Unintentional Poisoning Overdose Deaths in North Carolina: An Examination of Three Counties, 2007- 2008

In North Carolina, the unintentional poisoning death rate has increased by over 200% between 1999 and 2008. The N.C. Division of Public Health performed a tri-county retrospective study of deaths in order to 1) identify existing sources of information on unintentional poisoning deaths, 2) ascertain the extent to which prescription medications contributed to unintentional poisoning deaths, and 3) attempt to identify related risk factors in unintentional overdose deaths.

Unintentional and undetermined poisoning deaths in these counties were identified for the years of 2007 and 2008 using ICD10 codes X40-X44 and Y10-Y15. Data was collected from medical examiner case files and law enforcement reports and linked with data from a prescription monitoring. Information gathered included decedent demographics, causes of death, and decedent histories that included pain, mental health conditions, prior drug overdoses, and substance abuse.

The overall unintentional poisoning death rate for the three counties was 14.5 per 100,000 and 78.8% of unintentional poisoning deaths were caused by narcotics and hallucinogens. Within that category, 12.1% of deaths mentioned heroin, 24.6% other opioids, 27.6% methadone, and 6.5% other synthetic narcotics. Among the counties studied, 26.3% of decedents had a history of pain, 59.4% substance abuse, 17.5% mental health conditions, and 6.9% overdose.

Effective response to decreasing unintentional poisoning deaths requires strengthening surveillance system linkages in order to identify unsafe use of drugs and increase provider awareness. If successfully implemented, this coordinated system could provide data to build community and statewide programs and policies to reduce overdoses from prescribed medications.