Development of a Coroner-Based Surveillance System for Drug-Related Deaths in Los Angeles County
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Existing data sources do not provide comprehensive and timely information to adequately monitor drug-related mortality in Los Angeles County. To fill this gap, a surveillance system using coroner data was developed to examine patterns in drug-related deaths. The coroner provided data on all injury deaths in Los Angeles County. A list of keywords that indicate a death was caused by drug use was developed. The cause of death variables in the coroner data were searched for mentions of one of the keywords; if a keyword was detected, that death was classified as drug related. The effectiveness of the keyword list in classifying drug-related deaths was evaluated by matching records in the coroner death data to records in the state death files. Then, the drug-related deaths identified using the keywords were compared to drug-related deaths in the state mortality files identified using International Classification of Death codes. Toxicological test results were used to categorize drug-related deaths based on the type and legality of the drug(s) ingested. Mortality rates were calculated for each category of drug and legal status and for different demographic groups. Compared to the gold standard state mortality files, the coroner data had a sensitivity of 95.6% for identifying drug-related deaths. Over three quarters of all drug-related deaths tested positive for opiates and/or stimulants. Males, Whites, and 35–54-year-olds each accounted for more than half of all drug-related deaths. The surveillance of drug-related deaths using coroner data has several advantages: data are available in a timely fashion, the data include information about the specific substances each victim ingested, and the data can be broken down to compare mortality among specific subpopulations.
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) 2006. Accessed on: June 5, 2009. Available at: www.cdc.gov/ncipc/wisqars.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Increases in age-group-specific injury mortality—United States, 1999–2004. MMWR Morb Mortal Wkly Rep. 2007;56:1281-1284.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Unintentional and undetermined poisoning deaths—11 states, 1990–2001. MMWR Morb Mortal Wkly Rep. 2004;53:233-238.
- Fernandez W, Hackman H, Mckeown L, Anderson T, Hume B. Trends in opioid-related fatal overdoses in Massachusetts, 1990–2003. J Subst Abuse Treat. 2006;31:151-156. CrossRef
- Fingerhut L, Cox C. Poisoning mortality 1985–1995. Public Health Rep. 1998;113:217-233.
- Heinen M, Hall MJ, Boudrault MA, Fingerhut LA. Appendix table 12a. Poisoning and toxic effects hospital discharges by diagnosis, 1979-2001. in: National trends in injury hospitalizations, 1979-2001. Hyattsville, MD: National Center for Health Statistics, March 2005.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Increase in poisoning deaths caused by non-illicit drugs—Utah, 1991–2003. MMWR Morb Mortal Wkly Rep. 2005;54:33-36.
- Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf. 2006;15:618-627. CrossRef
- Wysowski DK. Surveillance of prescription drug-related mortality using death certificate data. Drug Saf. 2007;30:533-540. CrossRef
- Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology. Mortality in Los Angeles County 2005: Leading causes of death and premature death. Accessed on: July 2008 and available at: http://publichealth.lacounty.gov/dca/dcareportspubs.htm.
- Seal KH, Thawley R, Gee L, et al. Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: a pilot intervention study. J Urban Health. 2005;82:303-311.
- Kerr T, Tyndall MW, Lai C, Montaner JSG, Wood E. Drug-related overdoses within a medically supervised safer injection facility. Int J Drug Policy. 2006;17:436-441. CrossRef
- Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future national results on adolescent drug use: Overview of key findings, 2008 (NIH Publication No. 09-7401). Bethesda, MD: National Institute on Drug Abuse, 2009.
- Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville, MD, 2008.
- Brecht M. Patterns and Trends in Drug Abuse in Los Angeles County, California: June 2008 Update. In: Proceedings of the Community Epidemiology Work Group, Vol II, June 2008. (NIH Publication No. 09-6422). Bethesda, MD: National Institute on Drug Abuse, 2009.
- Corkery J. UK drug-related mortality—issues in definition and classification. Drugs Alcohol Today. 2008;8:17-25.
- Hickman M, Madden P, Henry J, et al. Trends in drug overdose deaths in England and Wales 1993–1998: methadone does not kill more people than heroin. Addiction. 2003;98:419-425. CrossRef
- Hoppe-Roberts J, Lloyd L, Chyka P. Poisoning mortality in the United States: comparison on national mortality statistics and poison control center reports. Ann Emerg Med. 2000;35:440-448.
- Blanc PD, Jones MR, Olson KR. Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the drug abuse warning network. Am J Emerg Med. 1993;11:14-19. CrossRef
- Linakis JG, Frederick KA. Poisoning deaths not reported to the regional poison control center. Ann Emerg Med. 1993;22:1822-1828. CrossRef
- Shah NG, Lathrop SL, Reichard RR, Landen MG. Unintentional drug overdose death trends in New Mexico, USA, 1990–2005: combinations of heroin, cocaine, prescription opioids and alcohol. Addiction. 2007;103:26-36.
- Mueller MR, Shah NG, Landen MG. Unintentional prescription drug overdose deaths in New Mexico, 1994–2003. Am J Prev Med. 2006;30:423-429. CrossRef
- Bryant WK, Galea S, Tracy M, Piper TM, Tardiff KJ, Vlahov D. Overdose deaths attributed to methadone and heroin in New York City, 1990–1998. Addiction. 2004;99:846-854. CrossRef
- Coffin PO, Galea S, Ahern J, Leon AC, Vlahov D, Tardiff K. Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990–98. Addiction. 2003;98:739-747. CrossRef
- Galea S, Ahern J, Tardiff K, et al. Racial/ethnic disparities in overdose mortality trends in New York City, 1990–1998. J Urban Health. 2003;80:201-211.
- World Health Organization. International Statistical Classification of Diseases and Related Health Problems. Tenth Revision, Volume 3. Geneva: World Health Organization; 1994.
- Office of National Statistics. Deaths related to drug poisoning: England and Wales, 2002–2006. Health Stat Q [online]. 2007; 36:66-72. [cited 2008 March 19]. Accessed on: March 19, 2008. Available from http://www.statistics.gov.uk/downloads/theme_health/HSQ36.pdf
- Last JM. A dictionary of epidemiology. 4th ed. New York: Oxford University Press; 2001.
- Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network. Drug Reference Vocabulary [online]. 2009 [cited 2009 June 6]. Accessed on: June 6, 2009. Available from http://dawninfo.samhsa.gov/drug_vocab/.
- Davidson PJ, McLean RL, Kral AH, Gleghorn AA, Edlin BR, Moss AR. Fatal heroin-related overdose in San Francisco, 1997–2000: a case for targeted intervention. J Urban Health. 2003;80:261-273. CrossRef
- Fugelstad A, Ahlner J, Brandt L, et al. Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users. Addiction. 2003;98:463-470. CrossRef
- Landen MG, Castle S, Nolte KB, et al. Methodological issues in the surveillance of poisoning, illegal drug overdose, and heroin overdose deaths in New Mexico. Am J Epidemiol. 2003;157:273-278. CrossRef
- Graham JK, Hanzlick R. Accidental drug deaths in Fulton County, Georgia, 2002: characteristics, case management and certification issues. Am J Forensic Med Pathol. 2008;29:224-230. CrossRef
- Sorg MH, Greenwald M. Patterns of drug-related mortality in Maine, 1997–2002. Maine Policy Rev. 2003;12:84-96.
- Poulin C, Stein J, Butt J. Surveillance of drug overdose deaths using medical examiner data. Chronic Dis Can. 1998;19:177-182.
- Darke S, Kaye S, Duflou J. Cocaine-related fatalities in New South Wales, Australia 1993–2002. Drug Alcohol Depend. 2005;77:107-114. CrossRef
- Oliver P, Keen J. Concomitant drugs of misuse and drug using behaviors associated with fatal opiate-related poisonings in Sheffield, UK, 1997–2000. Addiction. 2003;98:191-197. CrossRef
- Hickman M, Carrivick S, Paterson S, et al. London audit of drug-related overdose deaths: characteristics and typology, and implications for prevention and monitoring. Addiction. 2006;102:317-323. CrossRef
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Heroin overdose deaths—Multnomah County, Oregon, 1993–1999. MMWR Morb Mortal Wkly Rep. 2000;49:633-636.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Unintentional opiate overdose deaths—King County, Washington, 1990–1999. MMWR Morb Mortal Wkly Rep. 2000;49:636-640.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. Unintentional deaths from drug poisoning by urbanization of area—New Mexico, 1994–2003. MMWR Morb Mortal Wkly Rep. 2005;54:870-873.
- Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Drug Abuse Warning Network, 2004: Area Profiles of Drug-Related Mortality. DAWN Series D-31, DHHS Publication No. (SMA) 08-4346. Rockville, MD, 2008.
- Joranson DE, Gilson AM. Wanted: a public health approach to prescription opioid abuse and diversion. Pharmacoepidemiol Drug Saf. 2006;15:632-634. CrossRef
- Zacny J, Bigelow G, Compton P, Foley K, Iguchi M, Sannerud C. College on problems of drug dependence taskforce on prescription opioid non-medical use and abuse: position statement. Drug Alcohol Depend. 2003;69:215-232. CrossRef
- Huang B, Dawson DA, Stinson FS, et al. Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: results of the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry. 2006;67:1062-1073. CrossRef
- Fischer B, Rehm J. Understanding the parameters of non-medical use of prescription drugs: moving beyond mere numbers. Addiction. 2007;102:1931-1932. CrossRef
- CA Health and Safety Code, Section 11362.5-11362.9. Accessed on: March 3, 2010. Available at: http://www.leginfo.ca.gov/calaw.html.
- Development of a Coroner-Based Surveillance System for Drug-Related Deaths in Los Angeles County
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Volume 87, Issue 4 , pp 656-669
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