Unintentional Drug Poisoning Deaths, Michigan Residents, 1999-2009 Su Min Oh, PhD Michigan...
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Unintentional Drug Poisoning Deaths, Michigan Residents, 1999-2009
Su Min Oh, PhD
Michigan Department of Community HealthBureau of Substance Abuse and Addiction Services
Background – United States
• In 2009, drug poisonings became the leading cause of injury death in the United States, surpassing motor vehicle crashes
• Majority of drug poisonings are unintentional
• Increase in poisonings largely due to opioid analgesics
Background - United States (cont.)
• From 1999 to 2002, the number of unintentional drug poisoning deaths involving
• Opioid analgesics - increased 91%• Cocaine - increased 23% • Heroin – increased 12 %
• In 2007, number of overdose deaths involving opioid analgesic exceeded overdose deaths with heroin and cocaine combined
Background - Michigan
• Unintentional poisonings became the leading cause of injury death in 2009
• Increase in prescriptions for opioid analgesics
Purpose of Study
Examine unintentional drug poisoning deaths involving opioid analgesics, heroin, and cocaine between 1999 and 2009 in Michigan
Methods
• Data used from 1999-2009 Michigan death certificate files
• Limited to Michigan residents
• Analysis limited to deaths with an underlying cause of death as unintentional drug poisoning• ICD-10 code of X40-X44
Methods (cont.)
• Types of drugs involved were identified using the following ICD-10 codes• Opioid analgesics (T40.2-T40.4)• Heroin (T40.1)• Cocaine (T40.5)• Other specified (T36-T50.8)• Unspecified (T50.9)
Methods (cont.)
• Rates age-adjusted according to the 2000 U.S. Census population and calculated per 100,000 population
• Differences in unintentional drug poisoning death rates were examined by descriptive factors
Number of Unintentional Drug Poisoning Deaths, Michigan, 1999-2009
Year
Num
ber o
f dea
ths
Age-Adjusted Unintentional Drug Poisoning Death Rates by Gender,
Michigan,1999–2009
Rate
per
100
,000
pop
ulati
on
Year
Male
Female
Total
Age-Adjusted Unintentional Drug Poisoning Death Rates by Race,
Michigan, 1999–2009
Rate
per
100
,000
pop
ulati
on
Year
Black
White
Unintentional Drug Poisoning Death Rates by
Age Groups, Michigan, 1999–2009
Rate
per
100
,000
pop
ulati
on
Year
15-24 years
65+ years
55-64 years
45 – 54 years
35– 44 years
25– 34 years
Unintentional Drug Poisoning Death Rates by
Major Drug Type, Michigan, 1999–2009
Unspecified
Opioid analgesic involvement
Other specified
Heroin only
Cocaine and heroin
Cocaine only
Crud
e Ra
te p
er 1
00,0
00 p
opul
ation
Year
Unintentional Drug Poisoning Death Rates involving Opioid Analgesics, Michigan, 1999–
2009
Crud
e ra
te p
er 1
00,0
00 p
opul
ation
Year
Only opioid analgesic
With cocaineWith heroin
Heroin & cocaine
Total
Michigan’s 2005 Population by Preparedness Regions
Detroit
Detroit
Unintentional Drug Poisoning Death Rates by Region, Michigan, 1999
Unintentional Drug Poisoning Death Rates by Region, Michigan, 2004
Unintentional Drug Poisoning Death Rates by Region, Michigan, 2009
Discussion
• Unintentional drug poisoning death rates increased over the past decade in Michigan
• Death rates due to opioid analgesics increased more than heroin and cocaine
• Increase in deaths closely paralleled the increased number of Rx opioid analgesics statewide
Limitations
• Utilization of vital statistics data • Validity and completeness of data
• Toxicology testing varies by region/county
• Limited access to Michigan’s Prescription Monitoring System
Michigan Initiatives
• Increased surveillance by Task Force formed during fentanyl outbreak
• RxOTC Drug Abuse Workgroup established in Feb. 2011• Broaden statewide media message• Broaden education and use of Screening, Brief
Intervention, Referral, and Treatment (SBIRT)• Increase access and use of PMP
Recommendations
• Increased awareness • Health care providers• Patients and parents
• Multifaceted strategies• Safe storage & disposal of drugs• At-risk populations
Acknowledgements
Michigan Department of Community HealthBureau of Disease Control, Prevention and Epidemiology• Kim Hekman, MPH• Lorraine Cameron, MPH, PhD
ReferencesWarner, M. Updates to Drug Poisoning Data Brief 2009 mortality data. Emerging Opioid Overdose Conference Call. March 2012.Warner M, Chen LH, Makuc DM, Anderson RN, Minino AM. Drug poisoning deaths in the United States, 1980-2008. Hyattsville, MD: National Center for Health Statistics; 2011.Centers for Disease Control and Prevention. Unintentional drug poisoning in the United States. CDC Issue Brief. July 2010. Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf. Sep 2006; 15(9):618-627.Michigan 2009 Death Certificate Registry, Michigan Department of Community Health.Michigan Epidemiological Profile, Michigan Department of Community Health. March 2012.
Contact Information
Su Min Oh: [email protected]
Bureau of Substance Abuse and Addiction Services:www.michigan.gov/mdch-bsaas
Substance Abuse Epidemiology:www.michigan.gov/substanceabuseepi