthetic-related opioid overdose, such as fentanyl, oxymorphone, oxycodone, regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.4X: Synthetic opioids, excluding methadone]

Unintentional and Undetermined Intent:
Includes any unintentional and undetermined intent drug-related overdose (examples: poisoning by drugs, medications, and biological substances).

Unspecified Opioid/Narcotic:
Includes any unspecified opioid and/or narcotic overdose that doesn’t fall into traditional synthetic or ‘natural’ opioids, or those where specific drug information is limited, regardless of intention (examples: unintentional, self-harm, harm to others, undetermined, etc.). [ICD-10: T40.6X: Other and Unspecified Narcotics]

Injury is damage or harm to the body that results in an impairment or destruction of health. Injury results from harmful contact with people, objects, substances, or the environment. Examples of injuries include broken bones, cuts, brain and organ damage, poisoning (overdose), and burns. Injuries are identified through a process of surveillance that incorporates multiple data sources, such as death certificates, hospital discharge and emergency department visit data, trauma registries, violent death registries, and prescription drug monitoring data. Injury is described by intent and mechanism and is measured using raw counts as well as statistics including crude rates. Injuries may vary by social factors like age, gender/biological sex, race, ethnicity as well as more specific social determinants of health. Injury is dynamic and varies over time with new and emerging trends.

Data Sources:

• Oregon Vital Statistics Mortality Data

• Oregon Hospital and Emergency Department Discharge Data

• National Center for Health Statistics (NCHS)

• State Unintentional Drug Overdose Reporting Program (SUDORS)

• US Census Bureau

Counts:
Counts are the number of overdoses. See the Data Descriptions and Definitons tab for further information.

Rates:
Rates presented in this dashboard are crude (not age-adjusted) and are per 100,000 persons unless otherwise noted. Death overdose counts and rates are based on residents of Oregon that died in Oregon (example: Oregon residents that died out of state are not included) unless otherwise noted. As a result, rates and counts may differ from other sources, like the CDC. Hospital and emergency department discharge data are based on residents of Oregon that visited an Oregon facility.

Small Numbers:
To protect the privacy of individuals and avoid providing information that could be used to identify individual events, the data are not shown whenever the annual (State-level data) or four-year total counts (County and Demographic-level data) fall below certain thresholds. For death certificate data, when the count is between one and five overdose deaths, neither the count nor rate is shown. For hospital and emergency department discharge data, when the overdose related visit count is between one to nine, neither the count nor rate is shown. When zero overdose deaths or hospital/ED visits were reported, the count and rate are both shown as zero. It is advised that caution is used when interpreting rates presented that are based on fewer than 20 events.

Preliminary Data:
Preliminary data represent information that has not undergone the same quality control measures as the finalized data. This data is shown to provide more recent trends of the overdose crisis in Oregon. Preliminary data may change once finalized and are not available for download.

Demographics:
Because of limitations with the available data with respects to sex and gender, only male and female categories are shown. In death certificates, the decedent’s legal sex is recorded as what was provided on birth certificates and other identity documents; consequently, nonbinary individuals may be undercounted compared to self-reported gender identity. In hospital and emergency department discharge data, the available choices currently include male, female, other, unknown and refuse to answer. This, too, may result in undercounts of nonbinary individuals. In part due to the above deficiencies in data collection, the counts for nonbinary, other, unknown, and refuse to answer do not meet data confidentiality thresholds and have been withheld to protect the privacy of individuals.

Race categories for deaths:
When a person dies in Oregon, more than one race can be reported on their death certificate. This information is not able to be provided by the decedent, so their race and ethnicity information may not accurately reflect how they self-identified. On this dashboard, when more than one race is reported for a person, their least common reported race is used for counts and rates. This is sometimes called rarest race methodology. This approach has its limitations, but it amplifies the representation of Oregon’s smaller communities.

Fentanyl:
ICD-10 codes are used in death certificates for reporting the cause(s) of death. Currently, fentanyl-related deaths are not identifiable by the cause of death ICD-10 codes and must be included in the synthetic opioid death category. For data specific to fentanyl-related deaths, please use the Oregon Medical Examiner and SUDORS-related data from the CDC ; national and state-specific data are available.

Fentanyl coding was implemented for hospitals and emergency departments in October 2020 and should be used with caution. Increasing trends could be influenced by hospital staff gaining familiarity with the new diagnosis code.

Overdose Death Reporting:
The drug overdose deaths included in the dashboard include people with a primary cause or contributing cause of death attributed to a drug overdose. Only Oregon residents who died in Oregon are reported.

Hospital/Emergency Department Overdose Reporting:
Drug overdose hospitalizations and emergency department visits presented in the dashboard include any visit for an Oregon resident who received care in an Oregon facility and had an overdose diagnosis reported in their discharge information.

Caveats and limitations: Each data source used in this dashboard has limitations that warrant caution about interpretation and comparison of data.

Oregon Hospital and Discharge Data: Oregon Hospital and Emergency Department discharge data include all non-federal Oregon acute-care inpatient facilities (that is, all facilities but the Portland Veterans Administration). Hospitalizations include people who had an inpatient or overnight visit, but not visits that result solely in emergency room visits. Emergency department visits include people who were only seen in the emergency department and not admitted into the hospital. Hospitalization data are flagged if any overdose diagnostic codes are reported for the hospitalization, although any person hospitalized may have multiple diagnosis codes reported in their discharge data.

Emergency department data are flagged on any diagnosis or chief complaint codes. Due to Oregon getting emergency department data from 2018 forward, hospitalization and emergency department visits are reported from 2018 forward. Note that case definitions may change over time as ICD-10 diagnosis codes are added or removed.

Hospitalization and emergency department data do not contain personal identifiers that would facilitate identification of multiple admissions, and may include re-admissions, transfers, and visits where the patient died. Counts and rates are based on hospitalizations or emergency department visits and not necessarily unique persons; a person may be counted more than once in hospitalization and/or emergency department estimates if they had multiple visits.

For hospitalization and emergency department data, race is inconsistently reported and a sizable proportion of injury hospitalizations report race as “other” or “unknown”. As a result, the overdose counts and rates for some race categories may not represent the true burden of overdose hospitalization or emergency department visits.