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article imageNew study — Opioid deaths are 24 percent higher than we thought

By Karen Graham     Aug 8, 2017 in Health
Charlottesville - The grim death statistics are hard to swallow - 91 Americans die every day from an opioid overdose. But even with the disturbing numbers, a University of Virginia researcher says we are under-counting by about 24 percent.
The new study, published in the American Journal of Preventive Medicine, describes a method to fill in the blanks on death certificates. Dr. Christopher Ruhm, a professor of public policy and economics in the Frank Batten School of Leadership and Public Policy at the University of Virginia, says we are under-reporting opioid and heroin-related mortality figures by as much as 24 percent.
As Dr. Ruhm points out, while the opioid crisis is at epidemic proportions, the incidence of addiction varies from state to state, as does the proportion of opioid versus heroin deaths. Added to the lack of specific data is the fact that fully one-fourth of all death certificates fail to note the specific drug responsible for the death of the individual.
That failure adds to the difficulty of targeting enforcement and treatment programs at both the state and federal levels. However, the new research paper presents a corrective procedure that redefines the data, resulting is major shifts in the state-by-state statistics on drug overdose deaths.
Preparing heroin for injection.
Preparing heroin for injection.
Psychonaught | Wikimedia Commons
Virginia, along with states like Vermont and South Dakota identified the specific drug on death certificates over 95 percent of the time. For example, the Office of the Attorney General in Virginia estimates that over 900 residents died from heroin or opioid overdoses in the state in 2015.
To explain his findings, Dr. Ruhm says he used "statistical analysis to account for the roughly 20 to 25 percent of death certificates for which an overdose is listed as the suspected cause of death, but no drug is specified." By comparing death certificates from areas with similar demographics but more accurate reporting of specific drugs with certificates lacking drug information, he was able to show that "national estimates for specific types of drug involvement are 30 to 50 percent lower than they should be."
The information used in the study was obtained from the 2008 and 2014 Centers for Disease Control and Prevention Multiple Cause of Death (MCOD) files. The MCOD files included information on a single underlying cause of death and up to 20 additional causes, and also provided age, race/ethnicity, gender, year, weekday, and place of death.
Why is accurate reporting of specific drugs involved in an overdose death important? Generally, in the area of funding, federal policies specifically target states with severe opioid or heroin problems. However, more to the point, "geographic disparities in drug poisoning deaths are substantial and a correct assessment of them is almost certainly a prerequisite for designing policies to address the fatal drug epidemic," concludes Dr. Ruhm.
More about opioid crisis, statistical models, 24 percent higher, CDC, death certificates