NDEWS Hotspot Alerts is a dynamic notification system that quantifies the degree to which the observation deviates from the expected range of values over an 84-day window provided by biospatial.io.
Alerts are updated bi-weekly and limited to US states with statewide partnerships with biospatial.io: Alabama, Alaska, Arkansas, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Illinois, Kansas, Kentucky, Maine, Michigan, Minnesota, Mississippi, Montana, New Mexico, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Virginia, Wisconsin, and Wyoming.

2025
NDEWS Special Report EMS encounters for tianeptine-related overdoses (nonfatal or fatal) in the US January 1, 2023 – April 30, 2025
The data shows a statistically significant increase in tianeptine-related EMS encounters in the western states, in contrast to the declining trends observed in the central and eastern states and nationally overall.
- Published in NDEWS Weekly Briefing Issue 231: May 23, 2025
EMS encounters for nonfatal heroin-related overdoses in the US July 1, 2024 – April 30, 2025
The data shows a statistically significant increase in nonfatal heroin-related EMS encounters in the western states, in contrast to the declining trends observed in Central and Eastern states and nationally overall.
- Published in NDEWS Weekly Briefing Issue 231: May 16, 2025
EMS encounters for nitazene-related overdoses (nonfatal or fatal) in the US January 1, 2023 – April 30, 2025
The data shows that most counties were located in the southeastern region.
- Published in NDEWS Weekly Briefing Issue 229: May 2, 2025
EMS encounters for xylazine- and medetomidine-related overdoses (nonfatal and fatal) in the US January 1, 2023 – March 31, 2025
The data shows that counties were located throughout eastern region of the US. Among states with at least 75% coverage, there were 1,233 EMS encounters:
- Published in NDEWS Weekly Briefing Issue 226: April 11, 2025
NDEWS Special Report: EMS encounters for nonfatal methamphetamine-related overdoses in the US January 1, 2023 – March 31, 2025
The data shows that counties with the highest rates of EMS encounters for nonfatal methamphetamine-related overdose encounters over 27 months were heavily concentrated in the southeastern US. Among US states with at least 75% coverage, there were 735,651 EMS encounters in response to nonfatal methamphetamine-related overdoses:
- Published in NDEWS Weekly Briefing Issue 225: April 4, 2025
NDEWS Special Report: EMS encounters in the US for nonfatal inhalant-related overdoses January 1, 2023 – December 31, 2024
Among states with at least 75% coverage, there were 852 nonfatal inhalant-related EMS encounters:
- Published in NDEWS Weekly Briefing Issue 224: March 28, 2025
NDEWS Special Report: EMS encounters in the US for nonfatal tusi-related overdoses January 1, 2022 – February 28, 2025
The data shows that all counties with the highest rates of nonfatal tusi-related (also known as ‘pink cocaine’ overdose encounters over 38 months were on the east coast and west coast—especially the southeast and southwest of the US. Among states with at least 75% coverage, there were 105 nonfatal tusi-related overdose encounters:
- Published in NDEWS Weekly Briefing Issue 223: March 21, 2025
NDEWS Special Report: Trends in EMS encounters in the US for nonfatal fentanyl-related overdoses by month, January 2023 – February 2025
According to the recently published paper by NDEWS Co-Directors Drs. Palamar and Cottler, there has been a 1,194.2% increase in nonfatal pediatric fentanyl exposures reported to poison centers, rising from just 69 cases in 2015 to 893 in 2023.Since the paper’s data covers 2015-2023, we wanted to see if recent EMS data mirrored such trends in the US nationally across all ages. The data in the report shows that between January 2023 to June 2023, EMS encounters for nonfatal fentanyl-related overdoses significantly increased and then significantly decreased through February 2025:
- Published in NDEWS Weekly Briefing Issue 222: March 14, 2025
NDEWS Special Report: EMS encounters in the US for nonfatal methamphetamine-related overdoses among younger adults (18-64) and older adults (65+) January 1 – December 31, 2024
- Published in NDEWS Weekly Briefing Issue 221: March 7, 2025
NDEWS Special Report EMS encounters in the US for nonfatal opioid-related overdoses that also indicated suicide ideation January 1, 2023 – December 31, 2024
The data shows that all five counties with the highest rates of both nonfatal overdoses and suicide ideation over 24 months were in the lower half of the United States:

- Published in NDEWS Weekly Briefing Issue 220: February 28, 2025
NDEWS Special Report: EMS encounters for nonfatal and fatal heroin-related overdoses in the US January 1, 2023 – December 31, 2024
The graph included in this report depicts a decline in overdoses over time in EMS encounters for nonfatal heroin-related overdoses as well as fatal heroin-related overdoses:

- Published in NDEWS Weekly Briefing Issue 219: February 21, 2025
NDEWS Special Report: EMS encounters for nonfatal drug overdoses and suicide ideation in the US January 1 – December 31, 2024
- Published in NDEWS Weekly Briefing Issue 217: February 7, 2025
NDEWS Special Report: EMS dispatches for nonfatal fentanyl-related overdoses in the US January 1 – December 31, 2024
- Published in NDEWS Weekly Briefing Issue 216: January 31, 2025
NDEWS Special Report: 27.9% of nonfatal stimulant-related overdoses reported by EMS personnel in the US from July 1 – December 31, 2024 occurred between 18:00 and 22:59
- Published in NDEWS Weekly Briefing Issue 215: January 24, 2025
NDEWS Special Report: Counties with alerts for nonfatal overdoses involving opioids and non-opioids November 1 – December 31, 2024
- Published in NDEWS Weekly Briefing Issue 214: January 17, 2025
2024
NDEWS Special Report: 28.2% of nonfatal fentanyl-related overdoses reported by EMS personnel from August 1 – November 30, 2024, occurred between the hours of 16:00 and 20:59

- Published in NDEWS Weekly Briefing Issue 212: December 20, 2024
NDEWS Special Report: Frequency of counties ranking among the top five counties for nonfatal overdoses, September 7 – November 30, 2024
- Published in NDEWS Weekly Briefing Issue 211: December 13, 2024
NDEWS Hotspot Alerts: Counties with a higher-than-expected number of nonfatal drug-related 911 dispatch overdoses, November 25 – December 1, 2024
- Published in NDEWS Weekly Briefing Issue 210: December 6, 2024
NDEWS Special Report: Naloxone utilization in nonfatal fentanyl overdose related 911 dispatches, January 1 – October 31, 2024
NDEWS State Report: Hotspot County Alerts in California, January 1 – October 31, 2024: Opioid and non-opioid nonfatal overdose alerts
NDEWS Hotspot Alert: Nonfatal heroin, methamphetamine, opioid, and non-opioid 911 dispatches, October 30 – November 5, 2024
NDEWS Special Report: Nonfatal fentanyl-involved overdoses January 1 – September 30, 2024
NDEWS Special Report: Frequency of counties ranking among the top five counties for nonfatal overdoses from July 9 to September 30, 2024
NDEWS Hotspot Alert: Counties with higher-than-expected nonfatal overdoses October 8-14, 2024: Methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Hotspot Alerts: Counties with higher than expected nonfatal methamphetamine-involved overdoses from August 1 – September 30, 2024
NDEWS Hotspot Alerts: Counties with higher than expected nonfatal heroin-involved overdoses from January 1 – September 30, 2024
NDEWS Hotspot Alerts: Counties with higher than expected nonfatal overdoses from September 10 – 16, 2024: Heroin, methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Special Report: Naloxone utilization in nonfatal opioid overdose-related 911 dispatches from January 1 – August 31, 2024
NDEWS Special Report: Nonfatal fentanyl overdoses in the US from February 1 to July 31, 2024
NDEWS Special Report: Counties with the highest rates of nonfatal overdose May 1 – July 31, 2024
NDEWS Special Report August 1, 2023 – July 31, 2024: Nonfatal opioid overdose with suicide ideation
NDEWS Hotspot Alerts July 25 – 30, 2024: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts July 18 – 24, 2024: Opioid and non-opioid 911 dispatches
NDEWS Hotspot Alerts July 4 – 10, 2024: Methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Alerts May 9 – 15, 2024: Methamphetamine, opioid, and non-opioid 911 dispatches
NDEWS Hotspot Alerts April 11 – 17, 2024: Methamphetamine, opioid, and non-opioid 911 dispatches
NDEWS State Report Alerts in New York for 2023: Opioid and non-opioid nonfatal overdose alerts
NDEWS Hotspot Alerts March 21 – 27, 2024: Heroin, methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Hotspot Alerts March 14 – 20, 2024: Heroin, methamphetamine, opioid and non-opioid 911 dispatches
NDEWS State Report Alerts in Pennsylvania for 2023: Opioid and non-opioid nonfatal overdose alerts
NDEWS Hotspot Alerts February 29 – March 6, 2024: Heroin, methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Hotspot Alerts January 1 – February 28, 2024: Alerts by county and week
NDEWS Hotspot Alerts January 1 – February 21, 2024: Heroin-involved overdose dispatches
NDEWS Hotspot Alerts January 1 – February 14, 2024: Methamphetamine-involved overdose dispatches
NDEWS State Report alerts in Michigan for 2023: Opioid and non-opioid nonfatal overdose alerts
NDEWS State Report alerts in Florida for 2023: Opioid and non-opioid nonfatal overdose alerts
NDEWS Hotspot Alerts January 11 – 17, 2024: Heroin, methamphetamine, opioid and non-opioid 911 dispatches
NDEWS Special Report January 1 – December 31, 2023: Naloxone utilization in nonfatal opioid overdose-related 911 dispatches
2023
NDEWS Hotspot Alerts 23 counties with higher-than-expected drug related 911 dispatch counts
NDEWS Hotspot Alerts 27 counties with higher-than-expected drug related 911 dispatch counts
NDEWS Hotspot Alerts counties with four or more alerts for opioid or non-opioid overdoses September 14 to November 8
NDEWS Hotspot Alerts: 32 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: 32 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: 21 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: 31 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: 33 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: 38 counties among those with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: Counties with three or more alerts for non-opioid overdoses, July 13 to August 30
NDEWS Hotspot Alerts: Top 34 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: Counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: Top 37 counties with higher-than-expected drug-related 911 dispatch counts
NDEWS Hotspot Alerts: July 27 – August 2, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts: July 20–26, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches
NDEWS Special Report Nonfatal fentanyl overdoses in the US January 1 – June 7, 2023
NDEWS is excited to announce that we have expanded our partnership with biospatial inc. giving us access to new data and surveillance methods. With this expansion, we are able to look more closely at substances and trends, including substances that are of significant concern, such as fentanyl. In this report, fentanyl-specific overdose 911 dispatches in the US are examined between January 1 and June 7, 2023.

Click here to view the report.
NDEWS Hotspot Alerts: July 6–12, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts June 22–28, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts June 8–14, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts May 26–31, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts May 19–25, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches
NDEWS Hotspot Alerts May 4–10, 2023: Opioid, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 42 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=23) April 20–26, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 23 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=31) April 13–19, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 31 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=21) March 30 – April 5, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 21 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=24) March 23–29, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 24 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=24) March 16–22 , 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 24 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=21) March 9–15, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 21 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=27) March 2–8, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 27 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=31) February 23 – March 1, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 31 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=24) February 16–22, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 24 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=38) February 2–8 , 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 38 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=26) January 26 – February 1, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 26 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=25) January 12 – 18, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 25 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts (n=29) January 5 – 11, 2023: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 24 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts December 29 – January 4: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 33 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
2022
NDEWS Hotspot Alerts December 8–14, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 25 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts December 1–7, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 23 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts November 24–30, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 27 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here. Click here to read more about NDEWS Hotspot Alerts.
NDEWS Hotspot Alerts: Counties with above-expected counts for drug-related 911 dispatches October 27 – November 2, 2022

In this week’s NDEWS Hotspot Alerts report, 21 counties in 9 states were identified as having above-expected counts for drug-related 911 dispatches over the previous 7-day period. View the full alert here.
NDEWS Hotspot Alerts October 20–26, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alerts report includes 21 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report here.
NDEWS Hotspot Alerts October 13–19, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week’s NDEWS Hotspot Alert reported two counties with 911 dispatch counts higher than 10. San Francisco, CA had 23 methamphetamine-related 911 dispatches, and Salt Lake, UT had 10 non-opioid-related 911 dispatches. Higher counts were reported for 15 US counties. View the full report here.
NDEWS Hotspot Alerts October 6–12, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

NDEWS Hotspot Alerts is a dynamic notification system of biospatial.io that quantifies the degree to which observed 911 dispatch rates for drug-related events deviate from expected ranges of values. This week’s report identifies counties with above-expected drug-related 911 dispatches over the past week. View the full report here.
NDEWS Hotspot Alerts: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches September 1–7, 2022

NDEWS Hotspot Alerts is a dynamic notification system of biospatial.io that quantifies the degree to which observed 911 dispatch rates for drug-related events deviate from expected ranges of values. View the full report here.
NDEWS Hotspot Alerts in states with full coverage: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches August 25 – 31, 2022

During the seven day period from August 25 – August 31, 2022, seventeen counties had higher-than-expected rates of drug-related dispatches. View the full report here.
Past alerts:
911 Dispatch Information
911 Dispatch type | Description of dispatch | dispatch involves |
---|---|---|
Opioid-related | Based on the Enhanced State Opioid Overdose Surveillance (ESOOS) criteria as defined by the state of Rhode Island, intended to detect incidents involving opioid overdose. | Opioid overdose |
Heroin-related | Based on the Enhanced State Opioid Overdose Surveillance (ESOOS) criteria as defined by the state of Rhode Island, intended to detect incidents involving heroin overdose. | Heroin overdose |
Non-opioid-related | Based on the Virginia Department of Health criteria for incidents involving non-opioid overdoses. | Non-opioid overdoses |
Methamphetamine-related | Based on incidents involving methamphetamine due to terms and phrases found in the record narrative and chief complaint elements. | Methamphetamine overdose |
Last modified: 02/03/2025