As the opioid epidemic surges, Alabama’s toxicologists are testing more blood samples from overdose victims to determine what drugs were in their bodies.
But the results of those costly and time-consuming tests are not always ending up on death certificates. More often than not, when overdose victims are found to have multiple drugs in their bodies, coroners simply write “multiple drug toxicity†or “drug overdose†on the death certificate, says Alabama’s forensic science chief Michael Sparks.
As a result, public health officials in Alabama and at the U.S. Centers for Disease Control and Prevention (CDC) can be left in the dark as to which drugs are causing the most deaths. The lack of specificity can hamper states in developing potentially life-saving strategies for preventing overdoses.
Alabama was the least precise state when it came to drug overdose reporting in 2014, according to a CDC analysis of death certificate data from all 50 states.
U.S. opioid overdose deaths, including prescription painkillers and heroin, exceeded 28,000 in 2014, with a one year increase of 14 percent.
Eighty-one percent of all death certificates for a drug overdose listed the drugs involved. That number has grown in the last five years as states have stepped up efforts to include more details about overdoses to help develop strategies for quelling the opioid epidemic.
“We’ve been saying drug overdoses were a problem since 2006, but it wasn’t until it got to much higher levels around 2010 that people started waking up and saying ‘Oh, we need to do something about this,’ †said Robert Anderson, chief of the mortality statistics branch of the CDC.
Still, it’s taken some states longer than others to relay the message to the coroners, physicians and medical examiners who fill out death certificates at the local level, he said.
In Alabama, only 48 percent of death certificates mentioned the drugs involved in 2014, followed by Louisiana (49 percent), Indiana, Mississippi and Pennsylvania (all 50 percent), Montana (63 percent), Idaho (64 percent) and Michigan and New Jersey (both 70 percent).
In contrast, nine other states — Utah, New Mexico, Massachusetts, West Virginia, Vermont, Maine, New Hampshire, Connecticut and Rhode Island — listed the drugs involved in fatal overdoses on 98 percent or more of death certificates.
