Coroner

Research Finds Wide Variation on Death Certificates

Research from UVA has found that death certificates often omit the specific cause of death when an overdose is involved, skewing the opioid overdose count much lower. 

As reported by NPR, standards for how to investigate and report on overdoses vary widely across states and counties. As a result, opioid overdose deaths aren’t always captured in the data reported to the federal government. The country is undercounting opioid-related overdoses by 20 to 35 percent, according to a study published in February in the journal Addiction. Some states may be underestimating the impact of opioids by as much as 50%.

“We have a real crisis, and one of the things we need to invest in, if we’re going to make progress, is getting better information,” said Christopher Ruhm, the author of the paper and a health economist at the University of Virginia.

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On a death certificate, coroners and medical examiners often leave out exactly which drug or drugs contributed to a death. “In some cases, they’re classifying it as a drug death, but they don’t list the kind of drug that was involved,” said Ruhm. In the years he reviewed in his paper, 1999 to 2015, investigators didn’t specify a drug in one-sixth to one-quarter of overdose deaths.

Many overdoses not linked to a specific drug were likely opioid-related, Ruhm says, so the lack of specificity leads to undercounting. According to Ruhm’s earlier research published in 2017, Indiana’s opioid overdose fatality rate is especially far off. He estimated the state’s rate in 2014 was 14.3 overdose deaths per 100,000 people, twice as high as the rate reported that year.

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To learn more about the need for better public health data surrounding the opioid crisis, please visit NPR.

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