News: Opioid deaths 70,000 higher than previous estimates between 1999-2015

Because coroners and medical examiners did not specify the drugs contributing to death, potentially 70,000 opioid-related overdose deaths from 1999-2015 were excluded from national figures, according to MedPage Today.

“Our new research tells us that several states are likely dramatically underestimating the effect of opioid-related deaths because of incomplete drug reporting on death certificates,” Jeanine Buchanich, PhD, MEd, from the University of Pittsburgh, and coauthor of the study, told MedPage Today.

Drug-specific overdose deaths are identified by ICD-10 T codes, which are assigned by the coroner or medical examiner completing the death certificate, according to MedPage Today. For the study, the researchers abstracted unintentional drug overdose deaths with contributory T codes from the Mortality Multiple Cause Data Files of the National Center for Health Statistics from 1999-2015.

Then, the team reallocated unspecified overdose deaths for each state and year, assuming that their proportion would be the same as the proportion of opioid-related deaths among all fatal overdoses, MedPage Today reported.

In Alabama, Indiana, Louisiana, Mississippi, and Pennsylvania, more than 35% of overdose death certificates didn’t name a drug, according to the researchers. According to MedPage Today, the reallocation reclassified more than 70,000 unspecified fatal overdoses to opioid-related deaths, ranging from nine in Vermont to 11,152 in Pennsylvania.

According to Buchanich, part of the issue may stem from the fact that many states do not require the elected coroners to be physicians. And, states that had a decentralized county coroner system or a hybrid system with county coroners and medical examiners had higher proportions of unspecified drug codes, she told MedPage Today.

Despite the drastic underreporting the research suggests, the researchers did find that several states made progress in improving reporting over the time period. For instance, according to Buchanich, Kentucky’s opioid-related drug codes increased 43% in the time frame and their unspecified drug reporting decreased by 28%.

Editor’s note: To read MedPage Today’s coverage of this story, click here. To read the complete study, click here. To read a Q&A about capturing a patient’s true severity of illness on their death chart, click here.