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SUDORS (State Unintentional Drug Overdose Reporting System) is a CDC-supported surveillance system in which state and district health departments abstract detailed records of drug overdose deaths. The abstractions draw on death certificates, coroner or medical examiner reports and postmortem toxicology, and CDC’s page puts the total at more than 600 data elements. Per CDC (page updated February 13, 2025), 50 jurisdictions are funded: 49 states and the District of Columbia. This guide is general information, not medical advice.
Short answer: what SUDORS is
SUDORS is a death-investigation data system, not a count of overdose events. CDC describes its goals as explaining the circumstances of overdose deaths, identifying the specific substances involved and improving the timeliness and accuracy of overdose data. It is funded through CDC’s Overdose Data to Action in States (OD2A-S) program. If you arrived here looking for the English word for sweat, that is a different topic; this page covers the overdose surveillance acronym only.
Definition and scope
CDC’s NCHS page describes SUDORS as collecting information about unintentional overdoses and overdoses of undetermined intent. According to CDC, cases are identified using ICD-10 codes X40-X44 (unintentional) and Y10-Y14 (undetermined intent), and jurisdictions may also scan text-based cause-of-death fields and review coroner or medical examiner reports to find additional cases. Specific drugs are recorded rather than only drug classes, and new drugs can be added to the system as they are identified. Data are entered into a web-based CDC platform that CDC says is shared with the National Violent Death Reporting System (NVDRS).
How the data are assembled in practice
Each participating jurisdiction abstracts records from three required source types. The table below restates CDC’s description of what each contributes.
| Source record | Data elements CDC lists |
|---|---|
| Death certificate | Demographics, county and state of the overdose, cause and manner of death, place of death, date of death |
| Coroner or medical examiner report | History of prior overdoses, substance use disorder treatment, drug use history, routes of use, presence of bystanders, naloxone administration |
| Postmortem toxicology report | All drugs detected, drugs that contributed to the death, dates specimens were collected |
Because circumstances such as bystander presence or naloxone administration come from investigator reports rather than from the death certificate, they are available only where those reports record them.
Timeline
- 2016: began under Enhanced State Opioid Overdose Surveillance (ESOOS), covering opioid-involved deaths.
- 2019: expanded to all drug overdose deaths, with 47 states and DC participating through Overdose Data to Action (OD2A).
- 2023: 49 states and DC, funded through Overdose Data to Action in States (OD2A-S).
Source: CDC fact sheet dated April 1, 2024 (CDC Stacks, cdc/256897) and the CDC SUDORS page.
Where it matters for researchers and public health staff
CDC lists four uses: educating partners about location-specific risk factors, alerting partners to newly emerging drug threats, informing prevention and response planning, and evaluating prevention efforts. CDC and NCHS also publish a SUDORS Data Dashboard showing deaths by drug or drug class, month, sex, age, race and ethnicity, opioid or stimulant involvement, circumstances and potential intervention opportunities.
Checklist before you use SUDORS in a study
The first four points follow directly from CDC’s description; the last is an editorial interpretation.
- Unit of analysis: it covers deaths, so it cannot describe nonfatal overdoses.
- Case definition: unintentional and undetermined-intent deaths, per the ICD-10 codes above.
- Geography: 49 states and DC are funded, so check that your jurisdiction of interest participates and for which years.
- Access level: the public dashboard presents summaries; confirm with CDC or the jurisdiction what record-level access requires, and put any terms in a data use agreement.
- Editorial interpretation: because the data describe deaths at the population level, treat findings as ecological patterns and review the ecological fallacy before drawing individual-level conclusions. The design is closer to a cross-sectional description than to a cohort.
For the hospital prescribing side of the same public health problem, see opioid stewardship programs.
Common misunderstandings
- It is not a count of all overdoses. It describes fatal cases only.
- It does not record only drug classes. CDC says specific drugs are recorded.
- It is not limited to opioids today. It began with opioids in 2016 and has covered all drug overdose deaths since 2019.
- The 600-plus elements are not all on the death certificate. They come from three source types.
FAQ
What does SUDORS stand for?
State Unintentional Drug Overdose Reporting System.
Who runs it?
Participating state and district health departments abstract the data into a CDC web-based platform; CDC funds the work through Overdose Data to Action in States.
Which sources feed it?
Death certificates, coroner or medical examiner reports and postmortem toxicology reports.
Where can I see the data?
CDC publishes the SUDORS Data Dashboard under its Drug Overdose Data Resources.
Sources
- CDC, State Unintentional Drug Overdose Reporting System (SUDORS), updated February 13, 2025; read November 8, 2026.
- CDC NCHS, SUDORS, updated September 4, 2024; read November 8, 2026.
- CDC Stacks, SUDORS fact sheet, April 1, 2024; read November 8, 2026.
