Potentially 70,000 Opioid-Related Overdose Deaths Undercounted

MedicalResearch.com Interview with:

Jeanine M. Buchanich, Ph.D. Research associate  Professor in the University of Pittsburgh Graduate  School of Public Health’s Department of Biostatistics

Dr. Buchanich

Jeanine M. Buchanich, Ph.D.
Research associate
Professor in the University of Pittsburgh Graduate
School of Public Health’s Department of Biostatistics

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In the U.S., cause of death codes are assigned by the National Center for Health Statistics (NCHS) using information reported by the coroner or medical examiner completing the death certificate. Drug-specific overdose deaths are identified by the contributory causes of death, which are categorized as “T codes” and are assigned based on the specific drugs recorded by the coroner or medical examiner completing the death certificate. A code of T50.9 means “other and unspecified drugs, medicaments and biological substances.”

My colleagues and I extracted death data by state for 1999 through 2015 from the NCHS’s Mortality Multiple Cause Micro-data Files. We grouped overdose deaths into opioid-related, non-opioid-related and unspecified codes. In five states – Alabama, Indiana, Louisiana, Mississippi and Pennsylvania – more than 35 percent of the overdose deaths were coded as unspecified.

We then calculated the change in percentage of overdose deaths that fell into each category from 1999 to 2015 by state. In those 17 years, opioid-related overdose deaths rose 401 percent, non-opioid-related overdose deaths rose 150 percent and unspecified overdose deaths rose 220 percent.

This allowed us to extrapolate how many of the unspecified overdose deaths were likely opioid-related. By our calculations, potentially 70,000 opioid-related overdose deaths were not included in national opioid-related mortality estimates since 1999 because coroners and medical examiners did not specify the drug that contributed to the cause of death when completing the death certificates.  Continue reading