The CSTE Overdose Subcommittee was formed to raise the visibility of drug overdose deaths among applied epidemiologists and public health partners and to improve surveillance for overdoses at the state and local levels.

In 2009, national vital statistics data showed that drug overdose deaths exceeded motor vehicle deaths for the first time. 2023 marked the first annual decline in overdose deaths since 2018 in the United States. The decades-long overdose epidemic is characterized by three distinct waves: first prescription opioids, then heroin, then fentanyl and its analogs. Increasingly, a fourth wave of stimulant-related overdoses, including methamphetamine, other amphetamines, and cocaine, has begun to emerge. Improving epidemiologic data and public health prevention strategies for overdose remain high priorities. Death certificate-based vital statistics data are increasingly being supplemented with hospital administrative discharge, emergency medical services, and syndromic surveillance data. The use of new and timelier data sources has allowed the CSTE Overdose Subcommittee to build on methodological work to improve specific overdose reporting on death certificates.

Currently, the CSTE Overdose Subcommittee focuses on developing best practices for overdose surveillance, timely data sharing of morbidity and mortality data, and conducting multi-state studies to identify populations most impacted by overdose.

The subcommittee meets every other month (odd months) via Zoom call. For more information about the Overdose Subcommittee and its activities, please contact Rachel Jantz. Click here to explore other Injury, Substance Use & Mental Health Steering Committee activities. Additional CSTE Overdose work can be found via the Injury Surveillance Subcommittee page.

Additional CSTE Overdose Surveillance Resources and Tools

In related efforts, CSTE members and partners have developed overdose applied epidemiology support and technical assistance through initiatives such as capacity assessments, interactive learning series, webinars, and the creation of online courses. Recent tools and resources can be accessed at the Overdose Surveillance Capacity Building page.

Resources:

• 2019 CSTE Position Statement 19-CC-01 Nonfatal Opioid Overdose Standardized Surveillance Case Definition
  This case definition was designed to inform public health surveillance practice of case identification, follow-up investigation when possible, and the identification and combining of case data across data sources including reporting from healthcare providers, hospitals, emergency medical services, poison control centers, laboratories, syringe service programs, harm reduction programs, and law enforcement.

• 2016 Recommendations Document
  This document provides guidance and lessons learned by epidemiologists and public health professionals conducting fatal overdose surveillance.

• 2015 Death Certificate Analysis Tool
  
  This tool analyzes the text on death certificates and identifies specific drugs mentioned. This tool consists of a SAS program designed to review the text data on the death certificate, an excel spreadsheet with common search terms found on the death certificates, and a text document explaining the tool. These tools can help state analysts improve drug overdose surveillance activities. Click here to access a blog post about the tool ; or click here to download the tool (the downloadable zip file includes an Excel document, a SAS document, and a PDF document).