9/19/2022 Opioid Overdose SSuUrBvTeIiTllaL Ence Georgia, 2020 Drug Surveillance Unit Epidemiology Section Division of Health Protection Georgia Department of Public Health The purpose of this report is to describe fatal (mortality) and nonfatal (morbidity) opioid-involved overdoses, which occurred in Georgia during 2020, including prescription opioids, and illicit opioids such as heroin, fentanyl, and fentanyl analogs. Opioid overdose data were analyzed by the Georgia Department of Public Health (DPH) Epidemiology Program, Drug Surveillance Unit, using Georgia hospital inpatient discharge data and emergency department (ED) visit data, and DPH Vital Records death data. Key Findings Opioid-involved overdose deaths sharply increased in Georgia from 2012-2020, driven largely by increased use and misuse of prescription opioids (e.g., Oxycodone and Hydrocodone). Beginning in 2013, illicit opioids, such as heroin and fentanyl, drove the sharp increase in opioid-involved overdose deaths through 2020. o From 2012 to 2020, the total number of opioid-involved overdose deaths occurring in Georgia increased by 140%, from 554 deaths in 2012 to 1332 deaths in 2020. Overdose deaths in all drug categories increased from 2019 to 2020. In 2020, among Georgia residents: o Any opioid-involved overdoses accounted for 7,954 ED visits, 2,822 hospitalizations, and 1,266 deaths. o Heroin-involved overdoses accounted for 2,719 ED visits, 535 hospitalizations, and 407 deaths. o Fentanyl-involved overdoses accounted for 813 deaths. o From 2019 to 2020, fentanyl-involved overdoses increased by 107%. o Persons aged 35-44 years died from an opioid-involved overdose more frequently than persons of other age categories. o Persons aged 35-44 years more frequently died from a heroin- or fentanyl-involved overdose and visited an ED for an opioid-involved overdose than persons of other age categories, yet older persons aged 55 and older were more frequently hospitalized because of an opioid-involved overdose. o Males aged 25-34 years died from an opioid-involved overdose more frequently than any other age category and were 2.2 times more likely to die from an overdose than females of the same age. o Males were 6.8 times more likely to die from any opioid-involved overdose, and 2.7 times more likely to die from a heroin-involved overdose than females. However, females, particularly those aged 25-34 years, were more frequently hospitalized for an opioid-involved overdose than males. o Whites were 2.4 times more likely to die from an opioid-involved overdose, 2.8 times more likely to visit an ED for any opioid-involved overdose, 5.8 times more likely to visit an ED for a heroininvolved overdose, and 2.5 times more likely to be hospitalized for an opioid-involved overdose than Blacks. o The highest numbers of heroin- and opioid-involved overdose deaths, ED visits, and hospitalizations occurred predominantly among residents in urban areas (Atlanta Metropolitan Area, Augusta, Macon, Columbus, and Savannah). However, high rates of opioid overdoseinvolved ED visits and hospitalizations occurred among residents in both urban and rural areas, particularly in North, South Central, and Southeast Georgia. OPIOID OVERDOSE SURVEILLANCE REPORT | 2 Fatal Drug Overdoses (Mortality), Georgia, 2020 Data Source Overdose-involved deaths were derived from DPH Vital Records death certificates. The following data include all deaths that occurred in Georgia among Georgia residents and deaths that occurred outside of Georgia among Georgia residents, unless otherwise specified. Case Definitions (Note: categories are not mutually exclusive, includes only drug overdose deaths caused by acute poisoning) Any drug overdose death May involve any over-the-counter, prescription, or illicit drug Deaths with any of the following ICD-10 codes as any underlying cause of death: X40-44, X60-64, X85, Y10-14 Drug overdose death involving any opioid Involves both prescription opioid pain relievers (e.g., hydrocodone, oxycodone, and morphine), opioids used to treat addiction (e.g., methadone), as well as heroin, opium, and synthetic opioids (e.g., tramadol and fentanyl that may be prescription or illicitly manufactured) Deaths with any of the following ICD-10 codes as any underlying cause of death: X40-44, X60-64, X85, Y10-14 AND one of the following: Any of the following ICD-10 codes as any other listed cause of death: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 Any cause of death text field contains one of the following terms (or common misspelling): heroin, fentanyl (and fentanyl analogs), methadone, buprenorphine, butalbital, codeine, eddp, hydrocodone, hydromorphone, levorphanol, meperidine, norbuprenorphine, oxycodone, oxymorphone, tapentadol, tramadol OR (for cases without an X or Y code in the underlying cause of death): Any cause of death text field contains the word "TOXIC" AND at least one of the following terms (or common misspelling): heroin, fentanyl (and fentanyl analogs), methadone, buprenorphine, butalbital, codeine, eddp, hydrocodone, hydromorphone, levorphanol, meperidine, norbuprenorphine, oxycodone, oxymorphone, tapentadol, tramadol Drug overdose death involving synthetic opioids other than methadone Involves synthetic opioids other than methadone (e.g., tramadol and fentanyl that may be prescription or illicitly manufactured). Note: polysubstance abuse deaths may also involve methadone or other opioids Deaths with any of the following ICD-10 codes as any underlying cause of death: X40-44, X60-64, X85, Y10-14 AND one of the following: The following ICD-10 code as any other listed cause of death: T40.4 Any cause of death text field contains the following keywords and common misspellings: fentanyl (and fentanyl analogs), tramadol OR (for cases without an X or Y code in the underlying cause of death): Any cause of death text field contains the word "TOXIC" AND at least one of the following terms (or common misspelling): fentanyl (and fentanyl analogs), tramadol Drug overdose death involving heroin Involves heroin. Note: polysubstance abuse deaths may also involve other opioids Deaths with any of the following ICD-10 codes as any underlying cause of death: X40-44, X60-64, X85, Y10-14 AND one of the following: The following ICD-10 code as any other listed cause of death: T40.1 Any cause of death text field contains the following keywords and common misspellings: heroin, morphine OR (for cases without an X or Y code in the underlying cause of death): Any cause of death text field contains the word "TOXIC" AND at least one of the following terms (or common misspelling): heroin, morphine Drug overdose death involving fentanyl Note: polysubstance abuse deaths may also involve other opioids Any cause of death text field contains the word "TOXIC" AND at least one of the following terms (or common misspelling): fentanyl (and fentanyl analogs) Other Definitions or Limitations Deaths represent individual people who died in Georgia and deaths among Georgia residents outside of Georgia. Overdose death county represents the county of residence, or the place of injury (where the overdose occurred) as specified; when the place of injury field or the county of residence field was blank the county of the death certifier was used. OPIOID OVERDOSE SURVEILLANCE | 3 Rate indicates the number of deaths among Georgia residents per 100,000 population using 2020 Census data as the denominator, and all rates are age- adjusted unless age category is presented. Rates for categories with fewer than 5 deaths may not be accurate and are not presented in this report. ICD-10 Code Description X40-X44 (accidental poisonings by drugs), X60-X64 (intentional self-poisoning by drugs), X85 (assault by drug poisoning), Y10-Y14 (drug poisoning of undetermined intent), T40.0 (opium), T40.1 (heroin), T40.2 (natural and semisynthetic opioids), T40.3 (methadone), T40.4 (synthetic opioids, other than methadone, T40.6 (other and unspecified narcotics) Nonfatal Overdoses (Morbidity), Georgia, 2020 Data Source Nonfatal overdose counts were derived from Georgia hospitalization and emergency department (ED) visit discharge data, and included all ED visits or hospitalizations occurring in a non-Federal acute care hospital in Georgia, among Georgia residents, with a discharge diagnosis indicating acute drug overdose during 2018. Case Definitions (categories are not mutually exclusive) ED visit or hospitalization involving any drug overdose May include any over-the-counter, prescription, or illicit drug Any mention of ICD-10CM codes: T36-T50 AND 6th character: 1-4, and a 7th character of A or missing ED visit or hospitalization involving any opioid overdose Includes prescription opioid pain relievers (e.g., hydrocodone, oxycodone, and morphine), opioids used to treat addiction (e.g., methadone), as well as heroin, opium, and synthetic opioids (e.g., tramadol and fentanyl that may be prescription or illicitlymanufactured) Any mention of ICD-10CM codes: T40.0X, T40.1X, T40.2X, T40.3X, T40.4X, T40.60, T40.69 AND 6th character: 1-4, and a 7th character of A or missing ED visit or hospitalization involving a heroin overdose Any mention of ICD-10CM code: T40.1X AND 6th character: 1-4, and a 7th character of A or missing Other Definitions or Limitations Please Note: The case definition has changed and cannot be compared to previous reports. Any opioid may include prescription or illicit opioids. ED Visits and Hospitalization categories are not mutually exclusive. Hospitalizations may also appear in the ED Visits category if they were admitted to the hospital through the ED. ED visits and hospitalizations may represent multiple visits by individuals in Georgia. County indicates the patient's county of residence. Only Black and White are indicated for race because of incomplete or sparse data on other races and ethnicities. Rate indicates the number of ED visits or hospitalizations among Georgia residents per 100,000 population using 2020 Census data as the denominator, and all rates are age-adjusted unless age category is presented. Rates for categories with fewer than 5 ED visits or hospitalizations may not be accurate and are not presented in this report. ICD-10 CM Code Description Poisoning by: T36-T50 (range includes all drugs), T40.0X (opium), T40.1X (heroin), T40.2X (other opioids), T40.3X (methadone), T40.4X (synthetic narcotics), T40.60 (unspecified narcotics), T40.69 (other narcotics) 6th Character: 1 (accidental, unintentional), 2 (intentional self-harm), 3 (assault), 4 (undetermined intent) 7th Character: A (initial encounter) or missing OPIOID OVERDOSE SURVEILLANCE | 4 For more information: County level data and other Georgia drug surveillance reports: https://dph.georgia.gov/drug-surveillance-unit Georgia Department of Public Health (DPH) Main Opioid Page: https://dph.georgia.gov/stopopioidaddiction Georgia drug overdose mortality interactive maps and statistics: https://oasis.state.ga.us/PageDirect.aspx?referer=MortalityDrugOverdoses Prescription Drug Monitoring Program (PDMP) information: GA PDMP Overview and FAQs https://dph.georgia.gov/pdmp OPIOID OVERDOSE SURVEILLANCE | 5 Drug-Involved Overdose Deaths (Mortality) Note: Any opioid may include prescription or illicit opioids. Categories are not mutually exclusive. Overdoseinvolved deaths were derived from DPH Vital Records death certificates. Fentanyl is included in the synthetic opioid category. The following data include deaths that occurred in Georgia regardless of the patient's residence state. No. deaths Drug-Involved Overdose Deaths Occurring in Georgia, by Drug Type, 2012-2020 1400 1200 1000 800 600 400 200 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 Any Opioid Synthetic Opioids Heroin Fentanyl From 2012 to 2020, the number of opioid-involved overdose deaths increased by 140%, from 554 to 1332 deaths. Beginning in 2013, illicit opioids, such as heroin and fentanyl, drove the sharp increase in opioid-involved overdose deaths through 2020. From 2019 to 2020, the number of fentanyl-involved overdose deaths increased by 103%. All drug overdose death categories increased from 2019 to 2020. No. deaths Quarterly Drug-Involved Overdose Deaths Occurring in Georgia, by Drug Type, 2017-2020 400 350 Any Opioid 300 Heroin 250 200 Fentanyl 150 100 50 0 2017 2017 2017 2017 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Opioid-involved overdose deaths increased during 2020 Q1 to 2020 Q2, then trended downward. OPIOID OVERDOSE SURVEILLANCE | 6 Note: The following data include all deaths that occurred in Georgia among Georgia residents and deaths that occurred outside of Georgia among Georgia residents, unless otherwise specified. Fentanyl is included in the synthetic opioid category. Drug-Involved Overdose Deaths, by Drug Type, Georgia Residents, 2018-2020 2000 1500 1880 1507 1493 2018 2019 2020 1266 1000 500 910 904 916 449 496 314 323 407 813 327 392 0 All Drugs Any Opioid Synthetic Opioids Heroin Fentanyl No. deaths From 2019 to 2020, all drug overdose death categories increased: All drugs by 26%, any opioid by 40%, synthetic opioids by 85%, heroin by 26% and fentanyl by 107%. Drug-Involved Overdose Death Rates, by Age and Drug Type, Georgia Residents, 2020 Deaths/ 100,000 pop. 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Overall <1 Any Opioid Heroin Fentanyl 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Category (years) Persons aged 35-44 years died from an opioid-involved overdose more frequently than persons of other age categories. Persons aged 35-44 years died from a heroin- or fentanyl-involved overdose more frequently than persons of other age categories. OPIOID OVERDOSE SURVEILLANCE | 7 Deaths/ 100,000 pop. Drug-Involved Overdose Death Rates, by Race and Drug Type, 20.0 18.4 Georgia Residents, 2020 White Black 15.0 11.6 10.0 7.8 5.0 5.7 6.6 2.0 0.0 Any Opioid Fentanyl Race Heroin Whites were 2.4 times more likely to die from an opioid-involved overdose than Blacks. Deaths/ 100,000 pop Quarterly Opioid-Involved Overdose Death Rates, by Race, Georgia Residents, 2018-2020 6.0 5.3 5.0 4.8 4.6 4.0 3.7 3.4 3.4 3.5 3.1 3.1 3.1 3.3 3.7 3.0 2.5 2.3 2.0 1.0 0.9 0.9 1.2 1.4 1.5 1.2 1.4 1.5 1.4 1.0 0.0 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 White Black Opioid-involved overdose death rates among Whites and Blacks trended increased during 2020 Q1 to Q2 and trended downward in 2020 Q2. OPIOID OVERDOSE SURVEILLANCE | 8 Deaths/ 100,000 pop. Drug-Involved Overdose Death Rates, by Sex, Georgia Residents, 2020 18.0 16.3 16.0 14.0 12.0 10.0 8.3 8.0 6.0 4.0 2.0 0.0 Any Opioid 11.4 4.7 Fentanyl Sex Male Female 6.0 2.2 Heroin Males were 6.8 times more likely to die from any opioid-involved overdose than females, and 2.7 times more likely to die from a heroin-involved overdose than females. Deaths/ 100,000 pop. Opioid-Involved Overdose Death Rates, by Age and Sex, Georgia Residents, 2020 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Overall <1 Male Female Age Category (years) 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Males aged 35-44 years died from an opioid-involved overdose more frequently than persons of any other age category and were 2.2 times more likely to die from an overdose than females of the same age. OPIOID OVERDOSE SURVEILLANCE | 9 Deaths/ 100,000 pop Quarterly Opioid-Involved Overdose Death Rates, by Sex and Drug Type, Georgia Residents, 2018-2020 6.0 5.1 5.0 4.2 4.1 4.0 3.0 2.9 2.7 2.7 3.1 2.9 3.1 2.7 3.1 2.9 2.3 2.4 2.0 1.7 1.4 1.6 1.4 1.4 1.4 1.4 1.4 1.8 1.8 1.0 0.0 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Males Females Opioid-involved overdose death rates among males increased from 2020 Q1 to 2020 Q2 then trended downward from 2020 Q2 to 2020 Q4. Opioid-involved overdose deaths rates among females trended upward from 2019 Q4 to 2020 Q3 then downward from 2020 Q3 to 2020 Q4. OPIOID OVERDOSE SURVEILLANCE | 10 Opioid-Involved Overdose Emergency Department Visits and Hospitalizations (Morbidity) Note: This case definition has changed and cannot be compared to previously published reports. Any opioid may include prescription or illicit opioids. ED visits and hospitalization categories are not mutually exclusive. Hospitalizations may also appear in the ED visits category if they were admitted to the hospital through the ED. Note: The following data include all ED visits and hospitalizations that occurred in Georgia among Georgia residents. No. of visits or hospitalizations Opioid-Involved Overdose Emergency Department (ED) Visits and Hospitalizations, by Drug Type, Georgia Residents, 2018-2020 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 4985 1353 ED Visits 2018 4876 1420 ED Visits 2019 7954 Any Opioid Heroin 2719 2353 325 2176 339 2822 535 ED Visits 2020 Hospitalizations Hospitalizations Hospitalizations 2018 2019 2020 From 2019 to 2020, ED visits for opioid- and heroin-involved overdoses increased by 63% and 92% respectively. Hospitalizations for opioid- and heroin-involved overdoses decreased by 30% and 58% respectively. OPIOID OVERDOSE SURVEILLANCE | 11 ED visits/ 100,000 pop Quarterly Opioid-Involved Overdose Emergency Department (ED) Visit Rates, by Drug Type, Georgia Residents, 2018-2020 25.0 20.9 20.5 20.0 17.8 16.0 15.0 11.9 11.7 11.3 10.7 9.9 11.3 12.1 11.6 10.0 8.0 6.7 6.7 5.3 5.0 3.5 3.3 3.5 2.8 2.8 3.4 3.9 3.8 0.0 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Any Opioid Heroin Opioid-involved overdose ED visit rates increased from 2019 Q4 to 2020 Q2 then trended downward. Heroin-involved overdose ED visit rates trended slightly upward from 2019 Q4 to 2020 Q2 then trended downward. ED visits/ 100,000 pop. Total <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Hospitalizations/ 100,000 pop. Opioid-Involved Overdose ED Visit Rates, by Age and Drug Type, Georgia Residents, 2020 200.0 150.0 100.0 50.0 0.0 Any Opioid Heroin Opioid-Involved Overdose Hospitalization Rates by Age and Drug Type, Georgia Residents, 2020 60.0 50.0 Any Opioid Heroin 40.0 30.0 20.0 10.0 0.0 Age Category (years) Age Category (years) Persons aged 25-34 years were more likely to visit an ED because of an opioid-involved overdose than persons of other age categories, yet persons aged 55 and older were more frequently hospitalized because of an opioid-involved overdose. Heroin-involved overdoses occurred most frequently among persons aged 25-34 years and were less common among younger and older persons. OPIOID OVERDOSE SURVEILLANCE | 12 Visits or hospitalizations / 100,000 pop. Opioid-Invovled Overdose Emergency Department Visit and Hospitalization Rates, by Race and Drug Type, Georgia Residents, 2020 120.0 100.0 80.0 60.0 40.0 20.0 0.0 112.1 40.3 Any Opioid ED Visit White Black 46.2 8.0 Heroin ED Visit 35.6 14.1 8.8 1.9 Any Opioid Hospitalization Heroin Hospitalization Whites were 2.8 times more likely to visit an ED for any opioid-involved overdose, 5.8 times more likely to visit an ED for a heroin-involved overdose, and 2.5 times more likely to be hospitalized for an opioidinvolved overdose than Blacks. ED visits/ 100,000 pop Quarterly Opioid-Invovled Overdose Emergency Department (ED) Visit Rates, by Race, Georgia Residents, 2018-2020 35.0 32.3 29.7 30.0 26.8 23.3 25.0 20.0 17.2 16.6 16.4 14.9 13.7 15.3 16.9 16.5 15.0 10.0 6.8 6.6 6.1 6.9 6.7 7.8 7.6 6.8 9.0 12.1 9.9 9.3 5.0 0.0 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 White Blacks Opioid-involved ED visit rates among Whites trended upward from 2019 Q4 to 2020 Q2, and then downward. Opioid-involved ED visit rates among Blacks trended upward from 2019 Q4 to 2020 Q3, and then downward. OPIOID OVERDOSE SURVEILLANCE | 13 ED visits/ 100,000 pop. Total <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Hospitalizations/ 100,000 pop. Opioid-Involved Overdose ED Visit Rates, by Age and Sex, Georgia Residents, 2020 250.0 200.0 150.0 100.0 50.0 0.0 Male Female Opioid-Involved Overdose Hospitalization Rates by Age and Sex, Georgia Residents, 2020 Male Female 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Age Category (years) Age Category (years) Males aged 25-34 years visited an ED and/or died from an opioid-involved overdose more frequently than females of the same age category. Females, particularly those aged 25-34 years, more frequently visited an ED, Females aged 55 and up were more frequently hospitalized for an opioid-involved overdose than any age categories ED visits/ 100,000 pop Quarterly Opioid-Involved Overdose Emergency Department (ED) Visit Rates, by Sex, Georgia Residents, 2018-2020 30.0 25.0 20.0 15.0 10.0 5.0 0.0 2018 2018 2018 2018 2019 2019 2019 2019 2020 2020 2020 2020 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Males Females Opioid-involved ED visit rates among males trended upward from 2019 Q4 to 2020 Q2 then trended downwards. Opioid-involved ED visit rates among females trended upwards from 2019 Q4, then trended downwards in 2020 Q3. OPIOID OVERDOSE SURVEILLANCE | 14 OPIOID OVERDOSE SURVEILLANCE | 15 OPIOID OVERDOSE SURVEILLANCE | 16 NOTE: Rates could not be calculated for most counties due to the low number of heroin-involved overdose deaths, ED visits and hospitalizations. Therefore, the number (not rate) of overdoses are presented in this map OPIOID OVERDOSE SURVEILLANCE | 17 OPIOID OVERDOSE SURVEILLANCE | 18 OPIOID OVERDOSE SURVEILLANCE | 19 OPIOID OVERDOSE SURVEILLANCE | 20 NOTE: Rates could not be calculated for some counties due to the low number of heroin-involved overdose deaths, ED visits and hospitalizations. Therefore, the number (not rate) of overdoses are presented in this map. OPIOID OVERDOSE SURVEILLANCE | 21 OPIOID OVERDOSE SURVEILLANCE | 22 Opioid-Involved Overdose Emergency Department Visits and Hospitalizations, by Drug Type, Georgia, 2020 Any opioid may include prescription and/or illicit opioids; categories are not mutually exclusive Number represents events that occurred Number represents events that in Georgia regardless of the patient's occurred in Georgia among Georgia residence state residents Drug Category No. No. Any Opioid ED Visits 8629 7954 Any Opioid Hospitalizations 3017 2822 Heroin ED Visits 2952 2719 Heroin Hospitalizations 583 535 Counties with the Highest Number or Rate of Any Opioid-Involved Overdose Deaths, Emergency Department (ED) Visits and Inpatient Hospitalizations -- Georgia, 2020 Number, and age-adjusted rate per 100,000 population. Note: rates could not be calculated for some counties due to the low number of any opioid-involved overdose ED visits, hospitalizations, and deaths, only counties with >15 were included in the top 10 rate ranking Rank No. deaths County of residence No. deaths County of injury Death rate County of residence No. ED visits and hospitalizations County of residence ED visit and hospitalization rate County of residence 1 Fulton (132) Fulton (158) Clay (34.9) Fulton (563) Bartow (200.1) 2 Cobb (117) Cobb (131) Talbot (32.5) Cobb (509) Brantley (192.7) 3 Gwinnett (95) DeKalb (90) Ware (30.7) Gwinnett (418) Oglethorpe (182.0) 4 DeKalb (80) Gwinnett (87) Randolph (29.9) Chatham (330) Ware (167.5) 5 Richmond (47) Richmond (47) Haralson (26.3) Richmond (303) McIntosh (166.8) 6 Cherokee (44) Cherokee (39) Banks (25.8) Dekalb (302) Pierce (158.8) 7 Chatham (39) Clayton (38) Gilmer (25.0) Hall (242) Habersham (158.5) 8 Hall (31) Carroll (30) Dade (24.9) Bartow (219) Glynn (157.8) 9 Paulding (28) Hall (28) Seminole (24.8) Cherokee (214) Carroll (156.2) 10 Carroll (27) Chatham (25) Dodge (24.4) Carroll (190) Lee (155.5) OPIOID OVERDOSE SURVEILLANCE REPORT | 2 23 Note: The following data include deaths that occurred in Georgia regardless of the patient's residence state. Drug Overdose Deaths (Mortality) -- Georgia, 20122020 Any opioid may include prescription and/or and illicit opioids; categories are not mutually exclusive. Number represents events that occurred in Georgia regardless of the patient's residence state Any Drug Any Opioid Synthetic Opioids Heroin Fentanyl Year No. No. No. No. No. 2020 1880 1266 916 407 813 2019 1493 904 496 323 392 2018 1507 910 449 314 327 2017 1591 1051 506 284 381 2016 1436 954 399 228 245 2015 1364 901 411 252 255 2014 1041 637 164 236 138 2013 1113 556 82 131 52 2012 1066 554 65 106 48 Drug Overdose Emergency Department (ED) Visits and Hospitalizations (Morbidity) -- Georgia Residents, 2018-2020 Number, and age-adjusted rate per 100,000 population. Any opioid may include prescription and/or illicit opioids; categories are not mutually exclusive Any Opioid Heroin ED Visits Hospitalizations ED Visits Hospitalizations Year No. Rate No. Rate No. Rate No. Rate 2020 7954 75.2 2822 25.4 2719 26.7 535 5.2 2019 4876 45.0 2176 19.2 1420 13.9 339 3.3 2018 4985 45.6 2353 20.7 1353 13.1 325 3.2 OPIOID OVERDOSE SURVEILLANCE | 24 Opioid Related Overdose Morbidity and Mortality -- Georgia Residents, 2020 (emergency department (ED) visits, inpatient hospitalizations, and deaths) Number and rate per 100,000 population (rate is age-adjusted except when age categories are presented). Any opioid may include prescription and/or illicit opioids; categories are not mutually exclusive Any Opioid ED Visits Hospitalizations Deaths No. Rate No. Rate No. Rate Total 7954 75.2 Age group (yrs) <1 year 17 13.3 2822 4 25.4 1266 12.2 N/A 0 N/A 1-4 years 61 11.5 15 N/A 0 N/A 5 -14 years 20 N/A 7 N/A 2 N/A 15-24 years 857 59.5 187 13.0 109 7.6 25-34 years 2312 157.3 488 33.2 323 22.0 35-44 years 1628 118.7 413 30.1 365 26.6 45-54 years 1067 75.6 436 30.9 230 16.3 55-64 years 1059 82.4 621 48.3 176 13.7 65-74 years 623 69.6 429 48.0 54 6.0 75-84 years 233 55.7 181 43.3 6 N/A 85+ years 77 55.2 41 Sex (age group) Male 30.0 1 N/A <1 year 13 20.0 3 N/A 0 N/A 1-4 years 33 12.1 9 N/A 0 N/A 5-14 years 9 N/A 4 N/A 1 N/A 15-24 years 535 73.0 130 17.7 77 10.5 25-34 years 1536 210.5 307 42.1 228 31.2 35-44 years 1034 156.4 241 36.5 246 37.2 45-54 years 543 79.2 193 28.2 133 19.4 55-64 years 486 79.6 236 38.6 97 15.9 65-74 years 272 66.8 167 41.0 32 7.9 75-84 years 80 44.7 66 36.8 2 N/A 85+ years 28 56.1 13 26.1 0 0.0 Female OPIOID OVERDOSE SURVEILLANCE | 25 <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 Race White Black 4 26 11 322 775 594 524 573 350 153 43 6188 1370 6.4 10.0 N/A 45.5 104.6 83.7 72.2 85.0 71.9 64.0 44.4 112.1 40.3 1 4 3 57 181 172 243 385 262 115 27 2219 469 N/A 0 N/A N/A 0 N/A N/A 1 N/A 8.0 32 N/A 24.4 95 12.8 24.2 119 16.8 33.5 97 13.4 57.1 79 11.7 53.8 22 N/A 48.1 4 N/A 27.9 1 N/A 35.6 976 18.4 14.1 266 7.8 OPIOID OVERDOSE SURVEILLANCE | 26 Opioid Overdose Surveillance and Response Information/Resources To report an increase in overdoses, a potential overdose cluster, or any other unusual drug-related event, call the Georgia Poison Center at 1-800-222-1222. Please see https://dph.georgia.gov/stopopioidaddiction for more information on how the Georgia Department of Public Health (DPH) is working to combat the opioid epidemic, including: Opioid and substance misuse response: https://dph.georgia.gov/georgias-opioidresponse Prescription Drug Monitoring Program (PDMP): https://dph.georgia.gov/pdmp Drug Surveillance Unit: https://dph.georgia.gov/drug-surveillance-unit Please see https://dph.georgia.gov/opioid-epidemic-individuals-and-families for information on the opioid epidemic for individuals and families, including: Addiction prevention Drug take-back Signs of an overdose and steps to take Naloxone information Georgia's Prescription Drug Monitoring Program (PDMP) Georgia's Medical Amnesty Law Harm reduction Neo-natal abstinence syndrome Treatment resources Please see https://dph.georgia.gov/opioid-epidemic-medical-providers-and-pharmacists for information on the opioid epidemic for medical providers and pharmacists, including: Steps providers can take to help prevent opioid misuse and addiction in their patients Prescribing guidelines Georgia's Prescription Drug Monitoring Program (PDMP) Georgia's Naloxone Standing Order Georgia's Medical Amnesty Law OPIOID OVERDOSE SURVEILLANCE | 27 Please see https://dph.georgia.gov/opioid-epidemic-first-responders-and-ems for information on the opioid epidemic for Law Enforcement and EMS, including: Georgia's Prescription Drug Monitoring Program (PDMP) Responder safety Georgia's Medical Amnesty Law Georgia's Naloxone Standing Order Naloxone administration Case documentation guidelines Georgia Department of Public Health (DPH), Epidemiology Section, Drug Surveillance Unit https://dph.georgia.gov/drug-surveillance-unit OPIOID OVERDOSE SURVEILLANCE | 28