Introduction
An important barrier to formulating effective policies to address the rapid rise in
U.S. fatal overdoses is that the specific drugs involved are frequently not identified
on death certificates. This analysis supplies improved estimates of state opioid and
heroin involved drug fatality rates in 2014, and changes from 2008 to 2014.
Methods
Reported mortality rates were calculated directly from death certificates and compared
to corrected rates that imputed drug involvement when no drug was specified. The analysis
took place during 2016–2017.
Results
Nationally, corrected opioid and heroin involved mortality rates were 24% and 22%
greater than reported rates. The differences varied across states, with particularly
large effects in Pennsylvania, Indiana, and Louisiana. Growth in corrected opioid
mortality rates, from 2008 to 2014, were virtually the same as reported increases
(2.5 deaths per 100,000 people) whereas changes in corrected heroin death rates exceeded
reported increases (2.7 vs 2.3 per 100,000). Without corrections, opioid mortality
rate changes were considerably understated in Pennsylvania, Indiana, New Jersey, and
Arizona, but dramatically overestimated in South Carolina, New Mexico, Ohio, Connecticut,
Florida, and Kentucky. Increases in heroin death rates were understated in most states,
and by large amounts in Pennsylvania, Indiana, New Jersey, Louisiana, and Alabama.
Conclusions
The correction procedures developed here supply a more accurate understanding of geographic
differences in drug poisonings and supply important information to policymakers attempting
to reduce or slow the increase in fatal drug overdoses.
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Article Info
Publication History
Published online: August 07, 2017
Identification
Copyright
© 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
