Table 2

Joinpoint regression analysis of trends* in counts of fatal overdoses and non-fatal overdose-related emergency department visits, by drug type, 2010‒2020†, USA

Drug overdose typeAverage quarterly percent change (95% CI)Number of joinpointsTrend segments, quarterly percent change (95% CI)
Segment 1Segment 2Segment 3Segment 4Segment 5
All drug
Fatal 2.0 (1.3 to 2.7)4 Q1 2010–Q3 2014 1.0 (0.7 to 1.4) Q3 2014–Q1 2017 4.2 (3.4 to 5.1)Q1 2017–Q3 2019 −0.4 (−1.1 to 0.3) Q3 2019–Q2 2020 13.5 (5.3 to 22.3)Q2 2020–Q4 2020 −4.3 (−10.6 to 2.5)
Non-fatal0.3 (0.0 to 0.7)2Q1 2010–Q1 2014 0.0 (−0.5 to 0.5) Q1 2014–Q3 2016 1.9 (0.8 to 3.0)Q3 2016–Q4 2020 −0.3 (−0.7 to 0.1)
All opioid-involved
Fatal 2.8 (2.1 to 3.5)4 Q1 2010–Q2 2014 1.6 (1.1 to 2.0) Q2 2014–Q1 2017 5.3 (4.5 to 6.2)Q1 2017–Q3 2019 0.0 (−0.9 to 0.8) Q3 2019–Q2 2020 16.3 (7.1 to 26.4)Q2 2020–Q4 2020
−4.8 (−11.6 to 2.5)
Non-fatal 2.0 (1.3 to 2.8)3 Q1 2010–Q1 2015 1.9 (1.3 to 2.5) Q1 2015–Q3 2016 9.1 (5.2 to 13.3) Q3 2016–Q1 2019 −1.9 (−3.2 to0.5) Q1 2019–Q4 2020 2.2 (0.1 to 4.3)
Synthetic opioid-involved
Fatal 7.1 (6.0 to 8.2)4Q1 2010–Q2 2013 −0.6 (−2.6 to 1.4) Q2 2013–Q1 2017 16.8 (15.6 to 18.0) Q1 2017–Q3 2019 2.4 (1.3 to 3.5) Q3 2019–Q2 2020 21.0 (9.8 to 33.4)Q2 2020–Q4 2020 −4.4 (−12.1 to 4.1)
Non-fatal‡ 4.2 (3.0 to 5.3)1 Q1 2016–Q1 2019 1.5 (0.2 to 2.9) Q1 2019–Q4 2020 8.9 (6.3 to 11.5)
Heroin-involved
Fatal 3.3 (2.7 to 3.8)3 Q1 2010–Q3 2013 8.7 (8.0 to 9.5) Q3 2013–Q3 2016 5.2 (4.5 to 5.8) Q3 2016–Q2 2020 −0.9 (−1.3 to0.5) Q2 2020–Q4 2020 –12.3 (−20.0 to –3.8)
Non-fatal 4.3 (3.9 to 4.8)1 Q1 2010–Q4 2016 8.4 (7.8 to 9.0) Q4 2016–Q4 2020 −2.2 (−3.0 to1.5)
Stimulant-involved
Fatal 4.6 (3.9 to 5.4)4 Q1 2010–Q4 2014 2.9 (2.3 to 3.5) Q4 2014–Q2 2017 9.2 (7.8 to 10.6) Q2 2017–Q2 2019 2.2 (0.7 to 3.8) Q2 2019–Q2 2020 11.5 (6.4 to 17.0)Q2 2020–Q4 2020 –4.0 (−12.0 to 4.7)
Non-fatal 2.0 (1.0 to 3.1)2 Q1 2010–Q3 2011 8.7 (4.2 to 13.4)Q3 2011–Q4 2012 −2.5 (−9.3 to 4.8) Q4 2012–Q4 2020 1.5 (1.2 to 1.8)
All opioid and stimulant polysubstance
Fatal 5.6 (4.7 to 6.5)4 Q1 2010–Q3 2014 3.5 (2.7 to 4.2) Q3 2014–Q2 2017 10.5 (9.3 to 11.8) Q2 2017–Q3 2019 2.9 (1.7 to 4.1) Q3 2019–Q2 2020 18.4 (8.4 to 29.3)Q2 2020–Q4 2020 −6.3 (−13.5 to 1.4)
Non-fatal 3.0 (1.8 to 4.3)2 Q1 2010–Q1 2011 17.0 (3.5 to 32.3) Q1 2011–Q2 2017 2.8 (2.2 to 3.4)Q2 2017–Q4 2020 −0.2 (−1.3 to 0.9)
  • *Bold font indicates statistical significance at p<0.05.

  • †Beginning 1 October 2015 (corresponding with the start of Quarter 4 (Q4) 2015), coding for emergency department data transitioned from ICD-9-CM to ICD-10-CM which may impact the comparison of trends of non-fatal overdoses before and after this time period.

  • ‡Coding of non-fatal overdoses changed from ICD-9-CM to ICD-10-CM beginning 1 October 2015. Prior to this coding change, there were no diagnosis codes specific for synthetic opioids available for non-fatal data. For non-fatal synthetic opioid-involved overdoses, trends were assessed from 2016 to 2020.

  • ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.