Evidence map›Paper›PMID 41037998›Full record

ArticleDrug and alcohol dependence2025

Trends of all opioid-, heroin-, and fentanyl-involved nonfatal overdoses in the United States, October 2020 - April 2025.

Stephen Liu, Shannon Casillas, Emily Ussery, Michael Sheppard, Alana Vivolo-Kantor

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Fentanyl Purity and Overdose Decline: A Reexamination of Geographic Trends.medRxiv : the preprint server for health sciences · 2026
    Article
  3. Article
  4. Leucine Aminopeptidase fromBiomolecules · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Stephen LiuCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, Epidemiology and Surveillance Branch, 4770 Buford Hwy NE, Atlanta, GA 30341, United States. Electronic address: SLiu@cdc.gov.
Shannon CasillasCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, Epidemiology and Surveillance Branch, 4770 Buford Hwy NE, Atlanta, GA 30341, United States.
Emily UsseryCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, Epidemiology and Surveillance Branch, 4770 Buford Hwy NE, Atlanta, GA 30341, United States.
Michael SheppardCenters for Disease Control and Prevention, Office of Public Health Data, Surveillance, and Technology, 1600 Clifton Rd NE, Atlanta, GA 30329, United States.
Alana Vivolo-KantorCenters for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, Epidemiology and Surveillance Branch, 4770 Buford Hwy NE, Atlanta, GA 30341, United States.

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

backgroundThis study examined monthly trends of suspected, nonfatal opioid-involved overdoses from October 2020-April 2025 and assessed whether demographics and geographic region vary between opioid type, including heroin and fentanyl.

methodsCDC's National Syndromic Surveillance Program data using the Drug Overdose Surveillance and Epidemiology definitions for all opioid-, heroin-, and fentanyl-involved overdoses in EDs were used. The average monthly percentage change (AMPC) was estimated using Joinpoint regression for counts of all opioid, heroin, and fentanyl-involved overdoses. Demographic characteristics between heroin- vs. fentanyl-involved overdoses and regional differences by region were compared between all opioid-, heroin-, and fentanyl-involved overdose ED rates.

resultsFrom October 2020 to April 2025, nonfatal opioid-involved overdoses declined (AMPC=-0.5 %) and showed more counts in summer months. Heroin-involved overdoses decreased (AMPC=-3.1 %); conversely, fentanyl-involved overdoses increased (AMPC=2.0 %). Counts of heroin (n = 5571) were higher than fentanyl (n = 913) in October 2020; however, in February 2023, fentanyl (n = 2464) surpassed heroin (n = 2341) and remained higher through April 2025. Demographic characteristics were similar among persons with fentanyl-involved overdose compared with heroin except a higher proportion of fentanyl occurred among individuals aged 15-24 years (12.8 % vs. 5.7 %) compared to heroin. Heroin- and fentanyl-involved overdose rates were highest in Region 5-Chicago and Region 10-Seattle, respectively.

conclusionsA better understanding of trends, demographics, and geography in nonfatal opioid-involved overdoses by drug type has implications for tailored prevention messages, but regardless of opioid type, results suggest the continued opioid overdose reversal medication distribution and linkage to evidence-based treatment for opioid use disorder in EDs.

Indexed as

Emergency DepartmentFentanylHeroinOverdoseSurveillanceTrends

Identifiers

PMID41037998
PMCPMC13454966

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.