218249 Unintentional Poisoning Overdose Deaths in North Carolina: An Examination of Three Counties, 2007- 2008

Tuesday, November 9, 2010

Diane L. Downie, MPH , Department of Health Services, Wisconsin Division of Public Health, Madison, WI
Sharon Schiro, PhD , Department of Surgery, University of North Carolina, Chapel Hill, NC
Krista Ragan , Office of the Chief Medical Examiner, Office of the Chief Medical Examiner, Chapel Hill, NC
Katherine Harmon, MPH , Chronic Disease and Injury Section, North Carolina Division of Public Health, CSTE Fellow, Raleigh, NC
Scott Proescholdbell, MPH , Injury and Violence Prevention Branch, Chronic Disease and Injury Section, N.C. Division of Public Health, Raleigh, NC
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.

Learning Areas:
Administer health education strategies, interventions and programs

Learning Objectives:
1. Describe the types of drugs found in unintentional poisoning deaths in three counties in North Carolina. 2. Describe how linking data from existing surveillance systems in North Carolina was used to collect death and risk factor information in unintentional poisoning deaths. 3. Identify the potential value of a state-wide surveillance system in reducing unintentional poisonings.

Keywords: Drugs, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because my co-authors and I have worked with the NC Chronic Disease and Injury Section, NC Division of Mental Health/Substance Abuse and Disability Services, and the NC Medical Examiners office to identify, collect, and analyze this data.
Any relevant financial relationships? No

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.