provisional counts

A death is only counted once its record reaches the National Center for Health Statistics from a state vital registration office, and drug overdose deaths take longer to arrive than most, because they need investigation and toxicology testing before a cause can be assigned. NCHS therefore publishes provisional counts, based on the records received and processed as of a cutoff date, generally the first Sunday of the month. Provisional estimates of overdose deaths are reported four months after the date of death, shortened from six months in February 2022.

Two numbers are published side by side. Reported counts are the deaths actually received for the period, and NCHS says they are often incomplete, with causes still pending investigation, which makes them an underestimate relative to final counts. Predicted counts are those same figures adjusted by a method that models typical reporting delay, and they are what news coverage usually quotes.

Both are revised. Each monthly release updates earlier periods as more records arrive, and where a state is running slower than usual the adjustment may not fully absorb the delay. A provisional figure is therefore a good estimate of a trend and a poor final answer: the number will move, and only the final annual file settles it.