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Identifying Unreported Opioid Deaths Through Toxicology Data and Vital Records Linkage

Case Study in Marion County, Indiana, 2011–2016

Bibliographic Data

ID11026409
AuthorsEvan Marie Lowder (0000-0002-5855-2479, Evan M. Lowder and Bradley R. Ray are with the School of Public and Environmental Affairs, Indiana University–Purdue University Indianapolis, Indianapolis. At the time of this study, Philip Huynh and Dennis P. Watson were with the Center for Health Engagement and Equity Research, Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indiana University–Purdue University. Alfarena Ballew is with the Marion County Coroner’s Office, Indianapolis.), B Ray (0000-0003-3643-775X, Indiana University – Purdue University Indianapolis), Bradley R Ray (Evan M. Lowder and Bradley R. Ray are with the School of Public and Environmental Affairs, Indiana University–Purdue University Indianapolis, Indianapolis. At the time of this study, Philip Huynh and Dennis P. Watson were with the Center for Health Engagement and Equity Research, Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indiana University–Purdue University. Alfarena Ballew is with the Marion County Coroner’s Office, Indianapolis.), Philip Huynh (0000-0002-2361-8925, Evan M. Lowder and Bradley R. Ray are with the School of Public and Environmental Affairs, Indiana University–Purdue University Indianapolis, Indianapolis. At the time of this study, Philip Huynh and Dennis P. Watson were with the Center for Health Engagement and Equity Research, Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indiana University–Purdue University. Alfarena Ballew is with the Marion County Coroner’s Office, Indianapolis.), Alfarena Ballew (Evan M. Lowder and Bradley R. Ray are with the School of Public and Environmental Affairs, Indiana University–Purdue University Indianapolis, Indianapolis. At the time of this study, Philip Huynh and Dennis P. Watson were with the Center for Health Engagement and Equity Research, Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indiana University–Purdue University. Alfarena Ballew is with the Marion County Coroner’s Office, Indianapolis.), Dennis P Watson (0000-0001-7208-5160, Evan M. Lowder and Bradley R. Ray are with the School of Public and Environmental Affairs, Indiana University–Purdue University Indianapolis, Indianapolis. At the time of this study, Philip Huynh and Dennis P. Watson were with the Center for Health Engagement and Equity Research, Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indiana University–Purdue University. Alfarena Ballew is with the Marion County Coroner’s Office, Indianapolis.)
Year2018
Volume108
Issue12
Pages1682-1687
Publication date2018-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2018.304683
PMID30359109
OpenAlexW2898276228
LanguageEN
Citations received1
References cited17

Objectives. To demonstrate the severity of undercounting opioid-involved deaths in a local jurisdiction with a high proportion of unspecified accidental poisoning deaths. Methods. We matched toxicology data to vital records for all accidental poisoning deaths (n = 1238) in Marion County, Indiana, from January 2011 to December 2016. From vital records, we coded cases as opioid involved, specified other substance, or unspecified. We extracted toxicology data on opioid substances for unspecified cases, and we have reported corrected estimates of opioid-involved deaths after accounting for toxicology findings. Results. Over a 6-year period, 57.7% of accidental overdose deaths were unspecified and 34.2% involved opioids. Toxicology data showed that 86.8% of unspecified cases tested positive for an opioid. Inclusion of toxicology results more than doubled the proportion of opioid-involved deaths, from 34.2% to 86.0%. Conclusions. Local jurisdictions may be undercounting opioid-involved overdose deaths to a considerable degree. Toxicology data can improve accuracy in identifying opioid-involved overdose deaths. Public Health Implications. Mandatory toxicology testing and enhanced training for local coroners on standards for death certificate reporting are needed to improve the accuracy of local monitoring of opioid-involved accidental overdose deaths

Biology · Environmental health · Linkage (software) · Opioid · Forensic Toxicology and Drug Analysis · Internal Medicine · Medicine · Opioid Use Disorder Treatment · Poisoning and overdose treatments

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    Theodore L Caputi, Kevin A Sabet•American Journal of Public Health•2018

Unique citing works1
Citations per year0,17
Citation span2020 - 2020 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1

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