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Abstract #155804

Tony Kuo, MD, MSHS¹, Kathryn R. Martin, MPH², Parinaz Lajevardi, BS², and Paul Simon, MD, MPH³. (1) County of Los Angeles, Department of Public Health, Office of Senior Health, 3530 Wilshire Blvd, Suite 800, Los Angeles, CA 90010, 213-351-7341, tkuo@ph.lacounty.gov, (2) County of Los Angeles, Department of Public Health, Injury and Violence Prevention Program, 3530 Wilshire Blvd, Suite 800, Los Angeles, CA 90010, (3) County of Los Angeles, Department of Public Health, Division of Chronic Disease and Injury Prevention, 3530 Wilshire Blvd., Suite 800, Los Angeles, CA 90010

Concerns about prescription opiate misuse among older adults in the U.S. highlight the importance of monitoring mortality trends related to these medications. Using standardized case definitions to distinguished between different drug classes and death certificates matched to the Coroner's records, we conducted a retrospective case review of all cases of unintentional and intentional poisonings in Los Angeles County (n = 510) from 2000 to 2004. We examined the prevalence and characteristics of, and methods for identifying fatal poisonings caused by prescription opiates in adults aged 55 and older. Cases were compared by socio-demographics, co-morbid health conditions, circumstances surrounding the fatal incident, and toxicology data. Of the 510 cases, 13% were caused by prescription opiates, 24% by heroin, 13% by cocaine, 4% by alcohol, 1% by amphetamines, 32% by other prescription medications, and 13% by poisonings such as carbon monoxide. Although prescription opiates did not account for the greatest number of deaths in our study sample, the age-adjusted mortality rates for this drug class demonstrated an increase of 168% from 0.42 per 100,000 residents in 2000 to 1.12 per 100,000 residents in 2004. This represents a substantial increase compared to age-adjusted death rates for other drug classes. We conclude that deaths due to prescription opiates is rising among older adults and that the use of multiple data sources and a standardized protocol for describing drug-related mortality is a potentially underutilized method for monitoring prescription opiate-related deaths in the aging population, as these data are generally not available from vital statistics alone.

Learning Objectives:

• Describe mortality trends related to prescription opiate misuse among older adults aged 55 and older.
• Discuss the use of multiple data sources and standardized protocols for monitoring prescription opiate-related deaths in the aging population.
• Describe the limitations of vital statistics for surveillance of drug-related deaths.

Keywords: Drug Use, Drug Safety

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.