Status of US State Laws Mandating Timely Reporting of Nonfatal Overdose

Davis, Corey S.; Green, Traci C.; Hernandez-Delgado, Hector; Lieberman, Amy

doi:10.2105/ajph.2018.304589

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…There are several challenges to collecting opioid OD data, including barriers to complete information about specific drugs present and lengthy delays in finalizing death certificates. Additionally, requirements to report ODs in a timely manner differ among states (25). Our ongoing work aims to link several up-to-date data sources to better characterize and forecast the impacts of COVID-19 on the opioid OD crisis.…”

Section: Discussionmentioning

confidence: 99%

Changes in Characteristics of Drug Overdose Death Trends during the COVID-19 Pandemic

DiGennaro

Garcia

Stringfellow

et al. 2021

Preprint

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Background and Aims: There are limited reports analyzing opioid overdose (OD) mortality data during the COVID-19 pandemic. There is also great heterogeneity in outcomes across states, necessitating assessments of the effects of COVID-19 on OD deaths on a state-by-state level. This report aims to analyze overall trends in OD deaths in Massachusetts during COVID-19. Design: Using individual-level death records in Massachusetts, we identified and analyzed OD mortality trends during the COVID-19 pandemic as compared to 2018 and 2019. We analyzed the period between March 24 (stay-at-home order in 2020) and August 11 (latest reliable data). We also estimated the correlation between OD deaths and COVID-19 case fatality rates at the county level. Setting: Massachusetts. Participants: A total of 2,342 OD deaths were analyzed. Measurements: The outcomes studied were OD deaths and COVID-19 case fatality rates. Findings: OD deaths involving cocaine and amphetamines increased from 2019 to 2020, by 20% (276 vs. 330; P<0.01) and 79% (33 vs. 59; P<0.01), respectively, but were steady from 2018 to 2019. Heroin's presence continued to decrease (238 in 2018, 161 in 2019, 102 in 2020; P<0.001); however, fentanyl was present in more than 90% of OD deaths, reflecting its continued domination of the illicit opioid supply in Massachusetts. Prescription opioid presence was stable. 79% of OD decedents were White and 6% were Black in 2019, as compared to 74% and 10% in 2020 (P=0.01). We found no significant correlation between COVID-19 case fatality and OD death rates. Conclusions: Increased deaths involving stimulants and alcohol reflect concerning trends in the era of COVID-19. Rising OD death rates among Black residents underscore that interventions focused on racial equity are necessary. Surveillance efforts must utilize up-to-date data to measure COVID-19 impacts on OD death and respond to imminent threats in real time.

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Section: Discussionmentioning

confidence: 99%

Changes in Characteristics of Drug Overdose Death Trends during the COVID-19 Pandemic

DiGennaro

Garcia

Stringfellow

et al. 2021

Preprint

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“…Opioid overdose surveillance is a key public health strategy to inform rapid and targeted responses to the overdose crisis in the US . States have historically maintained their own surveillance systems, which vary in data collection methods and content and case definitions.…”

Section: Introductionmentioning

confidence: 99%

“…Opioid overdose surveillance is a key public health strategy to inform rapid and targeted responses to the overdose crisis in the US. 1 , 2 States have historically maintained their own surveillance systems, which vary in data collection methods and content and case definitions. The US Centers for Disease Control and Prevention (CDC) has been leading a national effort to standardize opioid overdose syndromic surveillance using emergency department (ED) visit data and a standard opioid overdose case definition from electronic health record (EHR) chief complaint field and opioid overdose–related diagnostic code data.…”

Section: Introductionmentioning

confidence: 99%

Examination of the Accuracy of Existing Overdose Surveillance Systems

Griffith,

Chambers,

Hallowell

et al. 2023

JAMA Netw Open

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ImportanceHealth departments have used a variety of methods for overdose surveillance, and the Centers for Disease Control and Prevention (CDC) is implementing a standardized case definition to improve overdose surveillance nationally. The comparative accuracy of the CDC opioid overdose case definition vs existing state opioid overdose surveillance systems is unknown.ObjectiveTo evaluate the accuracy of the CDC opioid overdose case definition and existing Rhode Island Department of Health (RIDOH) state opioid overdose surveillance system.Design, Setting, and ParticipantsThis cross-sectional study of ED opioid overdose visits was conducted at 2 EDs in Providence, Rhode Island, at the state’s largest health system from January to May 2021. Electronic health records (EHRs) were reviewed for opioid overdoses identified by the CDC case definition and opioid overdoses reported to the RIDOH state surveillance system. Included patients were those at study EDs whose visit met the CDC case definition, was reported to the state surveillance system, or both. True overdose cases were confirmed by EHR review using a standard case definition; 61 of 460 EHRs (13.3%) were double reviewed to estimate classification accuracy. Data were analyzed from January through May 2021.Main Outcome and MeasureAccurate identification of an opioid overdose was assessed by estimating the positive predictive value of the CDC case definition and state surveillance system using results from the EHR review.ResultsAmong 460 ED visits that met the CDC opioid overdose case definition, were reported to the RIDOH opioid overdose surveillance system, or both (mean [SD] age, 39.7 [13.5] years; 313 males [68.0%]; 61 Black [13.3%], 308 White [67.0%], and 91 other race [19.8%]; and 97 Hispanic or Latinx [21.1%] among each patient visit), 359 visits (78.0%) were true opioid overdoses. For these visits, the CDC case definition and RIDOH surveillance system agreed that 169 visits (36.7%) were opioid overdoses. Of 318 visits meeting the CDC opioid overdose case definition, 289 visits (90.8%; 95% CI, 87.2%-93.8%) were true opioid overdoses. Of 311 visits reported to the RIDOH surveillance system, 235 visits (75.6%; 95% CI, 70.4%-80.2%) were true opioid overdoses.Conclusions and RelevanceThis cross-sectional study found that the CDC opioid overdose case definition more often identified true opioid overdoses compared with the Rhode Island overdose surveillance system. This finding suggests that using the CDC case definition for opioid overdose surveillance may be associated with improved data efficiency and uniformity.

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