Tags

Type your tag names separated by a space and hit enter

The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015.
Public Health Rep. 2019 Nov/Dec; 134(6):667-674.PH

Abstract

OBJECTIVES

Opioid-related overdoses are commonly attributed to prescription opioids. We examined data on opioid-related overdose decedents in Massachusetts. For each decedent, we determined which opioid medications had been prescribed and dispensed and which opioids were detected in postmortem medical examiner toxicology specimens.

METHODS

Among opioid-related overdose decedents in Massachusetts during 2013-2015, we analyzed individually linked postmortem opioid toxicology reports and prescription drug monitoring program records to determine instances of overdose in which a decedent had a prescription active on the date of death for the opioid(s) detected in the toxicology report. We also calculated the proportion of overdoses for which prescribed opioid medications were not detected in decedents' toxicology reports.

RESULTS

Of 2916 decedents with complete toxicology reports, 1789 (61.4%) had heroin and 1322 (45.3%) had fentanyl detected in postmortem toxicology reports. Of the 491 (16.8%) decedents with ≥1 opioid prescription active on the date of death, prescribed opioids were commonly not detected in toxicology reports, specifically: buprenorphine (56 of 97; 57.7%), oxycodone (93 of 176; 52.8%), and methadone prescribed for opioid use disorder (36 of 112; 32.1%). Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death.

CONCLUSION

Linking overdose toxicology reports to prescription drug monitoring program records can help attribute overdoses to prescribed opioids, diverted prescription opioids, heroin, and illicitly made fentanyl.

Authors+Show Affiliations

Department of Medicine, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University School of Medicine & Boston Medical Center, Boston, MA, USA. Massachusetts Department of Public Health, Boston, MA, USA.Massachusetts Department of Public Health, Boston, MA, USA.Department of Medicine, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University School of Medicine & Boston Medical Center, Boston, MA, USA.Department of Emergency Medicine, Injury Prevention Center, Boston University School of Medicine & Boston Medical Center, Boston, MA, USA.Massachusetts Department of Public Health, Boston, MA, USA.Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31577519

Citation

Walley, Alexander Y., et al. "The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015." Public Health Reports (Washington, D.C. : 1974), vol. 134, no. 6, 2019, pp. 667-674.
Walley AY, Bernson D, Larochelle MR, et al. The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015. Public Health Rep. 2019;134(6):667-674.
Walley, A. Y., Bernson, D., Larochelle, M. R., Green, T. C., Young, L., & Land, T. (2019). The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015. Public Health Reports (Washington, D.C. : 1974), 134(6), 667-674. https://doi.org/10.1177/0033354919878429
Walley AY, et al. The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015. Public Health Rep. 2019 Nov/Dec;134(6):667-674. PubMed PMID: 31577519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015. AU - Walley,Alexander Y, AU - Bernson,Dana, AU - Larochelle,Marc R, AU - Green,Traci C, AU - Young,Leonard, AU - Land,Thomas, Y1 - 2019/10/02/ PY - 2019/10/3/pubmed PY - 2020/2/20/medline PY - 2019/10/3/entrez KW - fentanyl KW - heroin KW - overdose KW - prescription drug monitoring programs KW - prescription opioids SP - 667 EP - 674 JF - Public health reports (Washington, D.C. : 1974) JO - Public Health Rep VL - 134 IS - 6 N2 - OBJECTIVES: Opioid-related overdoses are commonly attributed to prescription opioids. We examined data on opioid-related overdose decedents in Massachusetts. For each decedent, we determined which opioid medications had been prescribed and dispensed and which opioids were detected in postmortem medical examiner toxicology specimens. METHODS: Among opioid-related overdose decedents in Massachusetts during 2013-2015, we analyzed individually linked postmortem opioid toxicology reports and prescription drug monitoring program records to determine instances of overdose in which a decedent had a prescription active on the date of death for the opioid(s) detected in the toxicology report. We also calculated the proportion of overdoses for which prescribed opioid medications were not detected in decedents' toxicology reports. RESULTS: Of 2916 decedents with complete toxicology reports, 1789 (61.4%) had heroin and 1322 (45.3%) had fentanyl detected in postmortem toxicology reports. Of the 491 (16.8%) decedents with ≥1 opioid prescription active on the date of death, prescribed opioids were commonly not detected in toxicology reports, specifically: buprenorphine (56 of 97; 57.7%), oxycodone (93 of 176; 52.8%), and methadone prescribed for opioid use disorder (36 of 112; 32.1%). Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death. CONCLUSION: Linking overdose toxicology reports to prescription drug monitoring program records can help attribute overdoses to prescribed opioids, diverted prescription opioids, heroin, and illicitly made fentanyl. SN - 1468-2877 UR - https://www.unboundmedicine.com/medline/citation/31577519/The_Contribution_of_Prescribed_and_Illicit_Opioids_to_Fatal_Overdoses_in_Massachusetts_2013_2015_ L2 - https://journals.sagepub.com/doi/10.1177/0033354919878429?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -