About the Naloxone Administration Heatmap
This tool provides insight into the incident location where naloxone was administered and reported by EMS providers throughout the state of Indiana. Indiana EMS providers report locations of patient encounters during which naloxone was administered when an opioid overdose was suspected. The drug, also known by the brand name Narcan®, reverses the effects of an opioid overdose and is administered with the intent to save the life of the patient. The Naloxone Administration Heatmap shows naloxone administrations as reported by EMS provider agencies since January 1, 2014.
How to use the map
Use the map to identify local trends specific to a given timeframe. The filters in the top right corner can be used to limit the view to a selected time period or time of day or week. Zoom in or type an address in the search bar to see incident location markers. The legend shows the range of random noise applied to the location in order to protect privacy.
Data source and timeliness
EMS data is sent by providers in the NEMSIS v2 or v3 format to the Indiana Department of Homeland Security (IDHS) database. Depending on the EMS provider, it can take anywhere from 24 hours to 6 weeks for the data to be sent to the database. The EMS data is analyzed by the Indiana Management Performance Hub (MPH).
- There may be up to a 6 week delay in the reporting of the data due to delays in submissions by EMS providers.
- Not all patient encounters during which naloxone is administered are overdose events. Preliminary analysis indicates approximately 75% of naloxone incidents are likely actual overdose events.
Incident addresses are converted to latitude and longitude using a geocoder. Approximately 15% of naloxone incidents have not been plotted on the map because the address was poorly formatted or missing. In several cases, the address of a hospital emergency department is listed as the incident address. These points are shown on the map but may be data entry errors and not reflective of the true incident location.
Points on the map are never placed at the exact incident location, but are altered randomly to protect privacy. In densely populated areas, the true location is within 100 meters of the point on the map. In moderately populated areas it’s within 300 meters, and in rural areas it’s within 500 meters. Where several incidents have occurred at the same location, each incident is moved slightly so the locations do not appear on top of each other. In order to display incidents that are reported as occurring at the exact same location, a slight amount of random noise (i.e., jitter) was applied to the coordinates of the incidents.
Naloxone is a drug that reverses the effects of opioids and can be administered when a person shows symptoms of an overdose, such as respiratory depression. When administered, a person typically shows a response to the naloxone within minutes, but may require additional doses depending on the severity of the opioid overdose. The heatmap displays such situations where multiple doses are administered as one incident. Naloxone is NOT a substitute for medical attention. More information can be found at the Indiana State Department of Health website.
Naloxone is often administered when the patient is unresponsive, not breathing, and drug use is suspected. Analysis by MPH and IDHS suggests that approximately 75% of individuals given naloxone were experiencing an opioid overdose, while 25% were most likely not experiencing an overdose.
Indiana by the Numbers
About the Data
The maps show the estimated rate of opioid prescriptions per 100 population for the selected year. Rates for the state and counties are based on the pharmacy location where the opioid was dispensed. Counties with a higher rate have a darker color.
Prescription data presented in the maps comes from the Centers for Disease Control and Prevention (CDC) website, and is based on retail pharmacy sample data from the QuintilesIMS Transactional Data Warehouse. Population estimates used to determine the rate per 100 population come from the U.S. Census Bureau’s Population Estimates Program.
https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html for more details.
According to this data, opioid prescription rates in Indiana rose from 103 per 100 population in 2008 to a peak of 112 per 100 population in 2012. They have been dropping since 2012, with a rate of 84 prescriptions per 100 population in 2016.
The maps show the rate of opioid poisoning deaths per 100,000 population for the selected year for the state of Indiana and its 92 counties. Deaths are shown according to the county where they occurred.
The line graph shows the count of drug poisoning deaths by year, grouped by the following categories:
- Heroin (Only) — Heroin was the only opioid included in the contributing cause of death
- Synthetic Opioid (Only) — Synthetic opioids such as Fentanyl, Tramadol, Meperidine, or Propoxyphene were the only opioids included in the contributing cause of death
- Other or Unspecified Opioid (Only) — Other or unspecified opioids such as Codeine, Hydrocodone, Hydromorphone, Methadone, Morphine, Opium, Oxycodone, or Oxymorphone were the only opioids included in the contributing cause of death
- Opioid (Multiple) — More than one opioid category was included in the contributing cause of death
Death record information comes from the Indiana Death Registration System (IDRS), managed by the Indiana State Department of Health (ISDH) Vital Records division. Data was analyzed and prepared by the Management and Performance Hub (MPH). The ISDH reports surveillance data for drug overdose deaths and opioid drug deaths according to the CDC’s opioid overdose standards to allow for comparison across states. For official ISDH reporting information, refer to https://gis.in.gov/apps/isdh/meta/stats_layers.htm and http://www.in.gov/isdh/27393.htm. For CDC reporting information, refer to https://www.cdc.gov/drugoverdose/data/statedeaths.html.
- Data for 2016 is provisional and subject to change.
- Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD-10). Drug poisoning deaths have ICD-10 underlying cause of death codes of X40 through X44 (unintentional), X60 through X64 (suicide), X85 (homicide), or Y10 through Y14 (undetermined intent). Opioid-related deaths include an ICD-10 contributing cause of death of T40.0 (Opium), T40.1 (Heroin), T40.2 (Other opioid), T40.3 (Methadone), T40.4 (Other synthetic opioids), or T40.6 (Other unspecified opioids).
Deaths involving more than one of these opioid categories were included in the “Opioid (Multiple)” group.
- Many drug poisoning death records do not contain an ICD-10 contributing cause of death code to indicate the specific type(s) of drug involved; deaths by drug type are undercounted as a result.
- Rates based on less than 20 deaths are considered unstable and should be interpreted with caution.
- Deaths are shown according to the county where they occurred, so Indiana residents that died outside of Indiana are not included and non-Indiana residents that died within Indiana are included.
- Population values used to determine the rate per 100,000 population come from the U.S. Census Bureau (2010).
Opioid-related death rates have risen from 4.5 per 100,000 population in 2008, to 11.7 per 100,000 in 2016. Drug deaths related to heroin have increased sharply beginning in 2011, and for synthetic opioids beginning in 2015.
Data were analyzed and prepared by the Management and Performance Hub (MPH).