Overdose Data FAQ

EMS, Trauma System, & Injury Prevention Section (EMSTSIP)

Author

Sandra Biller

Published

July 30, 2026

Purpose

This page is intended to serve as a general resource and answer common questions about Montana overdose data. Information is included on each data source, what overdose-related information it contains, and strengths and limitations of the data source.

Overdose data sources

Summary

What overdose data source to use depends on how you plan to use the data and how recent the data needs to be.

  • If you need to ensure your counts are verified overdoses, we suggest using hospital discharge data (MHDDS) for nonfatal data and death certificate or SUDORS for fatal data.

    • If your work is focused on unintentional overdoses, we recommend using MHDDS DOSE indicators for nonfatal data and SUDORS for fatal data, as these counts are limited to cases of unintentional or undetermined intent.

  • If you need the most current data, we suggest using EMS, syndromic surveillance, provisional SUDORS data, and ODMAP. These records are incomplete or unverified, so they may have missing data or include some false positives.

  • If you need to know about a specific drug (carfentanil, kratom, xylazine, etc.), we suggest using SUDORS. Poison Control data and Crime Lab seized drug testing may also provide helpful information, depending on the drug of interest.

Data Source Unit of measurement Confirmed or suspected Fatal overdoses Nonfatal overdoses Includes all intents Able to identify specific drugs Real-time or provisional data available
EMS EMS activation Suspected Yes Yes Yes No Yes
Hospital Discharge (MHDDS) Hospital or emergency department visit Confirmed Yes Yes Yes ICD-10 only No
Syndromic Surveillance (ESSENCE) Emergency department visit Suspected Yes Yes Yes Developed syndromes only Yes
ODMAP Suspected overdose Suspected Yes Yes No Unavailable for most records Yes
Death Certificates Death Confirmed Yes No Yes ICD-10 only Yes
SUDORS Death Confirmed Yes No No Yes Yes
Poison Control Call to Poison Control Confirmed Yes Yes Yes Yes Yes
Crime Lab – Seized Drugs Seized drug sample n/a No No No Yes Yes
Clinical drug testing Urine sample n/a No No No Yes Yes

Note: A response of “yes” does not necessarily mean that the data source captures every overdose that occurs – for example, EMS data only captures suspected opioid overdoses that receive an EMS response.

Where to find overdose data

Please refer to the dashboards and data products below to find overdose data. If you don’t find the data you’re looking for, fill out a data request form.

EMS

Hospital Discharge (MHDDS)

Syndromic Surveillance (ESSENCE)

  • MTODD

  • Any tribal, local, or state public health practitioner and select hospital employees in Montana may request access to the data using the appropriate access request form. Contact syndromic@mt.gov for more information

ODMAP

  • Not publicly available – fill out an interest form to inquire about access

Death Certificates

SUDORS

Poison Control

Crime Lab – Seized Drugs

Other Reports

EMS data

General

What is Emergency Medical Services (EMS) data?

Emergency medical services (EMS) data consists of patient care documentation collected by emergency care providers. Montana statute requires all ground transporting agencies (GTAs) and air medical agencies (AMAs) licensed in the state to submit a patient care report (PCR) for each patient encountered during an EMS activation. Non-transporting agencies (NTAs) are not required to report data, however, some NTAs voluntarily report. EMS data captures agency information, patient demographics, response times, incident location, prehospital interventions, and treatments provided to the patient. In general, EMS data is uploaded to the state data repository within 24 hours of the patient encounter.

What is NEMSIS?

NEMSIS stands for National EMS Information System. NEMSIS is the official EMS data collection standard for all EMS agencies in the country. It is an information systems compliance architecture which allows for standardization of data across different data systems, EMS agencies, and states. NEMSIS provides consistent definitions for data elements used in EMS and pre-hospital care settings. Montana has collected NEMSIS 3.4 data since January 2017, and transitioned to NEMSIS v3.5 starting in September 2023.

What is an EMS activation?

An EMS activation refers to a single record in the EMS dataset, which represents one EMS agency’s encounter with one patient during their response to an incident. The EMS dataset is a registry of EMS activations - it is not a “patient-based” dataset. Because multiple EMS agencies can respond to the same incident and care for the same patient, or there could be multiple patients involved in the same incident, there can be more than one EMS activation (record) per patient or incident. One EMS record is not the same as one person or incident.

EMS activations can be grouped by response type (911/scene response, interfacility or medical transport, other) and patient disposition (transported, transferred care, patient refusal, canceled).

Can there be more than one EMS record for the same patient?

Yes. Because multiple EMS agencies can respond to the same incident and care for the same patient, there can be more than one EMS activation (record) per patient/incident. One EMS record is not the same as one person.

Example: A non-transporting unit responds first to a 911 call, then a ground ambulance shows up to transport the patient. Due to the severity of the injury, air transport is requested and the ground ambulance transfers the patient to a helicopter to complete the transport. There would be three records (EMS activations) representing this patient:

  • One record for the non-transporting unit

  • One record for the ground ambulance

  • One record for the air transport (helicopter)

Overdose-specific

How are suspected opioid overdoses identified using EMS data?

Epidemiologists analyze EMS data and identify records that meet Montana’s EMS suspected opioid overdose syndrome definition. The syndrome searches for specific codes in structured variable fields (i.e. provider impression) as well as keywords within the EMS narrative. Examples of what would qualify as a suspected opioid overdose include:

  • Emergency care providers document a provider impression of opioid overdose

  • Emergency care providers document that the patient was given naloxone (an opioid overdose reversal drug) and the patient’s condition improved in response to it.

  • Emergency care providers write in the narrative that they responded to a suspected overdose and the narrative provides details such as the patient having pinpoint pupils and reporting they smoked fentanyl.

Syndromes are designed for quick identification of cases in the absence of a formal diagnosis – as such, they may count some non-overdoses (false positives) or miss some true opioid overdoses (false negatives). It’s also important to remember that not all suspected opioid overdoses will be relevant for all prevention activities, such as overdose spike response. For example, cases can include overdoses occurring as a result of illicit substance use, medication mis-dosing, and intentional overdose.

Can we use EMS data to track overdoses for any specific drugs?

No. If a specific drug is mentioned in EMS documentation, this information is based on observation, patient self-report, or information from bystanders – rather than a definitive lab test, which are not performed in the pre-hospital setting. Because the presence of specific drugs can only be confirmed with laboratory testing, EMS data cannot be used to pinpoint use of specific drugs.

Can we use EMS data to track non-opioid overdoses?

Not currently. Efforts are underway to develop a suspected stimulant overdose syndrome, which once implemented, will allow us to identify suspected overdoses due to drugs such as methamphetamine or cocaine. Additional syndromes for other drugs may become available in the future.

Can we track opioid overdose reversals using EMS data?

Partially. If naloxone (often referred to by the brand name Narcan) is administered and the patient improved, AND this is documented in the medications fields of the EMS report, we can track these as  probable opioid overdose reversals. Because Montana’s EMS dataset is not linked to hospital outcome information, we cannot say for sure whether an opioid overdose was reversed successfully.

Naloxone administration is often underreported in the medications fields, particularly if naloxone is administered prior to EMS arrival. Due to this underreporting, counts of probable opioid overdose reversals are likely an underestimate.

Why do EMS statistics about suspected opioid overdoses change from time to time?

EMS numbers and statistics can change for a few reasons:

While exact numbers may vary slightly, EMS data is an important tool for detecting trends or anomalies across the state in near real-time.

What are the benefits of using EMS data to track overdoses?

In general, EMS records are uploaded and made available in the reporting dataset within 24 hours of the event. This near real-time data allows analysts to detect any trends or anomalies happening quickly across the state. In contrast, other data sources such as mortality (death) data or hospital discharge data can have a delay of 6 to 18 months after the event has occurred due to data verification and cleaning processes.

What are the limitations of using EMS data to track overdoses?

  • The EMS overdose syndrome is specific to opioids and does not include non-opioid overdoses.

  • Syndromes are designed for quick identification of cases in the absence of a formal diagnosis – as such, they may count some non-overdoses (false positives) or miss some true opioid overdoses (false negatives).

  • Cases are suspected opioid overdoses, not confirmed. Even when EMS providers assign an “impression” of opioid overdose, this is not the same as a “diagnosis” which is given in the hospital.

  • EMS data is subject to data quality issues which can affect our ability to accurately capture opioid overdoses.

  • EMS data does not capture overdoses where EMS did not make patient contact.

  • EMS data does not capture naloxone administrations by law enforcement or the public unless they are documented as part of the EMS incident.

ED Visit and Hospitalization Discharge Data

General

What is the difference between ED visit and hospitalization data?

Hospitalizations refer to patients who are admitted for inpatient care – which usually occurs for more serious cases. The exception being if the patient dies in the ED before inpatient admission could occur. ED visits that result in admission to the hospital are NOT included in the ED visit dataset – only in the hospitalization dataset.

Can there be more than one record for the same patient?

Yes. Each record in the ED and hospitalization datasets refers to a single visit rather than a single patient. If a patient returns to the hospital due to a second overdose or other health condition, they will appear in the dataset twice. There are no identifiers in the data to allow for de-duplication of records.

Overdose-specific

How are overdoses identified in emergency department (ED) or hospital discharge data?

If there is any mention of an overdose ICD-10-CM code in the ED visit record, it is classified as an overdose-related ED visit. Visits can be further classified by type of drug using ICD-10-CM code categories (opioid, stimulant, etc.)

What is DOSE data?

DOSE stands for Drug Overdose Surveillance and Epidemiology and tracks nonfatal overdoses of unintentional or undetermined intent within hospital and emergency department data. On the Injury and Overdose Indicators dashboard there are several DOSE indicators. The difference between these and the other overdose indicators is that DOSE excludes intentional overdoses.

Can we use ED visit and/or hospitalization data to track specific drugs?

Possibly. As long as there is an ICD-10-CM code associated with the drug, and that code has been available during the date range you are interested in, you can use it for tracking. For example, a new ICD-10-CM code specific to fentanyl (T40.41) was introduced in October 2020 which allows us to definitively capture fentanyl involvement, and a code for methamphetamine (T43.65) was introduced in October 2023. However, there may be some underutilization of these codes as they begin to be used.

What are the benefits of using ED and hospital discharge data to track overdoses?

As opposed to EMS data, ED and hospital discharge data include diagnosis codes (ICD codes) that are based on lab results and physician expertise. This provides a definitive answer to drug involvement.

What are the limitations of using ED and hospital discharge data to track overdoses?

  • MHDDS data is provided courtesy of participating Montana Hospital Association (MHA) members and represents approximately 85% of annual hospital discharges in Montana.

  • MHDDS does not include data from nonparticipating hospitals, the U.S. Veterans Administration, Indian Health Service, or Montana State Hospital, and as a result may not be representative of all discharges in the state. County-level analyses should consider the degree of data available.

  • ED and hospital discharge data can take several months to be processed and become available. The lag in data availability can prevent real-time tracking of overdoses.

  • MHDD does not contain patient identifiers and cannot be deduplicated to exclude readmissions and transfers.

  • Naloxone administration is not captured in this dataset.

  • ED and hospital discharge data do not include data from patients that died in the field.

  • ED and hospital discharge data do not capture overdoses that were not seen in a hospital setting.

Syndromic Surveillance Data (ESSENCE)

General

What is syndromic surveillance data (ESSENCE)?

ESSENCE (Electronic Surveillance System for the Early Notification of Community-based Epidemics) is a web-based syndromic surveillance system designed for the early detection of disease outbreaks, suspicious patterns of illness, and public health emergencies. ESSENCE collects, processes, and analyzes information from patient records (such as chief complaints and triage notes from ED visits) to identify anomalous disease activity in a community. These records are uploaded by participating hospitals generally within 24 hours, depending on facility.

ESSENCE utilizes syndromes to identify suspected cases for a variety of conditions, such as flu, measles, or overdose. These syndromes utilize the chief complaint (free-text) and discharge diagnosis (ICD-10-CM codes) fields to identify cases.

What is the difference between ED discharge data and ED syndromic surveillance data (ESSENCE)?

ED discharge data is a final, cleaned, and verified dataset that is made available to epidemiologists in quarterly increments. ED syndromic data is updated in real time but is subject to change as the patient’s file is updated or edited to reflect changes in their care or diagnoses.

The ED discharge dataset is derived from billing data, while the ED syndromic surveillance data capture some narrative and other elements from the electronic health record that would not be available on the billing form – chief complaint, triage notes, initial temperature, initial pulse oximetry percent, height, weight, etc.

ESSENCE is not subject to the same exclusion criteria as ED discharge data (which excludes VA and IHS hospitals).  Any hospital with an emergency and/or urgent care department and the ability to meet the current PHIN HL7 messaging requirements can submit syndromic surveillance data to ESSENCE. Currently, no Montana IHS facilities submit data to ESSENCE.

Can there be more than one record for the same patient?

Yes. Each record in syndromic surveillance refers to a single visit rather than a single patient. If a patient returns to the ED due to a second overdose or other health condition, they will appear in the dataset twice. If a patient is transferred to another facility, they will also appear twice.

Hospitals use unique identifiers called a medical record number (MRN) to identify patients within their facility, and these can be used to identify if multiple records belong to the same patient. However, MRNs do not transfer across facilities, so a patient seen at multiple facilities will have an MRN for each facility.

There can also be duplication of records if a person arrives at an ED and a record is made prior to identifying the patient. Once the patient is linked to their MRN, a second record will be created.

Overdose-specific

How are suspected overdoses identified in ED syndromic surveillance data (ESSENCE)?

Currently, Montana uses pre-existing overdose syndrome definitions:

These definitions can be queried by location and time to create a temporospatial understanding of overdose in Montana.

As with EMS data, syndromes are designed for quick identification of cases in the absence of a formal diagnosis – as such, they may count some non-overdoses (false positives) or miss some true overdoses (false negatives). It’s also important to remember that not all suspected overdoses will be relevant for all prevention activities, such as overdose spike response. For example, cases can include overdoses occurring as a result of illicit substance use, medication mis-dosing, and intentional overdose. In practice, we have found that the All Drug overdose syndrome is particularly prone to false positives and inclusion of irrelevant cases, and we suggest using that syndrome with caution.

What are the benefits of using ED syndromic surveillance (ESSENCE) data to track overdoses?

About 86% of MT hospitals share data with ESSENCE, which captures approximately 96-99% of the ED visits that happen across the state. ESSENCE also has data on Montana residents who are seen in South Dakota EDs. Since these data are updated in real time, it may be used to observe any trends as they are happening across the state.

Syndromic surveillance data includes several free-text fields such as the chief complaint and triage notes. These fields can be particularly helpful for understanding the context around suspected overdoses and confirming whether a case is relevant for overdose monitoring.

What are the limitations of using ED syndromic surveillance data to track overdoses?

  • Not every hospital submits data to the ED syndromic surveillance dataset, which leaves some gaps in surveillance coverage.

  • Hospital connectivity and submission issues can cause artificial fluctuations in the volume of overall and condition-specific ED visits over time.

  • Since 2020, hospital reporting increased from about 65% to about 95%, which may affect some county-level trends.

  • ESSENCE records are subject to change as records are updated, so numbers may fluctuate.

  • There is substantial variability in the completeness and quality of the data by facility.

  • Laboratory results as well as final diagnoses are not always included in this dataset. Approximately 5-10% of ED visits have missing discharge diagnoses.

ODMAP

General

What is ODMAP?

ODMAP stands for the Overdose Detection Mapping Application Program. ODMAP provides maps of geocoded suspected overdose events. Entries are automatically added from:

Law enforcement can manually enter cases when they are not entered by EMS or a coroner. Hospital systems can also manually enter data in ODMAP for cases that may not have interacted with pre-hospital responders (EMS or law enforcement), however this is rarely done at this point.

Maps allow for the addition of multiple layers to provide further context (for example, layers that show reservation boundaries).

The system also allows for spike alerts, with communications sent to specified users if the number of overdoses in a defined geographic region exceeds a specified threshold in a 24 hour period.

Authorized users can request an account through DPHHS using this form.

Overdose-specific

Can we use ODMAP data to track fentanyl overdoses?

No. ODMAP data mainly comes from EMS, coroners, and law enforcement. Because the signs/symptoms of a fentanyl overdose are similar to those of other opioids, it is often not possible for pre-hospital responders to determine the specific type of opioid involved. If a specific opioid is mentioned, this information is based on observation, patient self-report, or information from bystanders – rather than a definitive lab test, which are not performed in the pre-hospital setting. Because the presence of fentanyl requires laboratory testing, ODMAP data cannot be used to identify fentanyl overdoses.

Can we use ODMAP to track overdoses for any specific drugs?

No. Like stated above, if a specific drug is mentioned in EMS documentation, this information is based on observation, patient self-report, or information from bystanders – rather than a definitive lab test, which are not performed in the pre-hospital setting. Because the presence of specific drugs can only be confirmed with laboratory testing, EMS data cannot be used to pinpoint use of specific drugs.

Can we use ODMAP to track non-opioid overdoses?

Partially. ODMAP records based on EMS data are for suspected opioid overdoses only. Records from coroners or law enforcement may include non-opioid overdoses, but we expect this will be an undercount.

What are the benefits of using ODMAP data to track opioid overdoses?

  • Near real-time availability of data

  • Provides precise location information

  • Captures a wider net of overdoses than any other single data source, because of EMS, law enforcement, and coroner participation

  • Able to upload map layers of interest

  • Facilitates coordination and communication between public safety and public health

What are the limitations of using ODMAP data to track opioid overdoses?

  • Data may include duplicates, accidental prescription overdoses, and false positives (not actually an overdose). Users should confirm data with other sources as possible.

  • Does not currently include overdoses that do not get reported by EMS, law enforcement, or coroners.

  • Spike alerts can only count overdoses that occur within 24 hours and cannot be extended to a longer timeframe.

Mortality (Death Certificate) Data

Overdose-specific

How are overdoses identified in mortality (death certificate) data?

Mortality data is pulled from death certificates, which include information on the underlying and contributing causes of death. If there is any mention of an overdose ICD-10 code on the death certificate, it is classified as an overdose death.

Can we use death data to track fentanyl overdoses?

To an extent, yes. Death certificates use ICD-10 codes when reporting causes of death. Unfortunately, unlike ICD-10-CM codes used in ED and hospital discharge records, there is no specific ICD-10 code for fentanyl as a cause of death at this time. The closest existing ICD-10 code is “T40.4- Other Synthetic Narcotics”, which is not specific to fentanyl (it can include fentanyl & fentanyl analogs, pethidine, levorphanol, tramadol, and dextropropoxyphene).

However, death certificates contain a free text field where coroners or medical examiners may add extra information outside of the ICD code fields. In the event of overdoses, coroners and medical examiners may write out the exact substances identified in a toxicology screen conducted during an autopsy. If the word “fentanyl” is written in a free text field, we can positively identify the death as fentanyl-related.

Limitations for using this data source to capture fentanyl overdose include:

  • Not every overdose death receives an autopsy and post-mortem toxicologic screen that can definitively identify the presence of fentanyl

  • Even if fentanyl is known to be involved, some coroners or medical examiners fail to document this in the free text fields of the death certificate

We recommend that people interested in understanding specific drugs involved in an overdose death use State Unintentional Drug Overdose Reporting System (SUDORS) data, which includes results from toxicology and other sources regarding drug involvement.

What are the benefits of using death data to track overdoses?

All deaths are required to have a death certificate which must include a cause of death. This means that death certificate data is representative of the Montana population.

What are the limitations of using death data to track overdoses?

  • Final mortality data are usually available six to seven months after the calendar year has finished. This does not allow for real-time tracking of overdoses.

  • There are inconsistencies with coroner’s and medical examiner’s methodology in completing death certificate data.

  • Naloxone administration or any other lifesaving measures attempted prior to the death is not captured in this dataset.

  • Death certificates do not always provide detailed information on the specific drugs involved in overdose deaths.

SUDORS Data

General

What is SUDORS data?

SUDORS stands for State Unintentional Drug Overdose Reporting System and collects data on all fatal unintentional overdoses that occur in Montana (regardless of residency) help people better understand the circumstances surrounding unintentional drug overdose deaths. The SUDORS program collects data from death certificates, coroner/medical examiner reports, law enforcement reports, toxicology reports, and other sources. More about SUDORS can be found on the CDC website.

Overdose-specific

Can we use SUDORS data to track overdoses for specific drugs?

Yes. Since 2022, over 95% of SUDORS cases receive postmortem toxicology testing, which provide data on the specific drugs detected in a person’s system during an unintentional overdose death. SUDORS also provides variables for whether the drug was detected, and whether the drug was detected and considered to contribute to cause of death. However, in the case of polysubstance deaths, the role a single drug played in the death may be difficult to interpret.

What are the benefits of using SUDORS data to track overdoses?

Because SUDORS data includes information from multiple sources, it provides comprehensive details about unintentional drug overdose deaths and can overcome some of the limitations of using a single data source on its own. SUDORS data can include information on the drugs that caused death, additional drugs detected, and additional context around the overdose (if bystanders were present, if naloxone was administered, if the decedent had a history of substance use disorder, etc.). The potential richness of this data can lend itself to multiple types of analyses.

After DPHHS submits SUDORS data, the CDC conducts extensive data cleaning and quality checks and sends a final dataset back to DPHHS about six months to one year after data is submitted.

What are the limitations of using SUDORS data to track overdoses?

Data completeness is dependent on information documented at the time of death and availability of evidence. This can lead to missing data, particularly for circumstance variables (past drug use, bystander information, if the decedent had received any treatment for prior substance use disorders, etc.). Since 2022, circumstance data has been available for over 90% of unintentional overdose deaths, although completeness for individual variables can vary. For example, over half of deaths were missing information on the route of drug use. DPHHS is working with counties to improve the level of detail available in reports.

Poison Control Data

General

What is poison control data?

The National Poison Data System (NPDS) is the data warehouse for the nation’s 54 poison centers. Each poison center submits de-identified case data to NPDS after providing necessary poison exposure management and information services to callers. This case information is uploaded to NPDS in near real time, making NPDS one of the few operational systems of its kind. Rocky Mountain Poison and Drug Safety is Montana’s regional poison control center.

NPDS data represents calls made to a Poison Control Center from Montana. Calls may be made by an individual, or a health care provider. Data includes detailed information on the drug(s) taken, severity of symptoms, treatment recommendations, outcome, and more.

Overdose-specific

Can we use poison control data to track overdoses for specific drugs?

Yes. Poison control data includes generic codes that track the specific drugs involved in a poison control call.

What are the benefits of using poison control data to track overdoses?

Poison control data can be queried in real-time to get the most current data regarding poison control calls.

Poison control data can track specific drugs, rather than just ICD-10-CM codes.

Poison control data can be used to analyze the severity of exposures and patient outcomes, which are generally not available in other data.

What are the limitations of using poison control data to track overdoses?

Most overdoses do not result in a call to poison control, so it will not represent a full count of overdoses for any substance. It may be more appropriate for less common overdoses or exposures for which alternative data sources are unavailable, such as kratom.

Crime Lab Data

Overdose-specific

What kind of data on overdoses is available from the state crime lab (Forensic Science division)?

Autopsy data, postmortem toxicology data, and seized drug data. Autopsy data and postmortem toxicology data both pertain to deaths, and seized drug data refers to drugs seized by law enforcement during an incident.

Autopsy data tells us about the causes of death and are typically finalized in less than 90 days. Post-mortem toxicology comes from the Toxicology Section and tells us what (if any) substances were present in a dead body but does not necessarily tell us whether those substances were related to the cause of death. Determination on which drugs contributed to cause of death is found on the death certificate and is based on toxicology results, autopsy results, scene evidence, and other available data.

Seized drug testing provides data on what drugs are found in seized drug samples and can give insight to the types of drugs passing through Montana communities. Counts are based on samples analyzed and not cases submitted. Data is pulled from the same data sent monthly to the National Forensic Laboratory Information system (NFLIS).  90% of cases are completed in less than 82 days in the Chemistry section (based on the Billings lab- the Missoula lab turn-around is currently 31 days).

When available, data from autopsies and toxicology results are included in the State Unintentional Drug Overdose Reporting System (SUDORS). Please refer to that section for more information.

What are the limitations of crime lab data?

  • For unintentional overdose deaths, about 75-80% receive an autopsy and over 95% receive toxicology testing.

  • For seized drug testing, because results are based on drugs found during a law enforcement event, they may not be representative of the illicit drug supply in Montana.

  • Results are limited to what the labs are able to test for, and it may be difficult to incorporate testing for emerging and novel drugs.

Clinical Drug Test Data (Millennium Health)

General

What is clinical drug test data?

Millennium Health provides urine drug testing for providers who treat patients for substance use disorder. Data represents a convenience sample of urine drug tests and can reflect trends in illegal use of fentanyl, heroin, methamphetamine, and cocaine. It can also provide some data on novel substances such as fentanyl analogs or xylazine.

Urine drug test results are only included for:

  • adult patients, 18 years of age or older

  • patients with a reported substance use disorder diagnosis excluding alcohol, cannabis, and tobacco

  • patients not prescribed fentanyl or methamphetamine.

NOTE: Montana-specific Millennium Health data is not publicly available. Regional data is available on the CDC Clinical Drug Test Dashboard, however be aware that regional trends may not be representative of Montana.

Can we use clinical drug test data to track overdoses?

No. Clinical drug test data is a convenience sample of substances detected among people being treated for substance use disorder. It does not contain data on overdoses, and it covers only a small number of people who use illegal drugs.

What are the benefits of using clinical drug test data?

While clinical drug test datadoes not represent overdoses, research suggests that this data does correlate with overdose trends. Because this data is updated every two weeks, it can be useful for identifying areas where overdoses may be increasing.

What are the limitations of using clinical drug test data?

  • This data cannot be used to estimate overall prevalence of drug use, nor is it a representative sample of people who use drugs

  • Data cannot be compared across counties due to differences in patient and provider characteristics across counties.

  • Data is available only from one service (Millennium Health), and some clinicians may use a different company for their urine drug testing services.

  • Changes in trends for small percentages may have limited public health impact

  • Changes in trends among low populations may be instable and should be interpreted with caution.

Please see the CDC Clinical Drug Test Dashboard for additional information.