Best Practices for Improving the Quality of Death Certificate Information on Drug Poisoning Deaths

Key Objectives:

1. To understand the state-to-state variation in the completeness and specificity of information from death certificates on drug poisoning deaths
2. To identify best practices that states can implement to improve the quality and completeness of information on death certificates for drug poisoning deaths

Brief Summary:
Poisoning is the leading cause of injury death in the United States, with drug poisoning accounting for more than 90% of poisoning deaths. Information about the drugs involved is critical for understanding the underlying trends and populations at risk, yet key information is often missing or incompletely described on the death certificate. For example, on average in the US only 75% of the death certificates that identify drug poisoning as the underlying cause of death name a specific drug; by state, the percent ranges from 42% to 98%. The lack of information in some states makes it difficult to do state-to-state comparisons, to identify regional “hot spots” for specific drugs, and to monitor the progress of prevention efforts over time. Additionally, funding for prevention is often tied to state rankings. States with a high percent of drug poisoning deaths that lack specific drug information will be at a disadvantage. Other factors are important as well. For example, the descriptive words found in the literal text influence the International Classification of Disease (ICD-10) codes assigned to the death. Use of particular words (e.g., “use”, “abuse”, “overdose”, “intoxication”) influences the categorization of the death as due to an external cause or not.  This session provides an opportunity to review critical factors that influence the completeness and specificity of information on death certificates for drug-related deaths, as well as the opportunity for participants to share best practices and ideas to improve the quality of data on drug poisoning mortality.