Overdose Deaths 2017 Data for all drug types

Overdose Deaths 2017

Data for all drug types

Drug Overdose Deaths in Tennessee, 2013 -2017 2 000 1 776 Number of Deaths 1 800 1 631 1 600 1 451 1 400 1 200 1 166 1 263 1 000 800 600 400 200 0 2013 2014 2015 Source: Tennessee Department of Health, Office of Informatics and Analytics 2016 2017

All Drug Overdose Deaths by Race and Sex, 2013 -2017 100 90 92 91 88 86 87 80 70 60 54 57 56 58 58 50 Percent White 40 Percent Male 30 20 10 0 2013 2014 2015 2016 2017

Number of people who died of a drug overdose in Tennessee by contributing substance, 2013 -2017 (n= 7, 287) Overdose Death 2013 2014 2015 2016 2017 All Drug 1, 166 1, 263 1, 451 1, 631 1, 776 Opioid 754 861 1, 034 1, 186 1, 268 Pain Relievers 578 603 689 739 644 Heroin 63 147 205 260 311 Fentanyl 53 69 169 294 500 Methadone 86 71 67 82 69 Benzodiazepine 371 388 492 573 504 Opioid and Benzodiazepine 340 352 447 522 447 Stimulants other than Cocaine 80 73 112 187 319 Cocaine 130 134 203 250 306 Opioids and Stimulants 56 49 65 111 177 (per CDC Definition, includes methadone)

Number of people who died of a drug overdose in Tennessee by contributing substance, 2013 -2017 (n= 7, 287) Overdose Death 2013 2014 2015 2016 2017 Count Percent Rate Count Percent Rate All Drug 1, 166 100 18 1, 263 100 19 1, 451 100 22 1, 631 100 25 1, 776 100 26 Opioid 754 65 12 861 68 13 1, 034 71 16 1, 186 73 18 1, 268 71 19 Pain Relievers (per CDC Definition, includes methadone) 578 50 9 603 48 9 689 48 10 739 45 11 644 36 10 Heroin 63 5 1 147 12 2 205 14 3 260 16 4 311 18 5 Fentanyl 53 5 1 69 6 1 169 12 3 294 18 4 500 28 7 Methadone 86 7 1 71 6 1 67 5 1 82 5 1 69 4 1 Benzodiazepine 371 32 6 388 31 6 492 34 7 573 35 9 504 28 8 340 29 5 352 28 5 447 31 7 522 32 8 447 25 7 80 7 1 73 6 1 112 8 2 187 11 3 319 18 5 Cocaine 130 11 2 134 11 2 203 14 3 250 15 4 306 17 5 Opioids and Stimulants 56 5 1 49 4 1 65 4 1 111 7 2 177 10 3 Opioid and Benzodiazepine Stimulants other than Cocaine Rate is per 100, 000 persons. Rates & percentages have been rounded to nearest whole number.

Number of Overdose Deaths in Tennessee by Drug Type, 2013 -2017 2000 1776 1800 1631 1600 1451 1400 1263 1166 600 0 All drug overdose Any opioid 861 754 578 603 Pain Relievers 689 739 644 500 400 200 1268 1034 1000 800 1186 63 53 2013 147 69 2014 205 294 260 311 169 2015 2016 2017 Heroin Fentanyl

Deaths by type as a percent of all overdoses, 2013 -2017 100 90 80 73 71 70 71 68 65 All Drug 60 Opioid Pain Relievers 50 48 Heroin 45 Fentanyl Methadone 40 32 29 30 31 28 10 5 5 7 Benzodiazepine 28 18 16 20 14 12 12 35 32 34 31 36 6 6 5 18 5 4 0 2013 2014 2015 2016 28 25 2017 Opioid and Benzodiazepine

Trends in overdose deaths by drug type (percent of overdose deaths), 2013 -2017 100 90 80 70 68 65 73 71 71 Opioid 60 Pain Relievers 50 48 50 Heroin 48 Fentanyl 45 Methadone 40 32 35 34 31 36 Benzodiazepine 28 30 20 14 12 10 5 5 7 16 18 18 12 6 6 5 5 4 0 2013 2014 28 2015 2016 Drug types are not mutually exclusive, so will not sum to 100% 2017 Linear(Fentanyl)

Trends in overdose deaths by type (numbers of overdose deaths), 2013 -2017 2 000 1 776 1 800 1 631 1 600 1 451 1 400 1 263 1 200 1 268 1 186 1 166 All Drug Opioid 1 034 Pain Relievers 1 000 861 800 600 Heroin 754 739 689 603 578 Fentanyl 644 500 504 492 388 371 400 200 63 53 Benzodiazepine 573 147 69 205 169 294 260 311 0 2013 2014 2015 2016 2017 -200 Drug types are not mutually exclusive, so will not sum to overdose death totals Linear(Fentanyl)

All Drug Deaths by Age Distribution, 2013 -2017 500 450 Number of Deaths 400 350 300 2013 2014 250 2015 2016 200 2017 150 100 50 0 <1 year 1 -4 years 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

All Drug Deaths by Age Distribution, 2013 -2017 500 450 Number of Deaths 400 350 300 2013 2014 250 2015 2016 200 2017 150 100 50 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

All Drug Deaths by Age Distribution, 2013 -2017 500 450 Number of Deaths 400 15 -24 years 350 25 -34 years 300 35 -44 years 250 45 -54 years 200 55 -64 years 65 -74 years 150 75 -84 years 100 85+ years 50 0 2013 2014 2015 2016 2017

Opioid specific data start here

All Opioid Overdose Deaths by Race and Sex, 2013 -2017 100 94 93 90 89 80 70 60 54 59 58 58 59 50 Percent White 40 Percent Male 30 20 10 0 2013 2014 2015 2016 2017

Opioids Present In Overdose Deaths, 2013 -2017* Percentage of Overdose Death 100 90 80 70 65 73 71 68 71 60 50 Opioid 40 30 20 10 Fentanyl 28 12 5 5 12 14 18 16 18 6 0 2013 2014 2015 2016 2017 * Percentages for fentanyl and heroin are included in the opioid category and are broken out for clarity. Heroin

Opioids Present In Overdose Deaths, 2013 -2017* 100 Percentage of Overdose Death 90 80 70 68 65 73 71 71 Opioid Fentanyl Heroin 60 Buprenorphine 50 40 28 30 20 10 12 5 5 2 6 18 16 12 14 4 18 4 3 4 0 2013 2014 2015 2016 2017 * Percentages for fentanyl, heroin, buprenorphine are included in the opioid category and are broken out for clarity.

All Opioid Deaths by Age Distribution, 2013 -2017 350 Number of Deaths 300 250 2013 200 2014 2015 150 2016 2017 100 50 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

All Opioid Deaths by Age Distribution, 2013 -2017 350 300 15 -24 years Number of Deaths 250 25 -34 years 35 -44 years 200 45 -54 years 150 55 -64 years 65 -74 years 100 75 -84 years 85+ years 50 0 2013 2014 2015 2016 2017

Pain relievers

All Pain Reliever Overdose Deaths by Race and Sex, 2013 -2017 100 95 94 93 92 90 90 80 70 60 53 56 54 53 50 51 Percent White Percent Male 40 30 20 10 0 2013 2014 2015 2016 2017

Pain Reliever Deaths by Age Distribution, 2013 -2017 250 Number of Deaths 200 150 2013 2014 2015 2016 100 2017 50 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

Pain Reliever Deaths by Age Distribution, 2013 -2017 250 Number of Deaths 200 15 -24 years 25 -34 years 150 35 -44 years 45 -54 years 55 -64 years 100 65 -74 years 75 -84 years 50 85+ years 0 2013 2014 2015 2016 2017

Heroin

All Heroin Overdose Deaths by Race and Sex, 2013 -2017 100 90 80 79 84 87 87 85 73 76 73 70 70 69 60 50 Percent White 40 Percent Male 30 20 10 0 2013 2014 2015 2016 2017

All Heroin Deaths by Age Distribution, 2013 -2017 100 90 Number of Deaths 80 70 60 2013 2014 50 2015 2016 40 2017 30 20 10 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

All Heroin Deaths by Age Distribution, 2013 -2017 100 90 Number of Deaths 80 15 -24 years 70 25 -34 years 60 35 -44 years 50 45 -54 years 40 55 -64 years 65 -74 years 30 75 -84 years 20 85+ years 10 0 2013 2014 2015 2016 2017

Fentanyl

All Fentanyl Overdose Deaths by Race and Sex, 2013 -2017 100 94 94 89 90 84 82 80 68 70 60 64 67 67 53 Percent White 50 Percent Male 40 30 20 10 0 2013 2014 2015 2016 2017

All Fentanyl Deaths by Age Distribution, 2013 -2017 180 160 Number of Deaths 140 120 2013 100 2014 2015 80 2016 2017 60 40 20 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

All Fentanyl Deaths by Age Distribution, 2013 -2017 180 160 Number of Deaths 140 15 -24 years 120 25 -34 years 100 35 -44 years 45 -54 years 80 55 -64 years 60 65 -74 years 40 75 -84 years 85+ years 20 0 2013 2014 2015 2016 2017

Stimulants other than cocaine

All Stimulants other than Cocaine Overdose Deaths by Race and Sex, 2013 -2017 100 95 93 95 91 90 94 80 70 60 61 67 64 65 59 Percent White 50 Percent Male 40 30 20 10 0 2013 2014 2015 2016 2017

Stimulants other than Cocaine Deaths by Age Distribution, 2013 -2017 100 90 Number of Deaths 80 70 60 2013 2014 50 2015 2016 40 2017 30 20 10 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

Stimulants other than Cocaine Deaths by Age Distribution, 2013 -2017 100 90 Number of Deaths 80 15 -24 years 70 25 -34 years 60 35 -44 years 50 45 -54 years 40 55 -64 years 65 -74 years 30 75 -84 years 20 85+ years 10 0 2013 2014 2015 2016 2017

Combination of opioids and stimulants

All Opioids plus Stimulant Overdose Deaths by Race and Sex, 2013 -2017 100 90 96 91 96 93 88 80 70 60 59 65 65 62 55 Percent White 50 Percent Male 40 30 20 10 0 2013 2014 2015 2016 2017

Opioid plus Stimulant Deaths by Age Distribution, 2013 -2017 60 Number of Deaths 50 40 2013 2014 30 2015 2016 2017 20 10 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years

Opioid plus Stimulant Deaths by Age Distribution, 2013 -2017 60 50 Number of Deaths 15 -24 years 40 25 -34 years 35 -44 years 30 45 -54 years 55 -64 years 20 65 -74 years 75 -84 years 10 85+ years 0 2013 2014 2015 2016 2017

Rates (instead of numbers)

All Drug Death Rates by Age Distribution, 2013 -2017 60 Rate of Deaths 50 40 2013 2014 30 2015 2016 2017 20 10 0 <1 year 1 -4 years 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

All Drug Death Rates by Age Distribution, 2013 -2017 60 50 15 -24 years Rate of Deaths 40 25 -34 years 35 -44 years 30 45 -54 years 55 -64 years 20 65 -74 years 75 -84 years 10 85+ years 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

All Opioid Death Rates by Age Distribution, 2013 -2017 40 35 Rate of Deaths 30 25 2013 2014 20 2015 2016 15 2017 10 5 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

All Opioid Death Rates by Age Distribution, 2013 -2017 40 35 Rate of Deaths 30 15 -24 years 25 -34 years 25 35 -44 years 20 45 -54 years 55 -64 years 15 65 -74 years 10 75 -84 years 85+ years 5 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

Pain Reliever Death Rates by Age Distribution, 2013 -2017 30 Rate of Deaths 25 20 2013 2014 15 2016 2017 10 5 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

Pain Reliever Death Rates by Age Distribution, 2013 -2017 30 25 15 -24 years Rate of Deaths 20 25 -34 years 35 -44 years 15 45 -54 years 55 -64 years 10 65 -74 years 75 -84 years 5 85+ years 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

All Heroin Death Rates by Age Distribution, 2013 -2017 12 Rate of Deaths 10 8 2013 2014 6 2015 2016 2017 4 2 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

All Heroin Death Rates by Age Distribution, 2013 -2017 12 10 15 -24 years Rate of Deaths 8 25 -34 years 35 -44 years 6 45 -54 years 55 -64 years 4 65 -74 years 75 -84 years 2 85+ years 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

All Fentanyl Death Rates by Age Distribution, 2013 -2017 20 18 16 Rate of Deaths 14 12 2013 2014 10 2015 2016 8 2017 6 4 2 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

All Fentanyl Death Rates by Age Distribution, 2013 -2017 20 18 16 15 -24 years Rate of Deaths 14 25 -34 years 12 35 -44 years 10 45 -54 years 8 55 -64 years 65 -74 years 6 75 -84 years 4 85+ years 2 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

Stimulants other than Cocaine Death Rates by Age Distribution, 2013 -2017 12 Rate of Deaths 10 8 2013 2014 6 2015 2016 2017 4 2 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

Stimulants other than Cocaine Death Rates by Age Distribution, 2013 -2017 12 10 Rate of Deaths 15 -24 years 8 25 -34 years 35 -44 years 6 45 -54 years 55 -64 years 4 65 -74 years 75 -84 years 2 85+ years 0 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

All Opioids plus Stimulant Death Rates by Age Distribution, 2013 -2017 7 6 Rate of Deaths 5 2013 4 2015 3 2016 2017 2 1 0 5 -14 years 15 -24 years 25 -34 years 35 -44 years 45 -54 years 55 -64 years 65 -74 years 75 -84 years 85+ years Rate is per 100, 000 persons.

All Opioids plus Stimulant Death Rates by Age Distribution, 2013 -2017 7, 00 6, 00 15 -24 years 5, 00 Number of Deaths 25 -34 years 35 -44 years 4, 00 45 -54 years 3, 00 55 -64 years 65 -74 years 2, 00 75 -84 years 85+ years 1, 00 0, 00 2013 2014 2015 2016 2017 Rate is per 100, 000 persons.

CSMD Concordance slides

Percent who filled any prescription in the Tennessee CSMD within 365 days of death by type of overdose death among all individuals who died by year, 2013 -2017 (n=7, 287 total)a Overdose Death 2013 2014 2015 2016 2017 Percent (n=1, 166) (n=1, 263) (n=1, 451) (n=1, 631) (n=1, 776) Differenceb All Drug 78 75 72 66 64 -14 Opioid Pain Relievers 81 78 75 67 66 -15 (per CDC Definition, includes methadone) 82 82 80 73 75 -7 Heroin 63 59 62 57 58 -5 Fentanyl 89 75 67 62 54 -35 Methadone 79 80 70 62 75 -4 Benzodiazepine Opioid and Benzodiazepine 83 83 80 72 75 -8 84 85 81 72 75 -9 b. Difference between 2017 and 2013

Percent who filled any prescription in the Tennessee CSMD within 60 days of death by type of overdose death among all individuals who died by year, 2013 -2017 (n=7, 287 total)a Overdose Death 2013 2014 2015 2016 2017 Percent (n=1, 166) (n=1, 263) (n=1, 451) (n=1, 631) (n=1, 776) Differenceb All Drug 61 58 54 47 43 -18 Opioid Pain Relievers 65 61 58 48 45 -20 (per CDC Definition, includes methadone) 66 66 65 57 58 -8 Heroin 38 36 39 34 28 -10 Fentanyl 77 62 45 36 30 -47 Methadone 58 61 49 43 55 -3 Benzodiazepine Opioid and Benzodiazepine 69 68 68 55 57 -12 70 70 70 56 56 -14 b. Difference between 2017 and 2013

Percent who filled a prescription for an opioid or benzodiazepine in the Tennessee CSMD within 60 days of death by type of overdose death among all individuals who died by year, 2013 -2017 (n=7, 287 total)a Benzodiazepine prescription filled Opioid prescription filled Overdose Death Percent 2013 2014 2015 2016 2017 Differenceb All Drug 52 48 45 37 34 -18 41 36 34 28 21 -20 Opioid 57 52 48 40 37 -20 43 38 36 28 21 -22 Pain Relievers 59 58 55 49 50 -9 43 43 43 36 30 -13 Heroin 25 28 27 26 22 -3 16 20 20 18 10 -6 Fentanyl 68 51 37 27 23 -45 53 38 24 17 11 -42 Methadone 50 49 30 32 46 -4 33 44 40 29 41 8 Benzodiazepine Opioid and Benzodiazepine 58 55 57 43 43 -15 56 52 53 39 38 -18 59 59 59 45 44 -15 56 52 54 40 37 -19 b. Difference between 2013 and 2017

Percent who filled a prescription for an opioid or benzodiazepine in the Tennessee CSMD within 180 days of death by type of overdose death among all individuals who died by year, 2013 -2017 (n=7, 287 total)a Opioid prescription filled Overdose Death Benzodiazepine prescription filled Percent b 2013 2014 2015 2016 2017 Differenceb All Drug 63 60 56 49 46 -17 47 43 40 34 26 -21 Opioid 66 64 59 51 49 -17 49 45 42 35 26 -23 Pain Relievers 69 69 65 60 59 -10 51 49 48 43 37 -14 Heroin 33 42 41 38 37 4 21 26 26 24 16 -5 Fentanyl 74 67 51 39 36 -38 62 46 30 22 14 -48 Methadone 60 62 48 49 61 1 42 49 43 34 45 3 Benzodiazepine Opioid and Benzodiazepine 68 71 66 55 55 -13 63 59 58 46 45 -18 69 74 68 57 55 -14 64 59 59 46 43 -21 b. Difference between 2013 and 2017

Percent who filled a prescription for an opioid or benzodiazepine in the Tennessee CSMD within 365 days of death by type of overdose death among all individuals who died by year, 2013 -2017 (n=7, 287 total)a Benzodiazepine prescription filled Opioid prescription filled Percent b Overdose Death 2013 2014 2015 2016 2017 Differenceb All Drug 71 69 65 59 57 -14 50 48 45 38 32 -18 Opioid 75 73 68 61 60 -15 53 50 46 38 32 -21 Pain Relievers 77 78 73 67 70 -7 54 55 52 47 42 -12 Heroin 44 51 52 50 51 7 25 32 29 26 21 -4 Fentanyl 85 70 59 53 48 -37 64 48 34 25 20 -44 Methadone 72 73 55 56 71 -1 43 58 46 37 49 6 Benzodiazepine Opioid and Benzodiazepine 77 78 73 63 67 -10 66 64 61 50 51 -15 78 81 74 64 68 -10 67 65 62 50 49 -18 b. Difference between 2013 and 2017

Dispensed a CS in past 60 days among overdose deaths, 2013 -2017 Percent Filled in TN CSMD 100 90 80 70 60 2013 2014 50 2015 2016 40 2017 30 20 10 0 All Drug Opioid Pain Relievers Heroin Fentanyl Methadone Benzodiazepine

Opioid dispensed in past 60 days among overdose deaths by contributing drug type, 2013 -2017 100 Percent Filled in TN CSMD 90 80 70 60 2013 2014 50 2015 2016 40 2017 30 20 10 0 All Drug Opioid Pain Relievers Heroin Fentanyl Benzodiazepine Opioid and Benzodiazepine

Benzodiazepine dispensed in past 60 days, 2013 -2017 100 Percent Filled in TN CSMD 90 80 70 60 2013 2014 50 2015 2016 40 2017 30 20 10 0 All Drug Opioid Pain Relievers Heroin Fentanyl Benzodiazepine Opioid and Benzodiazepine