About

Funded by Centers for Disease Control and Prevention Overdose Data to Action (OD2A) grant, this website was created in part by the University of Hawaiʻi at Mānoa and the Hawaiʻi State Department of Health, and made possible by ongoing collaboration with the following partners:

We gratefully acknowledge all staff who continue to build, maintain, and support this website. 

About the Overdose Data to Action project

Overdose Data to Action (OD2A) is a CDC cooperative agreement aimed at (1) expanding public health surveillance to allow for higher quality and more timely and comprehensive data collection for drug-related misuse and overdose morbidity and mortality, and (2) using these data to drive prevention strategies. The project has multiple surveillance and prevention focal points, including strengthening state and local capacity for public health programs; connecting health systems, state and local partners and agencies, and community members to improve prescribing practices and share data; increasing access and usability of the Prescription Drug Monitoring Program; improving treatment access and engagement; and building awareness among our community.

Common terms used in this dashboard:

1. Substance use disorder (SUD): “occur[s] when the use of alcohol and/or drugs causes
   clinically significant impairment, including health problems, disability, and failure to
   meet major responsibilities at work, school, or home” 1
2. Co-occurring disorders: disorders that a person experiences at the same time. In this
   dashboard, we present data on people with a substance use disorder who may also
   experience co-occurring mental illness, or vice versa (people with mental illness who
   may also experience co-occurring substance use disorder).
3. Polysubstance use: use or consumption of more than one drug at the same time or
   within a short period of time of each other.
4. Behavioral Health: emotional, psychological, and social aspects of health or well-being,
   including mental health and substance use.
5. Crisis: “an acute emotional upset; it is manifested in an inability to cope emotionally,
   cognitively, or behaviorally and to solve problems as usual.” 2 Signs of a crisis may
   include feeling like something is wrong without being able to explain the reason for it,
   feeling hopeless, panicked, trapped, empty, or in a lot of pain, and nothing seems to help.

Citations:

1. Substance Abuse and Mental Health Services Administration (2022) Mental health and
   substance use disorders SAMHSA. Available at: https://www.samhsa.gov/find-
   help/disorders#:~:text=Substance%20use%20disorders%20occur%20when,work%2C%20sc
   hool%2C%20or%20home (Accessed: January 30, 2023).
2. Centers for Disease Control and Prevention (2020) Crisis: A definition Available at:
   https://wwwn.cdc.gov/WPVHC/Nurses/Course/Slide/Unit2_7#:~:text=Crisis%20is%20an%20ac
   ute%20emotional,usual%20(Hoff%2C%202009 (Accessed: January 30, 2023).

For Drug Overdose Surveillance & Epidemiology (DOSE)

Discharge Data Case Definitions:

Each category below includes unintentional, intentional self-harm (analyzed separately), and
undetermined intent poisonings for the initial encounter only–does not include assault, adverse
effect, or underdosing.

1. All Drug: poisoning by drugs, medicaments and biological substances—does not include
   assault, adverse effect, underdosing; initial encounter only—does not include subsequent
   encounter(s) or sequela;
2. All Opioids: poisoning by opium, heroin, other opioids, methadone, synthetic narcotics,
   fentanyl or fentanyl analogs, tramadol, synthetic narcotics, unspecified narcotics, and
   other narcotics
3. Heroin: poisoning by heroin
4. Stimulants: poisoning by cocaine, unspecified psychostimulants, caffeine,
   amphetamines, methylphenidate, ecstasy, and other psychostimulants
   

Important Data Considerations:

• Missing Data: discharge data submitted by state/jurisdiction health departments can be
  delayed or temporarily stalled. Once data sharing resumes, emergency department visit or
  hospitalizations not shared during the initial data exchange, may not be backfilled or shared.
• Data overlap: drug overdose visit counts are not mutually exclusive and represent the
  nesting of drug categories (i.e., suspected all drug category includes the number of suspected
  opioid-, heroin-, and stimulant-involved overdose visits; suspected heroin counts are included
  in the suspected opioid category; and cases that involve multiple substances can include both
  opioids and stimulants).
• Reporting delays: as states/jurisdictions continue to onboard new data-sharing facilities to
  support syndromic surveillance activities, some facilities experience occasional interruptions
  in data availability. Data may also evolve over time (e.g., introducing new diagnosis codes).
  As a result, reported cases and rates can change over time.
• Suspected overdoses/poisonings: these data are not necessarily verified by toxicological
  testing and are considered “suspected” overdoses, not confirmed cases.
• Undercounts: data likely represent an undercount when accounting for inaccuracies in
  coding

References:

1. “Technical Guidance for the Drug Overdose Surveillance and Epidemiology (DOSE)
   System: Version 2.4.” CDC: Centers for Disease Control & Prevention, pg. 41, October
   2022.
2. “Drug Overdose Surveillance & Epidemiology (DOSE) Dashboard: Nonfatal Overdose
   Data.” CDC: Centers for Disease Control and Prevention, Important Data
   Considerations, https://www.cdc.gov/drugoverdose/nonfatal/dashboard/index.html.