More than 90 people die from overdoses of powerful prescription painkillers called opioids each day in the U.S., a stark picture of the drug abuse epidemic flooding the country today. But the Centers for Disease Control and Prevention (CDC) warns that the actual number of deaths from opioids may be underestimated.
One reason may be how cause of death is listed on death certificate. For example, the Minnesota Department of Health was notified about a middle-aged man who died suddenly at home. The man had been on long-term opioid therapy to treat back pain, and his family worried he was possibly abusing the painkillers. An autopsy revealed the man had pneumonia and a toxic level of opioids in his system. Yet, the death certificate only listed pneumonia as the cause of death. There was no mention of the opioid overdose.
Death certificates limit what researchers can track down within surveillance systems based solely on autopsy report codes. But a team of researchers led by Dr. Victoria Hall, a CDC field officer based in Minnesota, set out to find out how many opioid overdoses go under the radar.
They examined death records within the Minnesota Department of Health’s Unexplained Death surveillance system from 2005 to 2015. The system was set up to identify emerging diseases. Hall and her team searched the records for postmortem toxicology reports and found that among the 1,676 death reports that fit their criteria, 59 – or 3.5 percent – showed evidence opioid use. Those 59 deaths had not been identified by the state’s opioid surveillance system because they were not coded that way. Of the 59, 22 involved toxic levels of opioids.
“It’s quite concerning, because it means that the (opioid) epidemic, which is already quite severe, could potentially be even worse,” Hall said.