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It had allegedly been operating for two months and delivered drugs to Brazil, the United States and Europe. Two Brazilian chemists, who had previously been arrested in a drug processing lab in their home country, were detained alongside two Paraguayans. Police seized 37kg of cocaine, nearly 3, ecstasy pills and drug processing equipment. At the heart of this dynamic sits the Triple Frontier — centered on Ciudad del Este — where porous borders make interdiction difficult and invite incursions from foreign criminal actors. Among the many foreign groups known to operate in Paraguay, Brazilian organized crime is particularly prominent , with the Rio de Janeiro-based Red Command reported in to be shipping one ton of cocaine out of the country every month. Much of the Brazilian criminal activity is based in the eastern border area between the city and Ciudad del Este, with a spate of killings in and around Pedro Juan Caballero during the first months of linked to a war between Brazilian criminal groups. The arrest of two Brazilian chemists with a prior history for drug production and the proximity of the laboratory to the Triple Frontier suggests the two men may have been brought in by one or another Brazilian criminal group dedicated to supplying the growing demand for synthetic drugs in both Argentina and Brazil. In another sign of the growth of South American synthetic drug production, Argentina discovered its first reported ecstacy lab in late Subscribe to our newsletter to receive a weekly digest of the latest organized crime news and stay up-to-date on major events, trends, and criminal dynamics from across the region. Donate today to empower research and analysis about organized crime in Latin America and the Caribbean, from the ground up. Skip to content. Stay Informed With InSight Crime Subscribe to our newsletter to receive a weekly digest of the latest organized crime news and stay up-to-date on major events, trends, and criminal dynamics from across the region.

Journal of Illicit Economies and Development

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Share sensitive information only on official, secure websites. Some states currently have longer than usual delays in reporting drug overdose deaths. Recent trends may underestimate the death count in affected states and this potential impact should be considered when comparing results for states to previous months. Adjustments to account for typical reporting delays in the predicted counts may not fully account for these longer delays. Please see the Technical Notes of the dashboard for more information on adjustments for delayed reporting. This data visualization presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation see Technical notes resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts see Technical notes. The provisional data presented in this visualization include: a the reported and predicted provisional counts of deaths due to drug overdose occurring nationally and in each jurisdiction; b a U. The reported and predicted provisional counts represent the numbers of deaths due to drug overdose occurring in the month periods ending in the month indicated. These counts include all seasons of the year and are insensitive to variations by seasonality. Deaths are reported by the jurisdiction in which the death occurred. Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts see Technical notes. Reporting of the specific drugs and drug classes involved in drug overdose deaths varies by jurisdiction, and comparisons of death rates involving specific drugs across selected jurisdictions should not be made see Technical notes. Provisional data presented in this visualization will be updated on a monthly basis as additional records are received. After opening the drug class dropdown , click the top of the dropdown menu again to make the checkboxes disappear. Please see Technical notes for data quality inclusion criteria. NOTES: Reported provisional counts for month ending periods are the number of deaths received and processed for the month period ending in the month indicated. Drug overdose deaths are often initially reported with no cause of death pending investigation , because they require lengthy investigation, including toxicology testing. Reported provisional counts may not include all deaths that occurred during a given time period. Therefore, they should not be considered comparable with final data and are subject to change. Predicted provisional counts represent estimates of the number of deaths adjusted for incomplete reporting see Technical Notes. Deaths are classified by the reporting jurisdiction in which the death occurred. Percent change refers to the relative difference between the reported or predicted provisional numbers of deaths due to drug overdose occurring in the month period ending in the month indicated compared with the month period ending in the same month of the previous year. This table describes the 12 month-ending provisional counts of drug overdose deaths by jurisdiction, month and year. It includes columns for reported value, predicted value, percent pending investigation, as well as footnote. The jurisdiction displayed in the table is the same as that selected in the visualization. This table describes the percent change in 12 month-ending count of drug overdose deaths, by jurisdiction. It includes all jurisdictions by default, with data displayed by jurisdiction and reported or predicted value this changes with user input. Columns with values include Current month ending, Previous month ending, percent change, as well as footnotes. Provisional counts may not include all deaths that occurred during a given time period. Deaths in this report are classified by the reporting jurisdiction in which the death occurred and include foreign residents. Number of deaths in this report may not match final reported data, which are reported by the jurisdiction of residence and are limited to US residents. For jurisdictions not meeting quality measures for all periods starting with January , predicted values are shown for all data points that meet percent completeness and drug specificity thresholds with reported values only shown for months where all three data quality measures were met. As a result, estimates are shown for selected reporting periods before the most recent 6 months and there may be gaps in the trends. Opioid overdose deaths are identified by the presence of any of the following MCOD codes: opium, T These categories can be selected in the 'Select specific drugs or drug classes' drop-down menu above the chart. Categories are not mutually exclusive because deaths may involve more than one drug. Among deaths with an underlying cause of drug overdose, the percentage with at least one drug or drug class specified was determined using MCOD codes in the range of T36—T This table describes the 12 month-ending provisional number of drug overdose deaths by drug or drug class, of which there are 9 options. Each row represents a given jurisdiction, indicator i. Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics NCHS as of a specified cutoff date. The cutoff date is generally the first Sunday of each month. National provisional estimates include deaths occurring within the 50 states and the District of Columbia. The lag time i. Thus, provisional estimates of drug overdose deaths have traditionally been reported 6 months after the date of death. Given recent improvements in data timeliness, starting in February , the 6-month lag was shortened to 4 months. The reporting lag was shorted from 6 months to 4 months after years of monitoring the improving timeliness of death reporting and a recent comparison of predicted estimates calculated using the 4-month and 6-month lags. Estimates produced with the 6-month and 4-month lags had a difference of less than 0. State predicted drug overdose death counts differed by an average of 0. National predicted counts for deaths involving opioids had a difference of 0. For example, the month ending period in June would include deaths occurring from July 1, , through June 30, The month ending period counts include all seasons of the year and are insensitive to reporting variations by seasonality. Counts for the month period ending in the same month of the previous year are shown for comparison. These provisional counts of drug overdose deaths and related data quality metrics are provided for public health surveillance and monitoring of emerging trends. Provisional drug overdose death data are often incomplete, and the degree of completeness varies by jurisdiction and month ending period. Consequently, the numbers of drug overdose deaths are underestimated based on provisional data relative to final data and are subject to random variation. Methods to adjust provisional counts have been developed to provide predicted provisional counts of drug overdose deaths 2 , accounting for delayed reporting see Percentage of records pending investigation and Adjustments for delayed reporting. Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period. ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on use of the classification. Drug overdose deaths involving selected drug categories are identified by specific multiple cause-of-death codes. Drug categories presented include: heroin T Opioid overdose deaths are identified by the presence of any of the following multiple cause-of-death codes: opium T Among deaths with an underlying cause of drug overdose, the percentage with at least one drug or drug class specified is defined as that with at least one ICD—10 multiple cause-of-death code in the range T36—T These new categories, which are a combination of existing categories, are not displayed on the default figure to facilitate ease of display of the main drug categories, but are accessible through the drop-down box that allows for selection of specific drug categories. Drug overdose deaths may involve multiple drugs; therefore, a single death might be included in more than one category when describing the number of drug overdose deaths involving specific drugs. For example, a death that involved both heroin and fentanyl would be included in both the number of drug overdose deaths involving heroin and the number of drug overdose deaths involving synthetic opioids other than methadone. Provisional counts are presented by the jurisdiction in which the death occurred i. Data quality and timeliness for drug overdose deaths vary by reporting jurisdiction. These criteria are defined below. Values for records pending investigation are updated with each monthly release and reflect the most current data available. This number represents the best estimate of how many deaths occurred in a given jurisdiction in each month. Death records in the NVSS database must have both demographic and coded cause-of-death information. The percent completeness is obtained by dividing the number of death records in the NVSS database for each jurisdiction for each month period by the control counts and multiplying by The percentage of death records in which a specific drug or drug class is identified as involved in a drug overdose death varies by jurisdiction 7. Provisional counts of drug overdose deaths where a specific drug or drug class is reported on the death certificate are presented for the United States and for jurisdictions meeting this threshold. Additionally, as a data quality metric, the percentage of drug overdose death records where at least one drug or drug class is recorded is presented. In order for information on drug-specific overdose deaths to be reported by jurisdiction in the NCHS Vital Statistics Rapid Release Monthly Provisional Drug Overdose Death dashboard, states have been required to meet a set of timeliness and quality criteria consistently for each time point in the long-term trend line shown starting with January Some states may also drop out of the figure for a given month if they fall below data quality criteria. As the timeliness and data quality of the drug overdose mortality data improve, the list of included jurisdictions will be re-examined to determine whether additional jurisdictions should be included or excluded based on the criteria described above. Due to reporting variations by jurisdiction, comparisons across selected jurisdictions should not be made. Data quality measures are shown for all jurisdictions in the below table. Values are updated with each monthly release and reflect the most current data available. This table describes the data quality for all jurisdictions by year, month, and period with all jurisdictions included by default. Descriptive columns include jurisdiction, year, month, and time period, while data columns include percent with drugs specified, percent complete, and percent pending investigation. Provisional counts of drug overdose deaths are underestimated relative to final counts. Methods were developed to adjust provisional counts for reporting delays related to temporal factors i. The reported provisional counts can be multiplied by this factor to generate a set of predicted provisional counts that adjust for reporting delays. Results from these models were used to generate a set of multiplication factors that could be applied to the reported provisional counts of drug overdose deaths to estimate predicted provisional counts. True declines or plateaus in the numbers of drug overdose deaths across the U. Timeliness of drug overdose death reporting has improved in recent years. Adjustments for delayed reporting are based on final data from Relative to final data, month ending provisional counts of drug overdose deaths for were The degree of underestimation was largest for month periods ending in October and November. Completeness was slightly higher in than in With improvements in reporting and completeness, predicted values will be closer to reported values and the completeness of reported drug overdose death counts may be higher than in prior years. Adjustments are typically updated once the prior year of data are finalized. Given atypically high death counts and temporary changes to reporting through and , adjustments will continue to be based on final data. Coefficients from these updated models were used to update the multiplication factors applied to the reported provisional counts of drug overdose deaths. Model results for each of the ten drug outcomes of interest are presented below. This table describes the completeness of 12 month-ending provisional counts of drug overdose deaths relative to final counts from Columns include reporting jurisdiction, january, february, march, april, may, june, july, august, september, october, november, and december. NOTE: Completeness of weekly provisional data is shown with a 6-month lag following the month period ending in the month indicated. This table describes model results of the completeness of provisional data by month-ending and percent pending: Drug overdose deaths and deaths involving any opioid. Values are estimated coefficients robust standard errors. This table describes model results of the completeness of provisional data by month-ending and percent pending: deaths involving specific drugs and drug classes. There may be slight differences between provisional and final data for a given data year e. As such, provisional counts include approximately additional drug overdose death records where the decedents were not US residents. Provisional data are tabulated by state of occurrence to capture the burden on the place where the deaths occur, and to correspond to the various data quality metrics that are provided. After it is considered closed, the final file is no longer updated, even if additional updates or records are received from the jurisdictions. As a result, provisional drug overdose death counts published in the VSRR for the data year i. Estimates for and are based on provisional data. Provisional drug overdose death counts. National Center for Health Statistics. Skip directly to site content Skip directly to search. An official website of the United States government Here's how you know. Official websites use. Provisional Drug Overdose Death Counts. Minus Related Pages. On This Page. Technical notes Nature and sources of data Cause-of-death classification and definition of drug deaths Selection of specific states and other jurisdictions to report Percent of records pending investigation Percent completeness Drug specificity Improvements in Data Quality Adjustments for delayed reporting Differences between final and provisional data Source References Suggested citation. This visualization presents a line chart with the x-axis representing each 12 month-ending period since , and the y-axis the number of drug overdose deaths. Data for only one jurisdiction is presented at a time. Users may change the jurisdiction. In the chart is one line representing the reported values, and associated unfilled datapoints representing predicted values. Select Jurisdiction. This visualization presents a map of the United States, with each state filled with a color representing the percent increase or decrease in drug overdose deaths over the previous 12 months. There are 10 color categories, with deepest blue representing a decrease in percentage and deepest red indicating an increase. Select predicted or reported number of deaths Predicted Reported. Percent Change for United States. Data Table for Figure 1a. Select specific drugs or drug classes Select drug class. Cocaine T This visualization includes a line chart with up to 9 lines, each displaying a different drug class for the selected jurisdiction. The x-axis has a tick for each month, for 12 month-ending period, from , and the y-axis displays the number of deaths. Each line includes visible circles for the predicted values, and invisible circles along the line for reported values. Each line is a different color, with up to 9 options, including: cocaine, heroin, methadone, natural and semi-synthetic opioids, natural and semi-synthetic opioids including methadone, natural, semi-synthetic and synethetic opioids including methadone, opioids, psychostimulants with abuse potential, and synthetic opioids excluding methadone. Legend for Drug or Drug Class. Data Table for Figure 2. Technical notes Nature and sources of data Provisional drug overdose death counts are based on death records received and processed by the National Center for Health Statistics NCHS as of a specified cutoff date. Selection of specific states and other jurisdictions to report Provisional counts are presented by the jurisdiction in which the death occurred i. Drug specificity The percentage of death records in which a specific drug or drug class is identified as involved in a drug overdose death varies by jurisdiction 7. Improvements in Data Quality In order for information on drug-specific overdose deaths to be reported by jurisdiction in the NCHS Vital Statistics Rapid Release Monthly Provisional Drug Overdose Death dashboard, states have been required to meet a set of timeliness and quality criteria consistently for each time point in the long-term trend line shown starting with January Adjustments for delayed reporting Provisional counts of drug overdose deaths are underestimated relative to final counts. Table 1. Completeness of month ending provisional counts of drug overdose deaths relative to final counts from after six-month lag, by reporting jurisdiction and ending month Table 1. Completeness of month ending provisional counts of drug overdose deaths relative to final counts from after six-month lag, by reporting jurisdiction and ending month. Table 2. Model results of the completeness of provisional data by month-ending and percent pending: Drug overdose deaths and deaths involving any opioid. Table 3. Model results of the completeness of provisional data by month-ending and percent pending: deaths involving specific drugs and drug classes. Differences between final and provisional data There may be slight differences between provisional and final data for a given data year e. Timeliness of death certificate data for mortality surveillance and provisional estimates. Methods to adjust provisional counts of drug overdose deaths for underreporting. Vital Statistics Rapid Release; no 6. August Instructions for classifying the underlying cause of death. Published annually. Public Health Reports. State variation in certifying manner of death and drugs involved in drug intoxication deaths. Acad Forensic Pathol 3 2 —7. Drug overdose deaths in the United States, — Facebook Twitter LinkedIn Syndicate. Related Sites.

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