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Opioid Crisis


Opioid-Related Overdose Deaths


Opioids are drugs such as heroin, fentanyl, and prescription medications like hydrocodone and oxycodone. In 2016, there were 343 opioid-related overdose deaths in Alabama—a rate of 7.5 deaths per 100,000 persons—nearly half the national rate of 13.3 deaths per 100,000 persons. The number of deaths related to opioids included 157 related to synthetic opioids (mainly fentanyl), 126 attributed to heroin, and 124 related to prescription opioids.


In December 2020, the Centers for Disease Control and Prevention (CDC) issued a health advisory alerting health professionals of a "substantial increase in drug overdose deaths across the United States, primarily driven by rapid increases in overdose deaths involving synthetic opioids, excluding methadone, likely illicitly manufactured fentanyl." The CDC acknowledges that manufactured fentanyl has become increasingly present in all street drugs, including heroin, cocaine, and methamphetamine. According to the Alabama Department of Mental Health (ADMH) (2021), the number of opioid deaths in Alabama increased by 20% in 2020 - resulting in the state being one of 25 with the highest increases. State Health Officer, Dr. Scott Harris acknowledged the impact of the COVID-19 pandemic as a contributing factor to increased opioid usage in the state, encouraging families and friends of individuals with substance use disorders to become educated about the lifesaving use of naloxone (Narcan) and the importance of judgment and stigma-free support. For more information about naloxone training or to receive a free Narcan kit by mail through the Jefferson County Department of Health (JCDH), please email or call (205) 930-1065


Opioid Pain Reliever Prescriptions

In 2013, Alabama providers wrote 141.1 opioid prescriptions for every 100 persons (approximately 6.8 million prescriptions)—the highest prescribing rate in the country and almost twofold greater than the average U.S. rate of 79.3. Since then, opioid prescriptions in the U.S. have declined, with a nearly 17 percent decline in Alabama from 2013 to 2015, resulting in an estimated 120.3 opioid prescriptions per 100 persons (5.8 million prescriptions) in 2015 (IMS Health, 2016).

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Neonatal Abstinence Syndrome (NAS)


Among Medicaid recipients (the only available NAS data for Alabama) cases of NAS increased from 170 in 2010 to 345 in 2013 (Alabama Medicaid). The percentage of NAS in 2013 by Alabama county is shown in the chart to the right. In a separate study across 28 states, the national average rate for NAS in 2013 was 6.0 per 1,000 births (CDC, MMWR, 2014).

HIV Prevalence and HIV Diagnoses

Attributed to Injection Drug Use (IDU)

U.S. Incidence: In 2015, 9.1 percent (3,594 1) of the 39,513 new diagnoses of HIV in the United States were attributed to IDU. Among new cases, 8.2 percent (2,614 1) of cases among men and 13.2 percent (980) of cases among women were transmitted via IDU (CDC).

U.S. Prevalence: In 2014, 955,081 Americans were living with a diagnosed HIV infection—a rate of 299.5 per 100,000 persons. Of these, 18.1 percent (131,056 1) of males and 22.6 percent (52,013) of females were living with HIV attributed to IDU (CDC).

State Incidence: Of the new HIV cases in 2015, 481 occurred in Alabama, with 5.5 percent1 of new cases in males and 7.6 percent of new cases in females attributed to IDU (AIDSVu).

State Prevalence: In 2014, an estimated 12,439 persons were living with a diagnosed HIV infection in Alabama—a rate of 306 per 100,000 persons. Of these, 12.9 percent1 of males and 15.1 percent of females were living with HIV attributed to IDU (AIDSVu).

1. Includes transmission to individuals with injection drug use as a risk factor.

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Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use


U.S. Incidence: In 2015, there were 181,871 reported cases of chronic HCV and 33,900 estimated cases of acute HCV2 (CDC). Where data were available, 64.2 percent of acute cases reported IDU (CDC).

U.S. Prevalence: An estimated 3.5 million Americans are living with HCV, including approximately 2.7 million living with chronic infections (CDC).

State Incidence: In 2015, Alabama reported 70 cases of acute HCV (1.4 per 100,000 persons) (CDC).

State Prevalence: Current state prevalence data are not available. As of 2010, an estimated 52,400 (1,440 per 100,000) persons were living with HCV in Alabama (HepVu).



2. 2015 estimate after adjusting for under-ascertainment and under-reporting. Data for 2015 were unavailable for Alaska, Arizona, Connecticut, the District of Columbia, Hawaii, Iowa, Mississippi, New Hampshire, Rhode Island, and Wyoming.  

The National Institute of Health Funds Center

of Excellence in Pain Education


Alabama is home to one of the eleven Centers of Excellence in Pain Education (CoEPEs): The University of Alabama at Birmingham. The CoEPEs act as hubs for the development, evaluation, and distribution of pain management curriculum resources for medical, dental, nursing, pharmacy and other schools to improve how health care professionals are taught about pain and its treatment.


All content above is from the NIH National Institute on Drug Abuse

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