@article{ref1,
title="Linking death certificates, postmortem toxicology, and prescription history data for better identification of populations at increased risk for drug intoxication deaths",
journal="Pharmaceutical medicine",
year="2017",
author="Corey, Tracey and Hargrove, Sarah L. and Bunn, Terry L. and Slavova, Svetla and Ingram, Van",
volume="31",
number="3",
pages="155-165",
abstract="OBJECTIVEsOur objective was to assess and improve the completeness of drug-related information, to evaluate the risk for drug intoxication deaths associated with specific drugs among different demographic groups, and to show the benefit of multi-source surveillance to better target interventions and to inform policy evaluation.<br><br>METHODSThis study linked death certificate, prescription drug monitoring program, and postmortem toxicology data for Kentucky residents aged ≥18 years who died from drug intoxication during 2013-2014.<br><br>RESULTSThe most frequently listed contributing drugs were pharmaceutical opioids (60%), alprazolam (35%), and heroin (29%) (not mutually exclusive). The highest death rates from fentanyl (4 per 100,000 Kentucky population aged ≥18 years) and heroin (13 per 100,000) intoxication were among those aged 25-34 years, whereas the highest death rates associated with prescription opioids (excluding morphine and fentanyl) were among those aged 35-54 years (15 per 100,000). Appalachian county residents had a significantly higher intoxication fatality rate (34 per 100,000) than residents from non-Appalachian counties (27 per 100,000). One-quarter of death certificates did not list any specific contributing drug, but postmortem toxicology reports were available for 89% of these cases and provided information on drugs used before death. Analysis of decedents' controlled substance prescription records suggested drug diversion (e.g., only 36% of the decedents who tested positive for oxycodone had recently filled prescriptions).<br><br>CONCLUSIONSThe abuse and diversion of drugs significantly impact the health and safety of Kentucky citizens. This study demonstrated the benefit of integrated multi-source drug intoxication fatality surveillance to identify drug misuse and diversion and population groups at high risk for drug poisoning mortality and to inform targeted prevention programs.<p /> <p>Language: en</p>",
language="en",
issn="1178-2595",
doi="10.1007/s40290-017-0185-7",
url="http://dx.doi.org/10.1007/s40290-017-0185-7"
}