An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates.
Current death certificate data are problematic for understanding the drug poisoning epidemic, with a particular issue being the frequency with which no specific drug is identified. This results in an underestimate of the involvement of specific drugs in fatal overdoses (but not in the overall number of drug fatalities), which is sometimes substantial. For instance, mortality rates calculated using imputed data on specific drugs where such information was lacking on death certificates suggest that in 2014 opioid and heroin involved death rates were understated by more than half in Pennsylvania (8.5 vs 17.8 per 100,000 for opioids and 3.9 vs. 8.1 per 100,000 for heroin).
Via Pharma Guy
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