Background
Drug poisoning mortality
in the US has risen rapidly but the drugs involved are frequently unspecified
on death certificates.
Methods
Reported and adjusted
proportions of specific drug types involved in fatal drug poisonings were
calculated using vital statistics mortality data from 1999 to 2012. The
adjusted proportions were those predicted to occur if at least one specific
type of drug had been identified on the death certificates of all poisoning
fatalities.
Results
Adjusted involvement
rates of opioid analgesic mentions in 2012 were 54.3 % (95 %
confidence interval [CI]: 53.6 %–55 %), 40.8 % higher than the
reported 38.6 % rate. Adjusted rates for all narcotics, other narcotics,
sedatives, or psychotropics, and multiple drug use were 81.5 % (95 %
CI: 80.9 %–82.2 %), 38.4 % (95 % CI:
37.8 %–39 %), 30 % (95 % CI: 29.4 %–30.7 %),
26 % (95 % CI: 25.4 %–26.6 %) and 42.8 % (95 %
CI: 42.1 %–43.5 %) in 2012, compared to reported proportions of 60.7,
27.9, 18.7, 18 and 26.9 %. The adjustments typically had similar or
slightly smaller effects on the estimates in 1999, and larger impacts on
subcategories of drug types such benzodiazepines and antipsychotic medications.
Based on the adjusted proportions, 22,534, 15,933, 12,457, 10,798, and 17,670
drug deaths in 2012 were estimated to involve opioid analgesics, other
narcotics, sedatives, psychotropic medications, and drug combinations, compared
to death certificate reports of 16,007, 11,567, 7,754, 7,467, and 11,176.
Conclusions
Death certificates
substantially understate the involvement of opioid analgesics, sedatives,
psychotropics, and drug combinations in fatal drug poisonings. Adjustment
procedures that account for cases where only unspecified drugs are reported on
death certificates provide more accurate information.
Below: Poisoning and drug poisoning mortality rates
Below: Drug specification rate
Full article at: http://goo.gl/fkQHNN
Frank Batten
School of Leadership and Public Policy, University of Virginia, Garrett Hall
204, 235 McCormick Road, P.O. Box 400893, Charlottesville, VA 22904-4893 USA
National Bureau
of Economic Research, Cambridge, MA USA
Christopher J. Ruhm, Phone: +1-434-243-3729, Email: ude.ainigriv@mhur.
More at: https://twitter.com/hiv insight
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