Recommendations to Improve Specific Drug Reporting on Drug Overdose Death Certificates

BACKGROUND:   Due to the significant increase in fatal drug overdoses, state and local health departments have steadily relied on death certificate data to track drug overdose deaths. Unfortunately, the quality of death certificate data on drug overdoses is not consistent across the U.S and, in many cases, lacks specificity. Nationally, about 23% of drug poisoning deaths do not include information on the specific drugs involved. The percentage of drug overdose deaths that lack drug-specific information varies by state from 2-58%. State and local epidemiologists may be able to help improve the quality of drug overdose mortality data in their jurisdiction. METHODS:  Several members of the CSTE Overdose Subcommittee are collaborating on drug overdose mortality data quality improvement within their own jurisdictions and have developed recommendations based on their experiences. RESULTS:  Three main recommendations are: 1) review data in your jurisdiction to examine, for example, the percentage of drug overdose deaths with no drugs listed on the death certificate or the percentage of deaths with only an unspecific multiple cause code (T40.6 “other and unspecified narcotics”); 2) collaborate with your state’s vital statistics registrars as they work directly with local coroners and medical examiners and have insights on how to communicate the importance of accurate and complete death certificate data; and 3) have a conversation with your local coroners and medical examiners about the importance of specific drug reporting on death certificates, to understand their barriers, and to develop possible solutions to these barriers. Continue drug specificity review as part of routine surveillance. Lessons learned are included. CONCLUSIONS:  Specific drug reporting on death certificates has improved in several jurisdictions, and state and local epidemiologists have played a role in this process. These recommendations can be used by other epidemiologists and public health partners to improve specific drug reporting on death certificates in other jurisdictions.