Using death scene and toxicology evidence to define involvement of heroin, pharmaceutical morphine, illicitly manufactured fentanyl, and pharmaceutical fentanyl in opioid overdose deaths, 38 states and the District of Columbia, January 2018–December 2019

Original research
by
O'Donnell, Julie et al

Release Date

2021

Geography

USA

Language of Resource

English

Full Text Available

No

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

This study aimed to determine whether integrating death certificate data with medical examiner/coroner reports, including postmortem toxicology and death investigation findings, would enhance identification of 1) heroin and pharmaceutical morphine involvement in overdose deaths and 2) fentanyl source (illicitly manufactured vs. pharmaceutical).

Findings/Key points

The enhanced definition defined 18,393 deaths as confirmed, probable, or suspected heroin deaths (including 2,678 with morphine listed as cause of death on the DC), and 404 as probable pharmaceutical morphine deaths. Among deaths with fentanyl detected, 89.3% were defined as probable or suspected IMF and 1.0% as probable pharmaceutical fentanyl. Fentanyl source could not be determined for 9.7% of deaths.

Design/methods

Opioid overdose decedents from funded jurisdictions; deaths during January 1, 2018–December 31, 2019.
doi.org

Keywords

Overdose
Mortality
Evidence base
Illegal drugs