Underrepresentation of Heroin Involvement in Unintentional Drug Overdose Deaths in Allegheny County, PA
Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of “morphine” and “codeine” listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewe...
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| Veröffentlicht in: | Journal of forensic sciences 2014-11, Vol.59 (6), p.1583-1585 |
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| container_title | Journal of forensic sciences |
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| creator | Mertz, Kristen J. Janssen, Jennifer K. Williams, Karl E. |
| description | Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of “morphine” and “codeine” listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin‐related if documentation showed 6‐monoacetylmorphine in blood or urine, “stamp bags” or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine‐related if notes indicated morphine use, prescription, or morphine at scene, or codeine‐related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings. |
| doi_str_mv | 10.1111/1556-4029.12541 |
| format | Article |
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To assess the accuracy of “morphine” and “codeine” listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin‐related if documentation showed 6‐monoacetylmorphine in blood or urine, “stamp bags” or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine‐related if notes indicated morphine use, prescription, or morphine at scene, or codeine‐related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. 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To assess the accuracy of “morphine” and “codeine” listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin‐related if documentation showed 6‐monoacetylmorphine in blood or urine, “stamp bags” or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine‐related if notes indicated morphine use, prescription, or morphine at scene, or codeine‐related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings.</description><subject>Accidents</subject><subject>Codeine - blood</subject><subject>Codeine - urine</subject><subject>Coroners and Medical Examiners</subject><subject>Death Certificates</subject><subject>Drug Contamination</subject><subject>Drug overdose</subject><subject>Drug Overdose - mortality</subject><subject>Fatalities</subject><subject>forensic science</subject><subject>Forensic sciences</subject><subject>Forensic Toxicology</subject><subject>Heroin</subject><subject>Heroin Dependence - mortality</subject><subject>Humans</subject><subject>morphine</subject><subject>Morphine Dependence - mortality</subject><subject>Morphine Derivatives - blood</subject><subject>Morphine Derivatives - urine</subject><subject>opioid analgesics</subject><subject>overdose</subject><subject>Pennsylvania - epidemiology</subject><subject>poisoning</subject><issn>0022-1198</issn><issn>1556-4029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1vEzEQxS0EoqHlzA1Z4tID23q8ttd7jFLatKpIKwggLtZ-zKZbNnawdwP57-s0bQ5c8GU8nt97kt8Q8g7YCcRzClKqRDCenwCXAl6Q0f7lJRkxxnkCkOsD8iaEe8aYAgWvyQGXTIAEMSKLua3Re1x5DGj7om-dpa6hU_SutfTSrl23xmUc0djObWv7eI9Q0dEzPyzobI2-dgHpGRb9XdhS467DxR3aDZ24wfabj_RmfEReNUUX8O1TPSTz809fJ9PkenZxORlfJ5UQHBLZZEpXdVOoLFdVWZY14zorldZVkzcCaiZZXZU6TTNIBbAGM1EygTWHirNGpIfkeOe78u73gKE3yzZU2HWFRTcEA4pzmUspdUQ__IPeu8HHjz1SINJUaIjU6Y6qvAvBY2NWvl0WfmOAme0OzDZxs03cPO4gKt4_-Q7lEus9_xx6BOQO-NN2uPmfn7k6nz0bJztdG3r8u9cV_pdRWZpJ8_3zhcl_Tm9u9Y8v5lv6ADHjn3A</recordid><startdate>201411</startdate><enddate>201411</enddate><creator>Mertz, Kristen J.</creator><creator>Janssen, Jennifer K.</creator><creator>Williams, Karl E.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K7.</scope><scope>7X8</scope></search><sort><creationdate>201411</creationdate><title>Underrepresentation of Heroin Involvement in Unintentional Drug Overdose Deaths in Allegheny County, PA</title><author>Mertz, Kristen J. ; Janssen, Jennifer K. ; Williams, Karl E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4421-5f768cdfa6796cbbbd0287b688cf9f41d050dcb833713410fe74b04ed21c20f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accidents</topic><topic>Codeine - blood</topic><topic>Codeine - urine</topic><topic>Coroners and Medical Examiners</topic><topic>Death Certificates</topic><topic>Drug Contamination</topic><topic>Drug overdose</topic><topic>Drug Overdose - mortality</topic><topic>Fatalities</topic><topic>forensic science</topic><topic>Forensic sciences</topic><topic>Forensic Toxicology</topic><topic>Heroin</topic><topic>Heroin Dependence - mortality</topic><topic>Humans</topic><topic>morphine</topic><topic>Morphine Dependence - mortality</topic><topic>Morphine Derivatives - blood</topic><topic>Morphine Derivatives - urine</topic><topic>opioid analgesics</topic><topic>overdose</topic><topic>Pennsylvania - epidemiology</topic><topic>poisoning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mertz, Kristen J.</creatorcontrib><creatorcontrib>Janssen, Jennifer K.</creatorcontrib><creatorcontrib>Williams, Karl E.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of forensic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mertz, Kristen J.</au><au>Janssen, Jennifer K.</au><au>Williams, Karl E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Underrepresentation of Heroin Involvement in Unintentional Drug Overdose Deaths in Allegheny County, PA</atitle><jtitle>Journal of forensic sciences</jtitle><addtitle>J Forensic Sci</addtitle><date>2014-11</date><risdate>2014</risdate><volume>59</volume><issue>6</issue><spage>1583</spage><epage>1585</epage><pages>1583-1585</pages><issn>0022-1198</issn><eissn>1556-4029</eissn><coden>JFSCAS</coden><abstract>Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of “morphine” and “codeine” listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin‐related if documentation showed 6‐monoacetylmorphine in blood or urine, “stamp bags” or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine‐related if notes indicated morphine use, prescription, or morphine at scene, or codeine‐related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25041514</pmid><doi>10.1111/1556-4029.12541</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Accidents Codeine - blood Codeine - urine Coroners and Medical Examiners Death Certificates Drug Contamination Drug overdose Drug Overdose - mortality Fatalities forensic science Forensic sciences Forensic Toxicology Heroin Heroin Dependence - mortality Humans morphine Morphine Dependence - mortality Morphine Derivatives - blood Morphine Derivatives - urine opioid analgesics overdose Pennsylvania - epidemiology poisoning |
| title | Underrepresentation of Heroin Involvement in Unintentional Drug Overdose Deaths in Allegheny County, PA |
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