Journal ArticleDOI
Establishment of a comprehensive drug overdose fatality surveillance system in Kentucky to inform drug overdose prevention policies, interventions and best practices
Sarah L. Hargrove,Terry L. Bunn,Svetla Slavova,Dana Quesinberry,Tracey Corey,William Ralston,Michael Singleton,Van Ingram +7 more
TLDR
A comprehensive multisource DOFSS improved drug overdose fatality surveillance by increasing completeness of data and data quality and is a model that can be considered by other states to enhance their efforts in tracking drug overdose fatalities, identifying new and emerging trends, and informing policies and best practices.Abstract:
Background According to the National Center for Health Statistics, Kentucky had the third highest drug overdose fatality rate in the nation in 2015 at 29.9 drug overdose fatalities per 100 000 population. Objective The elevated drug overdose fatality rate necessitated the development and implementation of a comprehensive multisource drug overdose fatality surveillance system (DOFSS). Methods DOFSS stakeholder work group members and data sources were identified, and memorandums of understanding were established. The following data sources were used to establish DOFSS: (1) death certificates; (2) autopsy reports; (3) toxicology result reports; (4) coroner reports; and (5) Kentucky All Schedule Prescription Electronic Reporting (KASPER) (prescription drug monitoring programme) data. Drug overdose poisonings were defined using Injury Surveillance Workgroup 7 definitions. Analyses were performed to investigate possible drug overdose-related health disparities for disabled drug overdose decedents and to characterise gabapentin in drug overdose deaths. Results DOFSS identified 2106 drug overdose poisoning fatalities in Kentucky for 2013–2014. Identification of specific drugs involved in drug overdose deaths increased from 75.8% using a single data source to 97.5% using multiple data sources. Disabled drug overdose decedents were significantly more likely to have an active prescription for drugs identified in their system compared with the non-disabled drug overdose decedents. Toxicology data showed increased gabapentin involvement in drug overdose deaths from 2.9% in 2013 to 17% in 2014. Alprazolam was found most often in combination with gabapentin (41%), along with various other benzodiazepines and prescription opioids. Conclusions A comprehensive multisource DOFSS improved drug overdose fatality surveillance by increasing completeness of data and data quality. DOFSS is a model that can be considered by other states to enhance their efforts in tracking drug overdose fatalities, identifying new and emerging trends, and informing policies and best practices, to address and reduce drug overdoses.read more
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Journal ArticleDOI
Abuse and Misuse of Pregabalin and Gabapentin: A Systematic Review Update.
Kirk E. Evoy,Sarvnaz Sadrameli,Jillian Contreras,Jordan R. Covvey,Alyssa M. Peckham,Megan D. Morrison +5 more
TL;DR: Evidence suggests that gabapentinoid misuse/abuse represents a growing trend that is causing significant patient harm, and prescribers should exercise appropriate caution with use in high-risk populations and monitor for signs of misuse or abuse.
Journal ArticleDOI
Prevalence of gabapentin in drug overdose postmortem toxicology testing results.
Svetla Slavova,Svetla Slavova,Alison Miller,Terry L. Bunn,Jessica R. White,David Kirschke,Tom Light,Daniel Christy,Gary Thompson,Ruth E. Winecker +9 more
TL;DR: Routine gabapentin postmortem testing and linking of death certificate, medical examiner, coroner, toxicology, and prescription history data will provide more reliable information on the extent of gabAPentin misuse, diversion, and implications for clinical care.
Journal ArticleDOI
Methodological Complexities in Quantifying Rates of Fatal Opioid-Related Overdose
Svetla Slavova,Chris Delcher,Jeannine M. Buchanich,Terry L. Bunn,Bruce A. Goldberger,Julia F. Costich +5 more
TL;DR: The opioid overdose crisis has brought into focus some of the limitations of US MDI systems for drug overdose surveillance and has given rise to a sense of urgency regarding the pressing need for improvements in MDI data for public health action and research.
Journal ArticleDOI
Using medical examiner case narratives to improve opioid overdose surveillance.
Emily Hurstak,Christopher Rowe,Caitlin Turner,Emily Behar,Rachel Cabugao,Nikolas P. Lemos,Catherine Burke,Phillip O. Coffin +7 more
TL;DR: Using additional sources of information to classify opioid overdose cases resulted in a modest increase in the count of heroin overdose deaths but identified a substantial number of non-heroin injection-related opioid analgesic deaths.
Journal ArticleDOI
Potential undercounting of overdose deaths caused by specific drugs in vital statistics data: An analysis of Florida.
TL;DR: The MCOD data appear to undercount the number of fatal overdoses caused by the drugs the authors investigated, and efforts to improve the reporting of fatal overdose may enhance the understanding of and subsequently improve the response to the drug overdose epidemic.
References
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Journal ArticleDOI
CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
TL;DR: This guideline is intended to improve communication about benefits and risks of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy.
Journal ArticleDOI
Patterns of Abuse Among Unintentional Pharmaceutical Overdose Fatalities
Aron J. Hall,Joseph E. Logan,Robin L. Toblin,James A. Kaplan,James C. Kraner,Danae Bixler,Alex E. Crosby,Leonard J. Paulozzi +7 more
TL;DR: In this paper, the authors evaluated the risk characteristics of persons dying of unintentional pharmaceutical overdose in West Virginia, the types of drugs involved, and the role of drug abuse in the deaths.
Journal Article
Patterns of Abuse Among Unintentional Pharmaceutical Overdose Fatalities. Commentary
Aron J. Hall,Joseph E. Logan,Robin L. Toblin,James A. Kaplan,James C. Kraner,Danae Bixler,Alex E. Crosby,Leonard J. Paulozzi,A. Thomas McLellan,Barbara J. Turner +9 more
TL;DR: The majority of overdose deaths in West Virginia in 2006 were associated with nonmedical use and diversion of pharmaceuticals, primarily opioid analgesics.
Journal ArticleDOI
State Variation in Certifying Manner of Death and Drugs Involved in Drug Intoxication Deaths
TL;DR: Across the U.S., there is variation in the percent of drug intoxication deaths classified as having undetermined manner of death and with specific drugs identified on death certificates, which has significant implications for public health surveillance and for prevention efforts.