New model gives more accurate picture of opioid, heroin fatalities

One-quarter of all death certificates fail to distinguish the specific drug responsible for the cause of death.

By Amy Wallace
New research provides a correction procedure to more accurately estimate state opioid and heroin death rates. File photo by Maxal Tamor/Shutterstock
New research provides a correction procedure to more accurately estimate state opioid and heroin death rates. File photo by Maxal Tamor/Shutterstock

Aug. 7 (UPI) -- Researchers develop a correction procedure to refine state-by-state mortality rates to better identify the number of deaths from opioid and heroin use.

There were 36,450 fatal overdoses nationwide in 2008 and 47,055 in 2014, but half of the overdose fatalities reported unspecified drugs and in one-fifth to one-quarter, it was the only drug-related designation included.


The study, published in the August edition of the American Journal of Preventive Medicine, shows a new, more accurate picture of the rates of opioid and heroin deaths across the country.

Researchers found that the corrected mortality rates were 24 percent higher for opioids and 22 percent higher for heroin nationally.

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"A crucial step to developing policy to combat the fatal drug epidemic is to have a clear understanding of geographic differences in heroin- and opioid-related mortality rates," Christopher J. Ruhm, of the Frank Batten School of Leadership and Public Policy at the University of Virginia, said in a press release. "The information obtained directly from death certificates understates these rates because the drugs involved in the deaths are often not specified."

The corrected estimates can differ significantly from reported rates for example, the opioid and heroin death rates based on death certificate reports in Pennsylvania in 2014 were 8.5 and 3.9 per 100,000 people respectively. However, drug categories were only specified in half of the fatal overdose deaths.


Using the correction procedure showed actual opioid and heroin overdose deaths of 17.8 and 8.1 per 100,000 respectively.

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"For instance, Pennsylvania had the 32nd highest reported opioid mortality rate and the 20th highest reported heroin death rate, but ranked seventh and fourth based on corrected rates," Ruhm said.

"Similarly, Indiana's rankings moved from 36th and 29th to 15th and 19th, respectively, and Louisiana's from 40th and 31st to 21st and 20th, respectively. There were 19 states whose corrected and reported opioid rankings differed by at least five places and eight states where this occurred for heroin."

Researchers used the 2008 and 2014 Centers for Disease Control and Prevention Multiple Cause of Death, or MCOD, files in the study.

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The MCOD data gave information from death certificates on a single underlying cause of death, up to 20 additional causes and also showed age, race/ethnicity, gender, and time and place of death.

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