Using textual cause-of-death data to study drug poisoning deaths.

Area of Science:

• Epidemiology
• Toxicology
• Public Health

Background:

• Death certificates are crucial for poisoning death epidemiology.
• International Classification of Diseases (ICD) codes lack detailed substance information.
• The SuperMICAR system captures verbatim cause-of-death text.

Purpose of the Study:

• To analyze drug involvement in poisoning deaths using SuperMICAR text data.
• To identify frequently named substances and drug classes in mortality data.
• To compare the role of prescription versus illicit drugs in poisoning fatalities.

Main Methods:

• Utilized SuperMICAR text entries for 7,817 Washington State poisoning deaths (2003-2010).
• Tabulated named drugs and calculated age-adjusted/specific death rates.
• Categorized substances into prescription and illicit drug classes.

Main Results:

• Methadone was the most frequently named substance (2,149 certificates), followed by alcohol, opiates, cocaine, oxycodone, and methamphetamine.
• Prescription drugs were involved in more deaths than illicit drugs across all demographics.
• Only 4 of the top 25 most frequent drugs have unique ICD codes, highlighting data limitations.

Conclusions:

• Verbatim death certificate text is essential for comprehensive poisoning death analysis.
• Methadone and prescription drugs represent significant contributors to poisoning mortality.
• Enhanced data capture beyond standard ICD codes is needed for accurate drug-related death surveillance.