Overview of the Opioid Data Dashboard

  • The New York State Department of Health (NYSDOH) Opioid Prevention Program developed this Opioid Data Dashboard to provide comprehensive and useful data on opioid use and misuse. The dashboard improves timely opioid overdose reporting, supports statewide prevention efforts, and serves as a valuable tool for planning, identifying where communities are struggling, helping communities tailor interventions, and showing improvements.
  • Opioid Data State Dashboard
  • The state dashboard homepage displays a quick view of the most current data for 94 opioid-related indicators and compares them with data from previous time periods to assess progress. State level historical (trend) data can be easily accessed, and data for many state level indicators are also available by socio-economic status. County data (maps, tables and bar and trend charts) are also available for most opioid tracking indicators. These visualizations and data can be accessed from the state dashboard link above.
  • Opioid Data County Dashboard
  • The county dashboard homepage includes the most current data available for 73 opioid-related indicators. Each county in the state has its own dashboard and several indicators also have data at the ZIP Code level. These visualizations and data can be accessed from the county dashboard link above.

Technical Notes

 Definition of Indicators
Opioid Data Overview
Indicator Definition ICD codes/Detailed Explanation Data Source
Overdose deaths involving any opioid, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
The number of poisoning deaths involving any opioid (all manners, using all causes of death) per 100,000 population Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any opioid in all other causes of death: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 Vital Records a
Overdose deaths involving synthetic opioids other than methadone (incl. illicitly produced opioids such as fentanyl), crude rate per 100,000 population

County Dashboard Tracking Indicator Number
The number of poisoning deaths involving any synthetic opioid other than methadone (incl. illicitly produced opioids such as fentanyl), all manners, using all causes of death, per 100,000 population Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any synthetic opioids other than methadone in all other causes of death: T40.4 Vital Records a
Suspected opioid overdoses by EMS agencies, crude rate per 1,000 unique 911 EMS dispatches

County Dashboard Tracking Indicator Number
If any one of the following conditions are met:

1) naloxone is administered with positive response, 2) provider impressions indicate poisoning by opioids, 3) provider impressions indicate opioid related disorder and naloxone is administered, 4) provider impressions indicate unspecified drug overdose and opioid term is mentioned in narrative and response to naloxone is not worse and no narcotics are administered by EMS, 5) provider impressions indicate unspecified drug overdose, cardiac arrest, apnea, or respiratory failure and opioid term is mentioned in narrative and naloxone is administered and patient fatality is indicated, 6) opioid term and overdose term mentioned in narrative (with no rule out term) and at least two additional terms indicating an opioid overdose mentioned in narrative and no narcotics are administered by EMS
Please see appendix 1 for detailed methodology NYS e-PCR data, and selected regional EMS Program data collection methods (see Data Sources) d
Patients who received at least one buprenorphine prescription for opioid use disorder, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
Number and rate of patients who received at least one buprenorphine prescription for opioid use disorder per 100,000 residents

Because dispensed prescription data for controlled substances can be reported or corrected after the date the drug was dispensed, the historic prescription data on this webpage is subject to subsequent updating.
Patients who received at least one buprenorphine prescription for opioid use disorder within the state. NYS PMP registry e
All emergency department visits (including outpatients and admitted patients) involving opioid overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
The number of all emergency department visits involving any opioid poisoning as the principal diagnosis or first-listed cause of injury per 100,000 population ICD-10-CM: Principal Diagnosis: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
All emergency department visits (including outpatients and admitted patients) involving heroin overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
The number of all emergency department visits involving heroin poisoning, principal diagnosis or first-listed cause of injury per 100,000 population ICD-10-CM: Principal Diagnosis: T40.1 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T401X5S, T401X6S) SPARCS b
Hospital discharges involving opioid use (including abuse, poisoning, dependence and unspecified use), crude rate per 100,000 population

County Dashboard Tracking Indicator Number
Opioid use includes abuse, poisoning, dependence and unspecified use. ICD-10-CM: Opioid abuse (Principal Diagnosis: F1110, F11120, F11121, F11122, F11129, F1114, F11150, F11151, F11159, F11181, F11182, F11188, F1119); Opioid dependence and unspecified use (Principal Diagnosis: F1120, F11220, F11221, F11222, F11229, F1123, F1124, F11250, F11251, F11259, F11281, F11282, F11288, F1129, F1190, F11920, F11921, F11922, F11929, F1193, F1194, F11950, F11951, F11959, F11981, F11982, F11988, F1199); Opioid poisoning (Principal Diagnosis: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
Overdose deaths involving opioids and non-fatal opioid related hospital events, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
Poisoning deaths involving any opioid, non-fatal outpatient ED visits and hospital discharges involving opioid abuse, poisoning, dependence and unspecified use. Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any opioid in all other causes of death: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6

ICD-10-CM: Opioid abuse (Principal Diagnosis: F1110, F11120, F11121, F11122, F11129, F1114, F11150, F11151, F11159, F11181, F11182, F11188, F1119); Opioid dependence and unspecified use (Principal Diagnosis: F1120, F11220, F11221, F11222, F11229, F1123, F1124, F11250, F11251, F11259, F11281, F11282, F11288, F1129, F1190, F11920, F11921, F11922, F11929, F1193, F1194, F11950, F11951, F11959, F11981, F11982, F11988, F1199); Opioid poisoning (Principal Diagnosis: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S)
Vital Records a; SPARCS b
Outpatient ED visits and hospital discharges involving opioid abuse, dependence and unspecified use, crude rate per 100,000 population

County Dashboard Tracking Indicator Number
Outpatient ED visits and hospital discharges involving opioid abuse, dependence and unspecified use. ICD-10-CM: Opioid abuse (Principal Diagnosis: F1110, F11120, F11121, F11122, F11129, F1114, F11150, F11151, F11159, F11181, F11182, F11188, F1119); Opioid dependence and unspecified use (Principal Diagnosis: F1120, F11220, F11221, F11222, F11229, F1123, F1124, F11250, F11251, F11259, F11281, F11282, F11288, F1129, F1190, F11920, F11921, F11922, F11929, F1193, F1194, F11950, F11951, F11959, F11981, F11982, F11988, F1199) SPARCS b
Admissions to OASAS-certified substance use disorder treatment programs for any opioid (incl. heroin), crude rate per 100,000 population - Aged 12+ years

County Dashboard Tracking Indicator Number
Admissions to OASAS-certified substance use disorder treatment programs with heroin or any other synthetic or semi-synthetic opioid reported as the primary, secondary, or tertiary substance of use at admission, aggregated by client ZIP Code of residence. Clients may also have heroin or any other substance as the primary, secondary, or tertiary substance of use at admission.

Other opioid includes synthetic and semi-synthetic opioids. The OASAS Client Data System (CDS) collects specific data on methadone, buprenorphine, oxycodone, as well as “other synthetic opioids.” Other synthetic opioids also include drugs such as hydrocodone, pharmaceutical and/or nonpharmaceutical fentanyl.
OASAS c
Emergency Medical Services
1 - Unique naloxone administrations by EMS agencies, crude rate per 1,000 unique 911 EMS dispatches

County Dashboard Tracking Indicator Number - 1
Unique naloxone administrations represent an EMS encounter in which naloxone was administered during the course of patient care. Often, administrations of naloxone are given to patients presenting with similar signs and symptoms of a potential opioid overdose; final diagnosis of an opioid overdose is completed during definitive care or final evaluation. Medication administered is equal to Naloxone or Narcan. NYS e-PCR data, and selected regional EMS Program data collection methods (see Data Sources) d
2 - Suspected opioid overdoses by EMS agencies, crude rate per 1,000 unique 911 EMS dispatches

County Dashboard Tracking Indicator Number - 2
If any one of the following conditions are met:

1) naloxone is administered with positive response, 2) provider impressions indicate poisoning by opioids, 3) provider impressions indicate opioid related disorder and naloxone is administered, 4) provider impressions indicate unspecified drug overdose and opioid term is mentioned in narrative and response to naloxone is not worse and no narcotics are administered by EMS, 5) provider impressions indicate unspecified drug overdose, cardiac arrest, apnea, or respiratory failure and opioid term is mentioned in narrative and naloxone is administered and patient fatality is indicated, 6) opioid term and overdose term mentioned in narrative (with no rule out term) and at least two additional terms indicating an opioid overdose mentioned in narrative and no narcotics are administered by EMS
Please see appendix 1 for detailed methodology NYS e-PCR data, and selected regional EMS Program data collection methods (see Data Sources) d
Prescription Monitoring Program
3 - Opioid analgesics prescription, crude rate per 1,000 population

County Dashboard Tracking Indicator Number - 3



4 - Opioid analgesics prescription, age-adjusted rate per 1,000 population

County Dashboard Tracking Indicator Number - 4
Number and rate of opioid analgesic prescriptions per 1,000 residents

The rates presented are controlled substance prescription rates per population. These numbers are federally-standardized indicators used to measure types of progress toward combating the controlled substance epidemic in certain states. They are not rates of the number of different people who are receiving a controlled substance prescription in a certain population. Rather, they are rates of the number of specific controlled substance prescriptions written and dispensed within the period. For example, if a county has a rate of 25, that means there were 25 prescriptions per 1,000 people in the population. However, it does not necessarily mean that 25 out of 1,000 individuals received a prescription; all 25 controlled substance prescriptions could have been for one individual.

Because dispensed prescription data for controlled substances can be reported or corrected after the date the drug was dispensed, the historic prescription data on this webpage is subject to subsequent updating.

The data exclude buprenorphine prescriptions for the treatment of opioid use disorder.
Schedule II, III and IV opioid analgesic prescriptions dispensed to state residents. NYS PMP registry e
5 - Percentage of incidents when patients were opioid naïve and received an opioid prescription of more than seven days

County Dashboard Tracking Indicator Number - 5
Number and percent of incidents when patient was opioid naïve and received an index opioid prescription of more than seven days

The denominator was opioid naïve incidents which was defined as patient with no opioid for pain prescription in last 45 days.

The numerator was defined as opioid naïve incidents where patient received an index prescription of an opioid of more than seven days.
Schedule II, III and IV opioid analgesic prescriptions dispensed to state residents. NYS PMP registry e
6 - Patients prescribed opioid analgesics from five or more prescribers and dispensed at five or more pharmacies, crude rate per 100,000 population Multiple provider episodes for prescription opioids (five or more prescribers and five or more pharmacies in a six-month period), crude rate per 100,000 residents.

The data exclude buprenorphine prescriptions for the treatment of opioid use disorder.
Number of patients receiving prescriptions for opioid analgesics from five or more prescribers and that are dispensed at five or more pharmacies in a six-month period. NYS PMP registry e
7 - Percentage of patients prescribed one or more opioid analgesics with a total daily dose of 90 MME or more on at least one day

County Dashboard Tracking Indicator Number - 6
Percentage of patients with a total daily dose of >= 90 MME on at least one day Number of patients prescribed one or more opioid analgesics prescription with a total daily dose of 90 MME on at least one day among opioid analgesics patients NYS PMP registry e
8 - Percentage of patients* with two or more calendar days of overlapping opioid analgesic and benzodiazepine prescriptions

County Dashboard Tracking Indicator Number - 7
Percentage of patients with two or more calendar days of overlapping opioid analgesic and benzodiazepine prescriptions Percentage of patients* with two or more calendar days of overlapping opioid analgesic and benzodiazepine prescriptions Number of patients with two or more calendar days of overlapping opioid analgesic and benzodiazepine prescriptions among patients with at least one prescription for opioid analgesics or benzodiazepines during a given year NYS PMP registry e
9 - Percentage of patients* with two or more calendar days of overlapping opioid analgesic prescriptions

County Dashboard Tracking Indicator Number - 8
Percentage of patients with two or more calendar days of overlapping opioid analgesic prescriptions Number of patients with two or more calendar days of overlapping opioid analgesic prescriptions among patients with at least one prescription for opioid analgesics during a given year NYS PMP registry e
10 - Benzodiazepine prescription, crude rate per 1,000 population

County Dashboard Tracking Indicator Number - 9



11 - Benzodiazepine prescription, age-adjusted rate per 1,000 population

County Dashboard Tracking Indicator Number - 10
Number and rate of benzodiazepine prescriptions per 1,000 residents

The rates presented are controlled substance prescription rates per population. These numbers are federally-standardized indicators used to measure types of progress toward combating the controlled substance epidemic in certain states. They are not rates of the number of different people who are receiving a controlled substance prescription in a certain population. Rather, they are rates of the number of specific controlled substance prescriptions written and dispensed within the period. For example, if a county has a rate of 25, that means there were 25 prescriptions per 1,000 people in the population. However, it does not necessarily mean that 25 out of 1,000 individuals received a prescription; all 25 controlled substance prescriptions could have been for one individual.

Because dispensed prescription data for controlled substances can be reported or corrected after the date the drug was dispensed, the historic prescription data on this webpage is subject to subsequent updating.
Benzodiazepine prescriptions dispensed to residents within the state or specific county. Common benzodiazepine prescriptions include alprazolam, clonazepam, diazepam, and lorazepam. NYS PMP registry e
12 - Patients who received at least one buprenorphine prescription for opioid use disorder, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 11



13 - Patients who received at least one buprenorphine prescription for opioid use disorder, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 12
Number and rate of patients who received at least one buprenorphine prescription for opioid use disorder per 100,000 residents

Because dispensed prescription data for controlled substances can be reported or corrected after the date the drug was dispensed, the historic prescription data on this webpage is subject to subsequent updating.
Patients who received at least one buprenorphine prescription for opioid use disorder within the state. NYS PMP registry e
Overdose Deaths
14 - Overdose deaths involving any drug, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 13



15 - Overdose deaths involving any drug, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 14
All drug poisoning deaths Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 Vital Records a
16 - Overdose deaths involving any opioid, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 15



17 - Overdose deaths involving any opioid, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 16
Poisoning deaths involving any opioid, all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any opioid in all other causes of death: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 Vital Records a
18 - Overdose deaths involving heroin, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 17



19 - Overdose deaths involving heroin, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 18
Poisoning deaths involving heroin, all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Heroin in all other causes of death: T40.1 Vital Records a
20 - Overdose deaths involving opioid pain relievers (incl. illicitly produced opioids such as fentanyl), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 19



21 - Overdose deaths involving opioid pain relievers (incl. illicitly produced opioids such as fentanyl), age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 20
Poisoning deaths involving any opioid pain reliever (incl. illicitly produced opioids such as fentanyl), all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any opioid pain relievers (incl. illicitly produced opioids such as fentanyl) in all other causes of death: T40.2, T40.3, T40.4 Vital Records a
22 - Overdose deaths involving cocaine, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 21



23 - Overdose deaths involving cocaine, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 22
Poisoning deaths involving cocaine, all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Cocaine in all other causes of death: T40.5 Vital Records a
24 - Overdose deaths involving certain psychostimulants (e.g., methamphetamine, MDMA, prescription stimulants), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 23



25 - Overdose deaths involving certain psychostimulants (e.g., methamphetamine, MDMA, prescription stimulants), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 24
Poisoning deaths involving certain psychostimulants (e.g., methamphetamine, MDMA, prescription stimulants), all manners, using all causes of deaths Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Psychostimulants excl. Cocaine in all other causes of death: T43.6 Vital Records a
26 - Overdose deaths involving methadone, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 25



27 - Overdose deaths involving methadone, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 26
Poisoning deaths involving methadone, all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Methadone in all other causes of death: T40.3 Vital Records a
28 - Overdose deaths involving synthetic opioids other than methadone (incl. illicitly produced opioids such as fentanyl), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 27



29 - Overdose deaths involving synthetic opioids other than methadone (incl. illicitly produced opioids such as fentanyl), age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 28
Poisoning deaths involving any synthetic opioid other than methadone (incl. illicitly produced opioids such as fentanyl), all manners, using all causes of death Underlying cause of death, determined from the field designated as such, or, where missing or unknown, from the first listed multiple cause of death field: X40-X44, X60-X64, X85, Y10-Y14 AND Any synthetic opioids other than methadone in all other causes of death: T40.4 Vital Records a
Emergency Department Visits
30 - All emergency department visits (including outpatients and admitted patients) involving any drug overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 29



31 - All emergency department visits (including outpatients and admitted patients) involving any drug overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 30
All emergency department visits (including outpatients and admitted patients) involving any drug poisoning ICD-10-CM: Principal Diagnosis: T36-T50 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in The 5th/6th character (For T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9, a 5th character; for all others, a 6th character); and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
32 - All emergency department visits (including outpatients and admitted patients) involving any opioid overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 31



33 - All emergency department visits (including outpatients and admitted patients) involving any opioid overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 32
All emergency department visits (including outpatients and admitted patients) involving any opioid poisoning, principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
34 - All emergency department visits (including outpatients and admitted patients) involving heroin overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 33



35 - All emergency department visits (including outpatients and admitted patients) involving heroin overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 34
All emergency department visits (including outpatients and admitted patients) involving heroin poisoning, principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.1 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T401X5S, T401X6S) SPARCS b
36 - All emergency department visits (including outpatients and admitted patients) involving opioid overdose excluding heroin (incl. illicitly produced opioids such as fentanyl), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 35



37 - All emergency department visits (including outpatients and admitted patients) involving opioid overdose excluding heroin (incl. illicitly produced opioids such as fentanyl), age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 36
All emergency department visits (including outpatients and admitted patients) involving any opioid poisoning except heroin (incl. illicitly produced opioids such as fentanyl), principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.0, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
Hospital Discharges
38 - Hospital discharges involving any drug overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 37



39 - Hospital discharges involving any drug overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 38
Hospital discharges involving any drug poisoning ICD-10-CM: Principal Diagnosis: T36-T50 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in The 5th/6th character (For T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9, a 5th character; for all others, a 6th character); and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
40 - Hospital discharges involving any opioid overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 39



41 - Hospital discharges involving any opioid overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 40
Hospital discharges involving any opioid poisoning, principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
42 - Hospital discharges involving heroin overdose, crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 41



43 - Hospital discharges involving heroin overdose, age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 42
Hospital discharges involving heroin poisoning, principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.1 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T401X5S, T401X6S) SPARCS b
44 - Hospital discharges involving opioid overdose excluding heroin (incl. illicitly produced opioids such as fentanyl), crude rate per 100,000 population

County Dashboard Tracking Indicator Number - 43



45 - Hospital discharges involving opioid overdose excluding heroin (incl. illicitly produced opioids such as fentanyl), age-adjusted rate per 100,000 population

County Dashboard Tracking Indicator Number - 44
Hospital discharges involving any opioid poisoning except heroin (incl. illicitly produced opioids such as fentanyl), principal diagnosis or first-listed cause of injury ICD-10-CM: Principal Diagnosis: T40.0, T40.2, T40.3, T40.4, T40.6 (Excludes ‘adverse effect’ or ‘underdosing’ as indicated by the values of 5 and 6 in the 6th character; and ‘sequela’ as indicated by the value of ‘S’ in the 7th character; e.g. T400X5S, T400X6S) SPARCS b
46 - Newborns with neonatal withdrawal syndrome and/or affected by maternal use of opioid or other substance (any diagnosis), crude rate per 1,000 newborn discharges

County Dashboard Tracking Indicator Number - 45
Neonatal withdrawal symptoms from maternal use of drugs of addiction, and/or newborns affected by maternal use of drugs of addiction (other than cocaine) including opiates, sedative-hypnotics and anxiolytics ICD-10-CM: Principal Diagnosis: Z38 (liveborn infants) AND P96.1 (neonatal withdrawal symptoms from maternal use of drugs of addiction) or P04.49 (newborns affected by maternal use of drugs of addiction (other than cocaine)) or P04.14 (newborns affected by maternal use of opiates) or P04.17 (newborns affected by maternal use of sedative-hypnotics) or P04.1A (newborns affected by maternal use of anxiolytics) in any other diagnoses

P04.14, P04.17, and P04.1A are three new codes effect 10/1/2018
SPARCS b
Substance Use Disorder Treatment Admissions
47 - Admissions to OASAS-certified substance use disorder treatment programs for heroin, crude rate per 100,000 population - Aged 12+ years

County Dashboard Tracking Indicator Number - 46
Admissions to OASAS-certified substance use disorder treatment programs with heroin reported as the primary, secondary, or tertiary substance of use at admission, aggregated by client ZIP Code of residence. Clients may also have heroin or any other substance as the primary, secondary, or tertiary substance of use at admission. OASAS c
48 – Admissions to OASAS-certified substance use disorder treatment programs for any opioid (incl. heroin), crude rate per 100,000 population - Aged 12+ years

County Dashboard Tracking Indicator Number - 47
Admissions of clients to OASAS-certified substance use disorder treatment programs with heroin or any other synthetic or semi-synthetic opioid reported as the primary, secondary, or tertiary substance of use at admission, aggregated by client ZIP Code of residence. Clients may also have heroin or any other substance as the primary, secondary, or tertiary substance of use at admission.

Other opioid includes synthetic and semi-synthetic opioids. The OASAS Client Data System (CDS) collects specific data on methadone, buprenorphine, oxycodone, as well as “other synthetic opioids.” Other synthetic opioids also include drugs such as hydrocodone, pharmaceutical and/or nonpharmaceutical fentanyl.
OASAS c
Behavioral Risk Factor Surveillance System
49 - Percentage of adults who have self-reported prescription pain medication misuse in the past 12 months

County Dashboard Tracking Indicator Number - 48
Percentage of New York adult residents aged 18 years and older who have self-reported misuse of prescription pain medication in the past 12 months Survey question: “In the past 12 months, have you used prescription pain medicine without “In the past 12 months, have you used prescription pain medicine without a healthcare provider's prescription or differently than how the healthcare provider told you to use it?”

Responses: “A. Yes; B. No"
BRFSS f
50 - Age-adjusted percentage of adults who have self-reported prescription pain medication misuse in the past 12 months

County Dashboard Tracking Indicator Number - 49
Age-adjusted percentage of New York adult residents aged 18 years and older who have self-reported misuse of prescription pain medication in the past 12 months Survey question: “In the past 12 months, have you used prescription pain medicine without a healthcare provider's prescription or differently than how the healthcare provider told you to use it?”

Responses: “A. Yes; B. No"
BRFSS f
51 - Percentage of adults who have self-reported heroin use in the past 12 months Percentage of New York adult residents aged 18 years and older who have self-reported heroin use in the past 12 months Survey question: “In the past 12 months, have you used heroin?”

Responses: “A. Yes; B. No"
BRFSS f
52 - Age-adjusted percentage of adults who have self-reported heroin use in the past 12 months Age-adjusted percentage of New York adult residents aged 18 years and older who have self-reported heroin use in the past 12 months Survey question: “In the past 12 months, have you used heroin?”

Responses: “A. Yes; B. No"
BRFSS f
Youth Risk Behavior Surveillance System
53 - Percentage of high school students reporting ever using cocaine Percentage of respondents indicating that they had ever used cocaine Survey question: “During your life, how many times have you used any form of cocaine, including powder, crack, or freebase?”

Responses: “A. 0 times B. 1 or 2 times C. 3 to 9 times D. 10 to 19 times E. 20 to 39 times F. 40 or more times”
YRBSS g
54 - Percentage of high school students reporting ever using heroin Percentage of respondents indicating that they had ever used heroin Survey question: “During your life, how many times have you used heroin (also called smack, junk, or China White)?”

Responses: “A. 0 times B. 1 or 2 times C. 3 to 9 times D. 10 to 19 times E. 20 to 39 times F. 40 or more times”
YRBSS g
55 - Percentage of high school students reporting ever using methamphetamines Percentage of respondents indicating that they had ever used methamphetamines Survey question: “During your life, how many times have you used methamphetamines (also called speed, crystal, crank, ice, or meth)?”

Responses: “A. 0 times B. 1 or 2 times C. 3 to 9 times D. 10 to 19 times E. 20 to 39 times F. 40 or more times”
YRBSS g
56 - Percentage of high school students reporting ever injecting an illegal drug Percentage of respondents indicating that they had ever injected an illegal drug Survey question: “During your life, how many times have you used a needle to inject any illegal drug into your body?”

Responses: “A. 0 times B. 1 time C. 2 or more times”
YRBSS g
57 - Percentage of high school students reporting ever using synthetic marijuana Percentage of respondents indicating that they had ever used synthetic marijuana Survey question: “During your life, how many times have you used synthetic marijuana?"

Responses: “A. 0 times B. 1 or 2 times C. 3 to 9 times D. 10 to 19 times E. 20 to 39 times F. 40 or more times”
YRBSS g
National Survey on Drug Use and Health
58 - Illicit drug use in the past month, among persons aged 12 years or older The percentage of respondents who reported using illicit drugs in the past month Illicit drug use includes the misuse of prescription psychotherapeutics (pain relievers, tranquilizers, stimulants, or sedatives) or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one's own, use in greater amounts, more often, or longer than told or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. NSDUH h
59 - Illicit drug use other than marijuana in the past month, among persons aged 12 years or older The percentage of respondents who reported using illicit drugs other than marijuana in the past month Illicit drug use other than marijuana use includes the misuse of prescription psychotherapeutics (pain relievers, tranquilizers, stimulants, or sedatives) or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than told; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. This excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. NSDUH h
60 - Heroin use in the past year, among persons aged 12 years or older The percentage of respondents who reported using heroin in the past year Measures of use of heroin in the respondent's lifetime, the past year, and the past month were derived from responses to the questions about lifetime and recency of use (e.g., "How long has it been since you last used heroin?"). The question about recency of use was asked if respondents previously reported any use of heroin in their lifetime. NSDUH h
61 - Perceptions of great risk from trying heroin once or twice, among persons aged 12 years or older The percentage of respondents who reported preceiving great risk from trying heroin once or twice Respondents were asked to assess the extent to which people risk harming themselves physically and in other ways when they use various illicit drugs, alcohol, and cigarettes, with various levels of frequency. Response options were (1) no risk, (2) slight risk, (3) moderate risk, and (4) great risk. Although these questions on the perceived risk of harm from using various substances did not change for 2015, other changes to the 2015 questionnaire appeared to affect the comparability of several of these measures between 2015 and prior years. NSDUH h
62 - Pain reliever misuse in the past year, among persons aged 12 years or older The percentage of respondents who reported pain reliever misuse in the past year Measures of use or misuse of prescription pain relievers in the respondent's lifetime and past year were derived from a series of questions that first asked respondents about any use (i.e., for any reason) of specific prescription pain relievers in the past 12 months. Respondents were instructed not to include the use of over-the-counter (OTC) pain relievers, such as aspirin, Tylenol®, Advil®, or Aleve®. Respondents who did not report use of any pain reliever in the past 12 months were asked whether they ever, even once, used prescription pain relievers.

Respondents who reported they used specific prescription pain relievers in the past 12 months for any reason were shown a list reminding them of the drugs they used in the past 12 months. For each of these drugs, respondents were asked whether they misused it (or them) in the past 12 months (i.e., use in any way a doctor did not direct them to use it). Examples of misuse were presented to respondents and included (1) use without a prescription of the respondent's own; (2) use in greater amounts, more often, or longer than told to take a drug; or (3) use in any other way a doctor did not direct the respondent to use a drug. Beginning in 2017, respondents were reminded not to include OTC drugs when they were asked if they misused any other prescription pain reliever in the past 12 months.
NSDUH h
63 - Illicit drug dependence in the past year, among persons aged 12 years or older The percentage of respondents who reported illicit drug dependence in the past year NSDUH dependence questions for alcohol or illicit drugs ask about the following symptoms, consistent with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV): (1) spent a lot of time engaging in activities related to substance use, (2) used the substance in greater quantities or for a longer time than intended, (3) developed tolerance (i.e., needing to use the substance more than before to get desired effects or noticing that the same amount of substance use had less effect than before), (4) made unsuccessful attempts to cut down on substance use, (5) continued substance use despite physical health or emotional problems associated with substance use, (6) reduced or eliminated participation in other activities because of substance use, and (7) experienced withdrawal symptoms.

For the specific illicit drugs (i.e., cocaine, heroin, methamphetamine, prescription pain relievers, prescription stimulants, and prescription sedatives) and alcohol that include a withdrawal criterion as one of the criteria that can be used to establish dependence, respondents were classified as meeting the criteria for dependence if they met three out of the seven criteria. For illicit drugs that do not include questions in NSDUH about a withdrawal criterion for establishing dependence (i.e., marijuana, hallucinogens, inhalants, and prescription tranquilizers), respondents were classified as meeting the criteria for dependence if they met three out of the six criteria for that substance.

Respondents were asked the dependence questions for illicit drugs other than marijuana if they reported any use in the past 12 months. Respondents were asked the alcohol and marijuana dependence questions only if they indicated use of these substances on 6 or more days in the past 12 months.

These criteria were not used to define nicotine (cigarette) dependence, which used a different series of items. Questions about dependence related to the use of methamphetamine in the past year were added to the survey in 2015 and were patterned after the questions for cocaine dependence.
NSDUH h
64 - Pain reliever dependence in the past year, among persons aged 12 years or older The percentage of respondents who reported pain reliever dependence in the past year NSDUH dependence questions for alcohol or illicit drugs ask about the following symptoms, consistent with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV): (1) spent a lot of time engaging in activities related to substance use, (2) used the substance in greater quantities or for a longer time than intended, (3) developed tolerance (i.e., needing to use the substance more than before to get desired effects or noticing that the same amount of substance use had less effect than before), (4) made unsuccessful attempts to cut down on substance use, (5) continued substance use despite physical health or emotional problems associated with substance use, (6) reduced or eliminated participation in other activities because of substance use, and (7) experienced withdrawal symptoms.

For the specific illicit drugs (i.e., cocaine, heroin, methamphetamine, prescription pain relievers, prescription stimulants, and prescription sedatives) and alcohol that include a withdrawal criterion as one of the criteria that can be used to establish dependence, respondents were classified as meeting the criteria for dependence if they met three out of the seven criteria. For illicit drugs that do not include questions in NSDUH about a withdrawal criterion for establishing dependence (i.e., marijuana, hallucinogens, inhalants, and prescription tranquilizers), respondents were classified as meeting the criteria for dependence if they met three out of the six criteria for that substance. Respondents were asked the dependence questions for illicit drugs other than marijuana if they reported any use in the past 12 months.

Respondents were asked the alcohol and marijuana dependence questions only if they indicated use of these substances on 6 or more days in the past 12 months.

These criteria were not used to define nicotine (cigarette) dependence, which used a different series of items. Questions about dependence related to the use of methamphetamine in the past year were added to the survey in 2015 and were patterned after the questions for cocaine dependence.
NSDUH h
65 - Cocaine use in the past year, among persons aged 12 years or older The percentage of respondents who reported cocaine use in the past year Measures of use of cocaine, including powder, crack, free base, and coca paste, in the respondent's lifetime, the past year, and the past month were derived from responses to the questions about lifetime and recency of use (e.g., "How long has it been since you last used any form of cocaine?"). The question about recency of use was asked if respondents previously reported any use of cocaine in their lifetime. NSDUH h
66 - Methamphetamine use in the past year, among persons aged 12 years or older The percentage of respondents who reported methamphetamine use in the past year Measures of use of methamphetamine in the respondent's lifetime, the past year, and the past month were derived from responses to the questions about lifetime and recency of use (i.e., "Have you ever, even once, used methamphetamine?" and "How long has it been since you last used methamphetamine?"). The question about recency of use was asked if respondents previously reported any use of methamphetamine in their lifetime. Starting in 2015, respondents were asked about their use of methamphetamine separate from questions about their misuse of prescription stimulants.

The following definitional information preceded the question about lifetime use of methamphetamine: "Methamphetamine, also known as crank, ice, crystal meth, speed, glass, and many other names, is a stimulant that usually comes in crystal or powder forms. It can be smoked, 'snorted,' swallowed or injected." The methamphetamine section since 2015 has not included the prescription form of methamphetamine (Desoxyn®) as an example.
NSDUH h
67 - Perceptions of great risk from using cocaine once a month, among persons aged 12 years or older The percentage of respondents who reported preceiving great risk from using cocaine once a month Respondents were asked to assess the extent to which people risk harming themselves physically and in other ways when they use various illicit drugs, alcohol, and cigarettes, with various levels of frequency. Response options were (1) no risk, (2) slight risk, (3) moderate risk, and (4) great risk. Although these questions on the perceived risk of harm from using various substances did not change for 2015, other changes to the 2015 questionnaire appeared to affect the comparability of several of these measures between 2015 and prior years. NSDUH h
68 - Needing illicit drug or alcohol treatment in the past year, but not receiving illicit drug or alcohol treatment at a specialty facility, among persons aged 12 years or older The percentage of respondents who reported needing illicit drug or alcohol treatment in the past year, but not receiving illicit drug or alcohol treatment at a specialty facility Respondents who used alcohol or illicit drugs in the past year were classified into this category if they met criteria for having a substance use disorder (SUD) in the past year (i.e., dependence or abuse), based on definitions in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), but they did not report receipt of treatment in the past year at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center). This treatment measure is referred to as a treatment gap. NSDUH h
69 - Needing illicit drug treatment in the past year, but not receiving illicit drug treatment at a specialty facility, among persons aged 12 years or older The percentage of respondents who reported needing illicit drug treatment in the past year, but not receiving illicit drug treatment at a specialty facility Respondents who used illicit drugs in the past year were classified into this category if they met criteria for having a substance use disorder (SUD) in the past year (i.e., dependence or abuse), based on definitions in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), but they did not report receipt of treatment in the past year at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center). This treatment measure is referred to as a treatment gap. NSDUH h
70 - Opioid dependence or abuse in the past year, among persons aged 12 years or older The percentage of respondents who reported opioid use disorder in the past year Respondents were classified as having an opioid use disorder (OUD) if they met criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), for heroin use disorder, prescription pain reliever use disorder, or both in the past year. Respondents were not counted as having OUD if they did not meet the full dependence or abuse criteria individually for either heroin or prescription pain relievers. For example, respondents who met fewer than three criteria for heroin dependence and met fewer than three criteria for pain reliever dependence were not classified as having opioid dependence, regardless of whether the number of symptoms across the heroin and pain reliever dependence criteria summed to three or more. NSDUH h

a Vital Records (Vital Statistics):
Vital Event Registration:
New York State consists of two registration areas, New York City and New York State Exclusive of New York City (also referred to as Rest of State). New York City (NYC) includes the five counties of Bronx, Kings (Brooklyn), New York (Manhattan), Queens, and Richmond (Staten Island); the remaining 57 counties comprise New York State Exclusive of New York City. The Bureau of Vital Records, New York State Department of Health (NYSDOH), processes data from live birth, death, fetal death, and marriage certificates recorded in New York State Exclusive of New York City. Through a cooperative agreement, the NYSDOH receives data on live births, deaths, fetal deaths, and marriages recorded in New York City from the New York City Department of Health and Mental Hygiene (NYCDOHMH). The NYSDOH also receives data from other states and Canada on live births and deaths recorded outside of New York State attributed to residents of New York State.

Vital Event indicators for NYC geographical areas reported by NYSDOH and NYCDOHMH may be different since the former may include all NYC residents' events regardless of where they occurred, and the latter reports only events to NYC residents that occurred in NYC. The indicators may also differ due to timing and/or completeness of data.

The counts of births and deaths may be influenced by specific reporting issues each year. The specific issues are reported in the NYSDOH Annual Vital Statistics Tables, in the Report Measures section of the Technical Notes.

All the vital statistics presented in this report are based on the county/borough of residence.

b Statewide Planning and Research Cooperative System (SPARCS):
Statewide Planning and Research Cooperative System (SPARCS): Information about hospitalizations is collected through the hospital data system. ICD-10-CM codes were used for diagnoses, there is a primary diagnosis code and up to 24 additional diagnosis codes recorded to further describe the hospitalization. Statistics presented in these tables are based on the primary diagnosis unless otherwise noted.

Numbers and rates are based on the number of hospitalizations and ED visits that occurred and not the number of individuals who were hospitalized or who treated in the ED. SPARCS measures provided are generated based on patient residence county at time of discharge. If county is not known, county is assigned based on ZIP code.

c Office of Addiction Services and Supports (OASAS):
The New York State Office of Addiction Services and Supports (OASAS) provides data on admissions for heroin and admissions for any opioid. This information comes from the OASAS Client Data System (CDS). The CDS collects data on every person admitted to an OASAS-certified substance use disorder treatment program. The reported cases are based on the county of residence at the time of admission. The data are presented as two indicators: (1) Admissions for heroin use (i.e., admissions by county of residence where heroin was the primary, secondary or tertiary substance of use at admission), and (2) Admissions for the use of any opioid, including heroin (i.e., heroin or another opioid was the primary, secondary or tertiary substance of use at admission). The CDS includes data for people served in the OASAS-certified treatment system. It does not have data for people who do not enter treatment, get treated by the U.S. Department of Veterans Affairs, go outside New York State for treatment, are admitted to hospitals but not to substance use disorder treatment, or receive an addictions medication from a physician outside the OASAS system of care.

d New York State Emergency Medical Services (EMS) Data:
New York State maintains an EMS patient care data repository, in which all Electronic Patient Care Reporting (ePCR) data are captured from across the State. A majority of NYS EMS ePCR data from 2016, 2017, 2018 and the first three quarters of 2019 were collected via the National EMS Information Systems (NEMSIS) 2.2.1 standard. Most EMS agencies transitioned to the NEMSIS 3.4.0 data standard in the fourth quarter of 2019, which has improved the quality of EMS data.

Most data for Suffolk County are obtained through the Suffolk County Regional EMS Medical Control, to which all medication administrations by EMS–including naloxone–are required to be reported. The Suffolk County results in this report are a de-duplicated compilation of data received from Suffolk County Medical Control and data provided from e-PCRs submitted.

Data for Nassau County from 2018, 2019, and 2020 are primarily provided by the Nassau County Police Department, based on reports submitted by Nassau County first response agencies and most ambulance transport agencies serving the county. The EMS data from Nassau County Police Department are combined with e-PCR data submitted by other agencies, and deduplicated to avoid over-reporting.

Finally, part of the data for Richmond County is obtained directly from a major EMS agency serving the area, due to a difference in reporting mechanisms. These data are also deduplicated with ePCR data. This reporting is expected to come in line with the NEMSIS 3.4.0 reporting standard in the near future.

e New York State Prescription Monitoring Program (PMP) Registry:
The New York State Prescription Monitoring Program Registry (PMP) is an online registry that is maintained by New York State Department of Health’s Bureau of Narcotic Enforcement. The registry collects dispensed prescription data for controlled substances in schedules II, III, IV and V that are reported by more than 5,000 separate dispensing pharmacies and practitioners registered with New York State. The data must be submitted to the Bureau of Narcotic Enforcement (BNE) within 24 hours after the prescription is dispensed. BNE closely monitors all submitted prescriptions and their associated information. The integrity of the data is achieved through a variety of system edits, and it is the responsibility of the pharmacies to provide timely and accurate data. The BNE conducts an annual update of the National Drug Code (NDC) file used to identify select opioids, benzodiazepines, and stimulants in the PMP data. The historic prescription data is updated using the most recent NDC file each year. The application of the updated NDC file to the historic data may result in modifications to previous years data.

f The Behavioral Risk Factor Surveillance System (BRFSS):
The Behavioral Risk Factor Surveillance System (BRFSS) is an annual statewide random telephone and cellular surveillance survey designed by the Centers of Disease Control and Prevention (CDC). The survey is conducted in all 50 states and US territories. BRFSS monitors modifiable risk behaviors and other factors contributing to the leading causes of morbidity and mortality in the population. Data from the BRFSS are useful for planning, initiating, and supporting health promotion and disease prevention programs at the state and federal level, and monitoring progress toward achieving health objectives for the state and nation. New York State's BRFSS sample is representative of the non-institutionalized civilian adult population, aged 18 years and older. Some years of data also allow for county-level estimates; see Expanded Behavioral Risk Factor Surveillance System (Expanded BRFSS) for more information.

g The Youth Risk Behavior Surveillance System (YRBSS):
The Youth Risk Behavior Surveillance System (YRBSS) is a national survey of youth and young adults in the U.S. It was developed to monitor priority health risk behaviors that are often established in childhood and adolescence. The YRBSS had been conducted every two years since 1991 and surveys high school students on substance use, physical activity, dietary behaviors, sexual behaviors, and behaviors related to injuries and violence. The national survey is conducted by CDC and the state, territorial, tribal government, and local surveys are administered by departments of health and education.

h The National Survey on Drug Use and Health (NSDUH):
The National Survey on Drug Use and Health (NSDUH) is sponsored by the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA is a division within the U.S. Department of Health and Human Services (HHS). It is an on-going data collection plan designed to provide national and state-level statistical information on the use of alcohol, tobacco, and illicit drugs, including the non-medical use of prescription drugs, in the U.S. The survey tracks trends in substance use and identifies at-risk groups. It also collects data on mental health, co-occurring substance use and mental disorders, and treatment.
 Methodology and Limitations

Index

Return to top of page

Types of Estimates

  1. Weighted percentage/age-adjusted weighted percentage:  Weighted percentages were generated for survey data (e.g., Youth Risk Behavior Surveillance System, National Survey on Drug Use and Health) which ensures that the data are as representative of New York's population as possible. Weighted estimates are shown as a percentage (%) and corresponding 95% confidence intervals (CI) are presented when available.
    The weighted percentages were age-adjusted to the U.S. 2000 standard population using appropriate age distributions. 1 Age-adjustment is a process that is performed to allow communities with different age structures to be compared.2
  2. Rate/age-adjusted rate:  A rate is a measure of the frequency with which an event occurs in a defined population over a specified period of time. Rates used for the Opioid Data Dashboard tracking indicators are per 1,000, 10,000 or 100,000 population.
    The rates were age-adjusted to the U.S. 2000 standard population using appropriate age distributions. 1 Age-adjustment is a process that is performed to allow communities with different age structures to be compared.2

Return to top of page

Population Estimates

Population estimates are developed by the US Census Bureau.

Estimates for 2020 and earlier are from Bridged Race Categories files, developed by the Census Bureau for the National Center for Health Statistics. The 2018 population estimates are used to calculate rates for 2019 and 2020.

Estimates for 2021 and later are from Special Tabulations from the US Census Population and Housing Unit Estimates Program.

See this document for information about why different estimates were used, the differences in these estimates, and why 2018 estimates were used to calculate rates for 2019 and 2020.

Return to top of page

Unstable Estimates

An asterisk (*) is used to indicate that a rate is unreliable/unstable. For most indicators, this usually occurs when there are fewer than 10 events in the numerator. For BRFSS indicators, this occurs when the relative standard error (RSE) is greater than 0.3 or when one-half the confidence interval (CI) is greater than 10 (for asymmetrical confidence intervals, both the lower and upper intervals greater than 10).

Return to top of page

Direction of Indicator Estimates

Opioid Data Dashboard tracking indicators fall into two categories with regard to the desirable direction of their estimates. Sometimes lower estimates are better (e.g., the rate of overdose deaths involving any opioid, or the age-adjusted rate of opioid analgesics prescription) and in other cases higher estimates are better (e.g., the rate of patients who received at least one buprenorphine prescription for opioid use disorder (OUD)).

The direction of a given Opioid Data Dashboard tracking indicator is important to note because the county bar chart, map, and dial use color categories that are based on the direction of the Opioid Data Dashboard tracking indicator. The indicator performance is also based on the direction of the Opioid Data Dashboard tracking indicator. For details on how to tell the direction of a given indicator, please see the “Color Switch in County Dial Based on Direction of Indicator Estimates” subsection, below.

Return to top of page

Grouping County Estimates into Three Categories for the County Dial, County Maps, and County Bar Charts

Color Categories Defined

For each Opioid Data Dashboard tracking indicator, dials, maps and bar charts are generated when there are enough counties with data different from each other so that dials, maps and charts can show meaningful differences among the counties. In particular, dials, maps and charts are not generated if 46 or more counties have rates that are equal to 0 or are missing, or if more than half the counties have the same rate. Dials, maps and charts are generated all other times. Tables are generated for all indicators in all counties, regardless of rate values.

When dials, maps and charts are generated, county estimates are grouped into three categories: yellow, green, and blue. These categories are displayed consistently in the county dial, the bar chart, and the New York State map for each tracking indicator.

The three colors represent the quartile distribution of estimates for the counties ordered from those doing the best to those doing the worst.

For Opioid Data Dashboard tracking indicators where lower estimates are better (e.g., the rate of overdose deaths involving any opioid, or the age-adjusted rate of opioid analgesics prescription):

  • The YELLOW category includes counties who are performing the best (i.e., 50% of counties with the lowest estimates; those in quartile 1 and quartile 2) and is the most favorable category for a county's estimate to be in.
  • The BLUE category includes counties who are performing the worst (i.e., 25% of counties with the highest estimates; those in quartile 4) and is the least favorable category for a county's estimate to be in.
  • The GREEN category includes counties who are performing in the middle (i.e., 25% of counties or those in quartile 3).

For Opioid Data Dashboard tracking indicators where higher estimates are better (e.g., the rate of patients who received at least one buprenorphine prescription for opioid use disorder (OUD)):

  • The YELLOW category includes counties who are performing the best (i.e., 50% of counties with the highest estimates; those in quartile 3 and quartile 4) and is the most favorable category for a county's estimate to be in.
  • The BLUE category includes counties who are performing the worst (i.e., 25% of counties with the lowest estimates; those in quartile 1) and is the least favorable category for a county's estimate to be in.
  • The GREEN category includes counties who are performing in the middle (i.e., 25% of counties or those with estimates in quartile 2).

Length of Color Categories in the County Dial

The length of each color in the county dial represents the minimum and maximum values or cut-off points for the three categories. If the blue area is big, then the range of county estimates in the highest quartile is large; if the blue area is small, then the range of county estimates in the highest quartile is small.

For example, a county dial for one indicator / county shows a very large dark blue area which ranges from 139.2 to 304.3; while the blue-green area ranges from 98.6-<139.2 and has a much narrower width; similarly, the light green area has a narrow range of estimates from 20.4-<98.6.

ED visits (outpatients) and hospital discharges involving opioid abuse, dependence and unspecified use, crude rate per 100,000 population in                             
  Albany County shows a very wide blue category

Color Switch in County Dial Based on Direction of Indicator Estimates

For Opioid Data Dashboard tracking indicators where lower estimates are better (e.g., Overdose deaths involving any opioid, crude rate per 100,000 population in Albany county), the blue category is displayed on the right side of the dial.
Overdose deaths involving any opioid, crude rate per 100,000 population in                            
  Albany County shows a very wide yellow category

For Opioid Data Dashboard tracking indicators where higher estimates are better (e.g., Patients who received at least one buprenorphine prescription for opioid use disorder, crude rate per 100,000 population in Albany county), the blue category is displayed on the left side of the dial.
Patients who received at least one buprenorphine prescription for opioid use disorder,                          
  crude rate per 100,000 population

Return to top of page

Assessing the Indicator Performance

Three different methods were used to assess indicator performance.

  1. Conduct one-sided z-test to assess the change (increase/decrease or improve/worsen) in estimates between the two most recent time periods.4 The p-value for rejecting the null hypothesis is less than or equal to 0.05 and the critical value for the one-sided test (p-value at 0.05) is 1.645.
  2. Compare confidence intervals of estimates for the two most recent time periods. A confidence interval is a range around a measurement that conveys how precise the measurement is. Differences between estimates are considered “statistically significant” when the estimates do not have overlapping confidence intervals. If the confidence intervals overlap, the difference is not statistically significant at the 95% confidence level. For survey related indicators, estimates and the two-sided 95% confidence intervals were obtained and used. In some instances for count data (e.g., births, deaths, hospitalizations, and emergency department visits), we calculated the one-sided 95% confidence intervals for the estimates and used them for comparison to evaluate the indicator performance.5
    Note: This method is an approximation of a statistical test and may result in a more conservative finding. In some cases, an appropriate statistical test would indicate a statistically significant difference even though the confidence intervals overlap, falsely implying no significant difference. However, if two confidence intervals do not overlap, a comparable statistical test would always indicate a statistically significant difference
  3. Simple comparison was conducted where the two estimates were directly compared to each other based on their magnitude. This was performed when there was not a sufficient amount of data to conduct significance testing; or if confidence intervals could not be calculated; or if there is some overlap of the two time intervals being compared (e.g., 2015 and 2016 overdose deaths involving methadone in Albany County).


  4. The categories for the Indicator Performance are as follows:
    • Significantly improved
    • Significantly worsened
    • No significant change
    • Improved#
    • Worsened#
    • No change#
    • Significantly increased
    • Significantly decreased

The "#" sign indicates that the performance was determined using simple comparison and not statistical tests.

See Table 1 below for statistical significance techniques used for each type of data source to assess the indicator performance.

Use caution when interpreting significance. For more common conditions (i.e., high incidence rates), there is a higher likelihood that a relatively small change could be detected as statistically significant. Conversely, for rare conditions, the likelihood of detecting a statistically significant change is low even for reasonable changes.

Return to top of page

Data Filters

Several data filters are available at state and county levels to quickly select indicators based on commonly desired criteria such as indicator data status as being compared to the Opioid Data Dashboard 2018 targets or indicator performance over time. Multiple filters can be selected simultaneously.

  1. State data filters: one data filter is available for state level indicators
    • Filter on indicator performance over time: The performance status for each indicator is generated by comparing state level data for the two most recent time periods. This filter displays indicators based on indicator performance categories selected.
  2. County data filters: two data filters are available for county level indicators
    • Filter on indicator performance over time: The performance status for each indicator is generated by comparing estimates for the two most recent time periods for a specific county. This filter displays indicators based on indicator performance categories selected.
    • Filter on county’s position of risk: This filter displays indicators based on the relative position represented by the pointer on the County Dial for risk categories selected.

Return to top of page

ZIP Code Level Data

To better serve the needs for more local level data, we have assessed the availability of sub-county level data for the existing county level indicators. Depending on the availability of the information from the data sources, ZIP Code level data are presented.

  • ZIP Code:  ZIP Code refers to resident address ZIP Code. If a ZIP Code crosses county borders, the ZIP Code is assigned to the county that has the largest proportion of the population of that ZIP Code. ZIP Code level population estimates used for calculating rates were obtained by the New York State Department of Health (NYSDOH) from the Claritas Corporation.

Based on further assessment of the stability of the estimates and the impact of data suppression, the following four indicators were selected to be incorporated into the current Opioid Data Dashboard.

  • ZIP Code level:
    • Overdose deaths involving opioids and nonfatal opioid related hospital events
    • Unique naloxone administrations by EMS agencies
    • Suspected opioid overdoses by EMS agencies
    • Admissions to OASAS-certified substance use disorder treatment programs for heroin
    • Admissions to OASAS-certified substance use disorder treatment programs for any opioid (incl. heroin)

County maps display ZIP Code level data geographically by quartile. Regional quartiles were calculated separately for the five boroughs (counties) of New York City and the remaining counties of the state. Suppressed rates are included in the quantiles' calculation. A ZIP Code's color indicates the regional quartile it belongs to. Each map also contains the rate for the county, New York State, and its region.

Return to top of page

Data Suppression for Confidentiality

Results are not shown (i.e., suppressed) when issues of confidentiality exist. Suppression rules vary depending on the data source and the indicator.

Table 1. Summary of data suppression and statistical evaluation significance for the Opioid Data Dashboard Indicators by data source

Data Sources Suppression Criteria Statistical Significance Techniques
Sample Surveys
BRFSS Unweighted denominator <50 or Unweighted numerator between 1 - 5 cases Rate: one sided chi-square test with p-value <0.05
YRBSS Unweighted denominator <100 95% CI comparison
NSDUH   95% CI comparison
Population Count Data
Death Denominator population <50 Rate: one sided chi-square test with p-value <0.05
SPARCS Numerator between 1 - 5 cases Rate: one sided chi-square test with p-value <0.05
OASAS Numerator between 1 - 10 cases Rate: one sided chi-square test with p-value <0.05
PMP Numerator between 1 - 5 cases Rate: one sided chi-square test with p-value <0.05
EMS Numerator between 1 - 10 cases Rate: one sided chi-square test with p-value <0.05

CI:  Confidence Interval
BRFSS:  Behavioral Risk Factor Surveillance System
YRBSS:  The Youth Risk Behavior Surveillance System
NSDUH:  National Survey on Drug Use and Health
SPARCS:  Statewide Planning and Research Cooperative System
OASAS:  Office of Addiction Services and Supports
PMP:  Prescription Monitoring Program
EMS:  Emergency Medical Services

Return to top of page

Data Limitations

Table 2. Summary of Limitations for Data Presented on the Opioid Data Dashboard

Data Source Limitations
Vital Records The accuracy of indicators based on codes found in Vital Statistics data is limited by the completeness and quality of reporting and coding. Death investigations may require weeks or months to complete; while investigations are being conducted, deaths may be assigned a pending status on the death certificate (ICD-10-CM underlying cause code of R99, “other ill-defined and unspecified causes of mortality”). Analysis of the percentage of death certificates with an underlying cause of death of R99 by age, over time, and by jurisdiction should be conducted to determine potential impact of incomplete underlying causes of death on drug overdose death indicators. The percentage of death certificates with information on the specific drug(s) involved in drug overdose deaths varies substantially by state and local jurisdiction and may vary over time. The substances tested for, the circumstances under which the tests are performed, and how information is reported on death certificates may also vary. Drug overdose deaths that lack information about the specific drugs may have involved opioids. Even after a death is ruled as caused by a drug overdose, information on the specific drug might not be subsequently added to the certificate. Therefore, estimates of fatal drug overdoses involving opioids may be underestimated from lack of drug specificity. Additionally, deaths involving heroin might be misclassified as involving morphine (a natural opioid), because morphine is a metabolite of heroin. The indicator “Overdose deaths involving opioid pain relievers” includes overdose deaths due to pharmaceutically and illicitly produced opioids, such as fentanyl.
EMS Documentation data entry errors can occur and may result in ‘naloxone administered’ being recorded when a different medication had actually been administered. Patients who present as unresponsive or with an altered mental status with unknown etiology may be administered naloxone, as part of the treatment protocol, while attempts are being made to determine the cause of the patient’s current unresponsive state or altered mental status. Not all cases are confirmed opioid overdose incidents. Electronic PCR data currently capture approximately 99% of all EMS data statewide, from 60%-65% of all certified EMS agencies. The remaining data are reported via paper PCR, from which extracting data related to naloxone administrations or opioid/heroin overdoses is impractical. The Suffolk County Medical Control data do not include patients recorded as ‘unresponsive/unknown’ who received a treatment protocol that includes naloxone. The National Emergency Medical Services Information System (NEMSIS) is a universal standard for how EMS patient care data are collected. Prior to 2019, most EMS agencies in New York State adhered to the NEMSIS version 2.2.1 standard that was released in 2005. As of January 1, 2020, most have transitioned to the updated NEMSIS version 3.4.0 standard. Now that NEMSIS version 3 data are being captured by New York State, the receipt of historical data has increased the number of naloxone administration reports counted for several counties. Additional increases may occur as more EMS agencies begin to submit NEMSIS version 3 data, which will be reflected in future as the data become available.
SPARCS The recent data may be incomplete and should be interpreted with caution. Health Care Facilities licensed in New York State, under Article 28 of the Public Health Law, are required to submit their inpatient and/or outpatient data to SPARCS. SPARCS is a comprehensive all-payer data reporting system established in 1979 as a result of cooperation between the healthcare industry and government. Created to collect information on discharges from hospitals, SPARCS now collects patient level detail on patient characteristics, diagnoses and treatments, services, and charges for hospitals, ambulatory surgical centers, and clinics, both hospital extension and diagnosis and treatment centers. Per NYS Rules and Regulations, Section 400.18 of Title 10, data are required to be submitted: (1) monthly, (2) 95% within 60 days following the end of the month of patient’s discharge/visit, and (3) 100% are due 180 days following the end of the month of the patient discharge/visit. Failure to comply may result in the issuance of Statement of Deficiencies (SODs) and facilities may be subject to a reimbursement rate penalty. The accuracy of indicators, which are based on diagnosis codes (ICD-10- CM on or after Oct. 1, 2015) reported by the facilities, is limited by the completeness and quality of reporting and coding by the facilities. The indicators are defined based on the principal diagnosis code or first-listed valid external cause code only. The sensitivity and specificity of these indicators may vary by year, hospital location, and drug type. Changes should be interpreted with caution due to the change in codes used for the definition. The SPARCS data do not include discharges by people who sought care from hospitals outside of New York State, which may lower numbers and rates for some counties, especially those which border other states.
OASAS Client Data System (CDS) Upon review, 2018 data was determined to be the most complete data year available. The CDS includes data for individuals served in the OASAS-certified treatment system. It does not have data for individuals who do not enter treatment, get treated by the U.S. Department of Veterans Affairs, go outside New York State for treatment, are admitted to hospitals but not to substance use disorder (SUD) treatment, get diverted to other systems, or receive an addictions medication from a physician outside the OASAS system of care. OASAS-certified substance use disorder treatment programs are required to submit their admissions data to the CDS not later than the fifth of the month following the clinical admission transaction. Data are considered to be substantially complete five months after the due date, but are able to be updated indefinitely. The accuracy of measures, which are based on data reported by the programs, is limited by the completeness, consistency and quality of reporting and coding by the programs. The sensitivity and specificity of these indicators may vary by provider, program, and possible substances reported. Opioid admissions data are not direct measures of the prevalence of opioid use. The availability of substance use disorder treatment services within a county may affect the number of admissions of county residents to programs offering those services.
PMP For all PMP indicators, several exclusions were applied. Prescriptions for out-of-state patients or without a valid patient’s NY ZIP Code were removed from the analysis. Data from veterinarians and prescription drugs administered to animals were not included in the analysis of PMP data. Prescriptions filled for opioids that have supply days greater than 90 were eliminated from the analysis. Also, opioids not typically used in outpatient settings and cold formulations including elixirs, antitussives, decongestants, antihistamines and expectorants were not included in the analyses. The Bureau of Narcotic Enforcement conducts an annual update of the National Drug Code (NDC) file used to identify select opioids, benzodiazepines, and stimulants in the PMP data. The historic prescription data is updated using the most recent NDC file each year. The application of the updated NDC file to the historic data may result in modifications to previous years data.
BRFSS https://www.cdc.gov/brfss/about/brfss_faq.htm

https://www.cdc.gov/brfss/publications/data_qvr.htm
YBRSS https://www.cdc.gov/healthyyouth/data/yrbs/index.htm
NSDUH NSDUH estimates of substance use among adolescents have generally been lower than corresponding estimates from two school-based surveys: Monitoring the Future (MTF) and the Youth Risk Behavior Surveillance System (YRBSS) In December 2012, SAMHSA released a report, "Comparing and Evaluating Youth Substance Use Estimates from the National Survey on Drug Use and Health and Other Surveys," which explored some of the reasons for this. It is important to note that, although NSDUH has consistently shown lower prevalence rates than MTF and YRBSS, the trends have usually been parallel. Unlike, MTF and YRBSS, NSDUH conducts interviews in the adolescent's home. The SAMHSA report stated, "It is possible that conducting an interview in an adolescent's home environment has an inhibitory effect on adolescent substance users' willingness to report use, even if parents or other household members are not in the same room as the adolescent and are not able to see how adolescents are answering the substance use questions."

The SAMHSA report noted that factors besides interview privacy also could contribute to lower estimates of adolescent substance use in NSDUH than in MTF or YRBSS. These other factors include the focus of the survey (e.g., primary focus on substance use or on broader health topics), how prominently substance use is mentioned when a survey is presented to parents and adolescents, procedures for obtaining parental permission for their children to be interviewed, assurances of anonymity or confidentiality, the placement and context of substance use questions in the interview, the survey mode (e.g., computer-assisted interviewing with skip patterns or paper-and-pencil questionnaires), and the question structure and wording.

For example, NSDUH asks filter questions about lifetime use before asking about the most recent use of a substance or the frequency of use. Research has shown that filter questions can depress the reporting of certain behaviors. Some NSDUH respondents also may realize early during their interview that if they answer "no" to the initial filter questions about lifetime substance use, they can avoid having to answer subsequent questions and therefore will finish the interview in less time. The YRBSS questionnaire does not have these kinds of skip patterns, and the MTF questionnaire uses skip patterns minimally. In addition, students taking a survey in a classroom administration setting may not be motivated to finish sooner if they otherwise have to stay until the end of the class period.
Population The 2018 population estimates are also used to calculate rates for 2019 and 2020.

Return to top of page

References

  1. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy People Statistical Notes, no. 20. Hyattsville, Maryland: National Center for Health Statistics. January 2001. (see: www.cdc.gov/nchs/data/statnt/statnt20.pdf)
  2. About Age Adjusted Rates, 95% Confidence Intervals and Unstable Rates (see: www.health.ny.gov/statistics/cancer/registry/age.htm)
  3. Klein RJ, Proctor SE, Boudreault MA, Turczyn KM. Healthy People 2010 criteria for data suppression. Statistical Notes, no 24. Hyattsville, Maryland: National Center for Health Statistics. June 2002. (see: www.cdc.gov/nchs/data/statnt/statnt24.pdf)
  4. Statistical Significance (see: www.health.ny.gov/statistics/chac/chai/docs/statistical_significance.pdf)
  5. One-sided 95% confidence interval (see: http://www.graphpad.com/guides/prism/6/statistics/index.htm?one_sided_confidence_intervals.htm)
  6. Guidelines for using confidence intervals for public health assessment, Washington State Department of Health (see: www.doh.wa.gov/Portals/1/Documents/1500/ConfIntGuide.pdf)

User's Guide

Contact Us

If you have questions about the reports, please contact:

Public Health Information Group at: opioidprevention@health.ny.gov