What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles

Bibliographic Data

ID21594828
AuthorsJoseph Friedman (0000-0002-5225-3267, University of California San Diego, corresponding author), Ruby Romero (0000-0002-7977-2585, University of California, Los Angeles), Arthur Funnell (0009-0003-5556-0339, Southern California Clinical and Translational Science Institute), David Goodman-Meza (0000-0001-9382-3564), Chelsea L Shover (0000-0002-0728-4101, University of California, Los Angeles)
Year2026
Volume148
Pages105129
Publication date2026-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Drug Policy (JOURNAL)
Journal identifiersISSN: 0955-3959 • E-ISSN: 1873-4758
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.drugpo.2025.105129
PMID41468628
OpenAlexW7117559390
LanguageEN
References cited18

Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis grows increasingly polysubstance in nature, improving the epidemiological tracking of deaths involving multiple drugs, and drugs not captured by ICD-10 codes currently, is of paramount importance

Concordance · Medical examiner · Medical record · Poison control · Polysubstance dependence · Suicide prevention · Wonder · Forensic Toxicology and Drug Analysis · Opioid Use Disorder Treatment · Pharmacovigilance and Adverse Drug Reactions · Epidemiology

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