The opioid crisis has put severe strains on the system through which deaths are analyzed and reported in the United States. Opioid deaths are expensive to investigate because they require autopsies and sophisticated toxicology. As the number of opioid deaths grow, the system, which was already stressed, became unable to cope with the increasing demand. This paper reviews the issues, and proposes a different way of thinking about the information required.
Statistics Canada; Available from: https://www150.statcan.gc.ca/n1/pub/12-539-x/2009001/administrative-administratives-eng.htm.
2.
National Center for Health Statistics; 2003. Available from: https://www.cdc.gov/nchs/data/dvs/death11-03final-acc.pdf.
3.
HanzlickR. Death Registration: History, Methods, and Legal Issues. Journal of Forensic Sciences. 1997; 42(2): 265–269.
4.
Centers for Disease Control and Prevention. Coroner Training Requirements; 2016. Available from: https://www.cdc.gov/phlp/publications/coroner/training.html.
5.
HickmanJMHughesKASternKJRupero-MillerJD. Medical Examiners and Coroners Offices. U.S. DOJ Bureau of Justice Statistics; 2004. Report NCJ216756.
6.
HoffCJBRatradR. Louisiana Death Certificate Accuracy: A Concern for the Public’s Health. Journal of the Louisiana State Medical Society. 2010; 162: 350–352.
7.
RobinsonR. County Coroners and their role in the heart of the opioid epidemic. Academic Forensic Pathology. 2017 March; 7(1): 80–86.
8.
SlavonaSO’BrienDBCreppageKDaoDFondarioAHaileE, et al. Drug Overdose Deaths: Let’s Get Specific. Public Health Reports. 2015; 130: 339–342.
9.
RoxburghAPilrimJLHallWDBurnsL. Accurate identification of opioid overdose deaths using coronial data. Forensic Science International. 2018; 287: 40–46.
10.
GoldbergerBAMaxwellJCCampbellAWilfordBB. Uniform Standards and Case Definitions for Classifying Opioid-Related Deaths: Recommendations by a SAMHSA Concensus Panel. Journal of Addicitive Diseases. 2013; 32(3): 231–243.
11.
WilliamsKEJanssenJ. Guidelines for the Interpretation of Toxicology reports in Instances of Apparent Overdose Death; 2017. Unpublished manuscript.
12.
WarnerMPaulozziLJNobleKBDavisGG. State Variation in Certifying Manner of Death and Drugs Involved in Drug Intoxication Deaths. Academic Forensic Pathology. 2013; 3(2): 231–237.
National Institute on Drug Abuse. Overdose Death Rates; Available from: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.
15.
Centers for Disease Control and Prevention. Data Brief 294. Drug Overdose Deaths in the United States, 1999–2016; Available from: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.
16.
RuhmCJ. Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates. American Journal of Preventive Medicine. 2017; 53(6): 745–753.
17.
DavisGC, the National Association of Medical Examiners and the American College of Medical Toxicology Expert Panel. Evaluating and Reporting Opioid Deaths. Journal of Medical Toxicology. 2014; 10: 100–106.
18.
CochranWG. Sampling Techniques. 3rd ed. New York: J. Wiley & Sons; 1977.
19.
U S Department of Transportation. National Motor Vehicle Crash Causation Survey; 2008. Available from: https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/811059.
20.
Healthcare Cost and Utilization Project. Nationwide HCUP Databases; Available from: https://www.hcup-us.ahrq.gov/databases.jsp.
