docs/us_health/health_substance_use_county_year

health_substance_use_county_year

Substance use and addiction indicators by county. CDC opioid dispensing rate, CDC PLACES drug overdose mortality, and CDC WONDER alcohol-induced death rate.

tier badmin_recordhealthsubstance_useopioidalcoholcdcplaceswonderdispensing
grain
county-year
years
2018 – 2024
cadence
Annual
overview

overview

9,946 county-year rows. Opioid dispensing complete; PLACES universal; WONDER alcohol subject to suppression.

current vintage — Opioid dispensing 2023; PLACES 2025; WONDER alcohol 2018-2024 pooled

history — Opioid dispensing: 2006-present; PLACES: 2020-present; WONDER: 1999-present

provenance

source & licensing

authority
U.S. Centers for Disease Control and Prevention
dataset
CDC Opioid Dispensing Data + CDC PLACES 2025 + CDC WONDER (alcohol-induced)
license
Public domain (U.S. Federal Government work)
citation
CDC Opioid Dispensing Data (IQVIA-derived) + CDC PLACES 2025 + CDC WONDER alcohol-induced mortality 2018-2024.
schema

fields

nametypedefinition
_ingested_attimestampTimestamp when this record was written to BigQuery.Pipeline metadata field.
_reliability_tierstringData quality tier (A/B/C) assigned at ingestion.Pipeline metadata field.
alcohol_deaths_pooledint64 · countPooled count of alcohol-related deaths, typically aggregated across multiple years to stabilize estimates in small counties. Higher values reflect greater cumulative alcohol mortality.
alcohol_mortality_per_100kfloat64 · rate per 100kAge-adjusted mortality rate attributable to alcohol use disorders and alcohol-related causes per 100,000 county residents. Higher values indicate greater alcohol-related mortality burden.
country_idstringISO alpha-2 country code (always 'US' for domestic tables).
county_idkeystring5-character FIPS code identifying the county.Joins dim.counties on county_id.
opioid_dispensing_ratefloat64 · rate per 100 personsNumber of retail opioid prescriptions dispensed per 100 county residents in a given year. Higher values indicate greater opioid prescribing activity in the county.
pct_adults_binge_drinkingfloat64 · percent (0–100)Estimated percentage of adults who report binge drinking (defined as 4+ drinks on one occasion for women, 5+ for men) in the past 30 days. Higher values indicate higher prevalence of heavy episodic alcohol consumption.
rate_bandstringCategorical label grouping the opioid dispensing rate into a predefined range band (e.g., 'low', 'medium', 'high'). Used to summarize rate variation across counties without exposing suppressed cell counts.
state_idstring2-character FIPS code identifying the state.Joins dim.states on state_id.
yearkeyint64Reference year of the observation.
relationships

joins

primary key
county_id, year
common joins
dim.geographies on county_id
health_mortality_despair_county_year on (county_id, year)
health_mental_health_county_year on (county_id, year)
usage

how to use this table

method

Opioid dispensing rate per 100 from IQVIA Xponent (county). PLACES drug overdose mortality is modeled BRFSS proxy. CDC WONDER alcohol-induced from death certificates.

do not use for

Illicit drug use (dispensing measures Rx only); causal claims about prescribing -> mortality; single-year change in small counties.

known issues

Opioid dispensing peaked ~2012 then declined; current low rates may reflect undertreatment, not lower addiction.

last updated · May 5, 2026