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Health Indicator Report of Drug Overdose and Poisoning Incidents

In 2002 the age-adjusted rate of drug poisoning deaths (14.0 per 100,000 population) surpassed the rate of motor vehicle crash (MVC) deaths (13.5 per 100,000 population) in Utah. Until this time, motor vehicle crashes had been responsible for more lives lost than any other cause of injury. By 2013, the age-adjusted death rate from drug poisonings (21.7 per 100,000 population) was more than three times as high as it was from MVC deaths (7.1 per 100,000 population). Prescription pain medications are responsible for many of the drug poisoning deaths in Utah.

Poisoning Deaths by Year, Utah and U.S., 1999-2013

Notes

Data are age-adjusted (2000 U.S. standard population). Poisoning deaths are defined as ICD-10 codes X40-X49, Y10-Y19, X60-X69, X85-X90, Y35.2, *U01.6-U01.7. Drug poisoning deaths are a subset of poisoning deaths and are defined as ICD-10 codes X40-44, X60-X64, X85, Y10-Y14. The Consensus Recommendations for National and State Poisoning Surveillance definition of a drug is as follows: A drug is any chemical compound that is chiefly used by or administered to humans or animals as an aid in the diagnosis, treatment, or prevention of disease or injury, for the relief of pain or suffering, to control or improve any physiologic or pathologic condition, or for the feeling it causes. The definition specifically includes: -Street drugs such as heroin, cocaine, and hallucinogens; -Prescription drugs; -Over-the-counter drugs; -Biological substances such as vaccinations; -Veterinary drugs; -Dietary supplements; and -Non-medicinal substances used primarily for the feeling they cause. The definition specifically excludes: -Alcohol; -Tobacco; and -Chemicals that are deliberately inhaled for the feeling they cause but are chiefly used for other purposes (i.e. organic solvents and halogen derivatives of aliphatic and aromatic hydrocarbons).

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2013
  • National Center for Injury Prevention and Control's Web-based Injury Statistics Query and Reporting System (WISQARS)

Data Interpretation Issues

Poisoning incidents are classified according to ICD codes. ICD stands for the International Classification of Diseases. It is a coding system maintained by the World Health Organization and the U.S. National Center for Health Statistics used to classify causes of death, injury, and disease. These codes are updated approximately every ten years to account for advances in medical technology. The U.S. is currently using the 10th revision (ICD-10) to code causes of death. The 9th revision (ICD-9) is used for hospital and emergency department (ED) visits. Poisoning deaths are defined by ICD-10 codes X40-X49 (unintentional), X60-X69 (suicide), X85-X90, *U01 (.6-.7) (homicide), Y10-Y19 (undetermined), and Y35.2 (other). Drug poisoning deaths are a subset of poisoning deaths and are defined by ICD-10 codes X40-44 (unintentional), X60-X64 (suicide), X85 (homicide), and Y10-Y14 (undetermined). ED and hospitalization drug poisoning incidents are defined by ICD-9 codes E850-E858, E950 (.0-.5), E962, E980 (.0-.5). Prescription opioid deaths are identified using data from the Office of the Medical Examiner in the Utah Violent Death Reporting System.

Definition

Poisoning deaths: number of deaths among Utah residents resulting from poisoning (ICD-10 codes X40-X49, X60-X69, X85-X90, Y10-Y19, Y35.2, *U01 [.6-.7]) per 100,000 population. Drug poisoning deaths: number of deaths among Utah residents resulting from drug poisoning (ICD-10 codes X40-44, X60-X64, X85, Y10-Y14) per 100,000 population. Drug poisoning ED visits/hospitalizations: number of incidents (ED visits or hospitalizations) among Utah residents resulting from drug poisoning (ICD-9 codes E850-E858, E950 [.0-.5], E962, E980 [.0-.5]) per 10,000 population. Prescription opioid deaths: number of unintentional and undetermined intent deaths among residents and non-residents resulting from prescription opioids that occurred in Utah.

Numerator

Poisoning deaths: number of deaths among Utah residents resulting from poisoning (ICD-10 codes X40-X49, X60-X69, X85-X90, Y10-Y19, Y35.2, *U01 [.6-.7]). Drug poisoning deaths: number of deaths among Utah residents resulting from drug poisoning (ICD-10 codes X40-X44, X60-X64, X85, Y10-Y14). Drug poisoning ED visits/hospitalizations: number of incidents (ED visits or hospitalizations) among Utah residents resulting from drug poisoning (ICD-9 codes E850-E858, E950 [.0-.5], E962, E980 [.0-.5]). Prescription opioid deaths: number of resident and non-resident unintentional and undetermined prescription opioid deaths that occurred in Utah.

Denominator

Total number of persons in the population of Utah.

Healthy People Objective IVP-9.1:

Prevent an increase in the rate of poisoning deaths: All persons
U.S. Target: 13.1 deaths per 100,000 population
State Target: 12.9 per 100,000 population

Other Objectives

Healthy People 2020 Objective IVP-9.1: Prevent an increase in the rate of poisoning deaths: All persons -U.S. Target: 13.1 deaths per 100,000 population -Utah Target: 12.9 deaths per 100,000 population Healthy People 2020 Objective IVP-9.2: Prevent an increase in the rate of poisoning deaths: Persons aged 35 to 54 years -U.S. Target: 25.5 deaths per 100,000 population -Utah Target: 23.2 deaths per 100,000 population Healthy People 2020 Objective IVP-9.3: Prevent an increase in the rate of poisoning deaths: Unintentional or undetermined intent among all persons -U.S. Target: 11.1 deaths per 100,000 population -Utah Target: 9.7 deaths per 100,000 population Healthy People 2020 Objective IVP-9.4 Prevent an increase in the rate of poisoning deaths: Unintentional or undetermined intent among persons aged 35 to 54 years -U.S. Target: 21.6 deaths per 100,000 population -Utah Target: 34.9/100,000 population (prevent an increase in the 2010 crude rate) Healthy People 2020 Objective IVP-10: Prevent an increase in the rate of nonfatal poisonings -U.S. Target: 304.4 nonfatal poisonings per 100,000 population -Utah Target: 291.5 nonfatal poisonings per 100,000 population

How Are We Doing?

Utah has seen a 4% decrease in the age-adjusted drug poisoning death rate from 2012 (22.6 per 100,000 population) to 2013 (21.7 per 100,000 population). Prescription pain medications underlie many Utah poisoning deaths. In 2013, 23.8% of Utah poisoning deaths were of undetermined intent, 14.0% were self-inflicted, and 62.0% were unintentional. From 2011 to 2013, males had a significantly higher drug poisoning death rate compared to females. Utahns between 25-64 years of age were significantly higher than the state rate of 19.5 per 100,000 population. Males and females had the highest rates in the 45-54 year old age group. For ages 18-34, male drug poisoning death rates were significantly higher than female drug poisoning death rates. Children infrequently require hospitalization for the ingestion of poison, but 1 to 4 year-olds had significantly higher drug poisoning emergency department (ED) visits rates (38.4 per 10,000 population), along with 15-24 year olds (28.2 per 10,000 population), and 25-34 year olds (21.2 per 10,000 population) compared to the state (17.3 per 10,000 population) in 2010-2012.

How Do We Compare With the U.S.?

From 2010 to 2013, the U.S. age-adjusted rate of drug poisoning deaths from all intents was 13.1 per 100,000 population. During this same time period, Utah's age-adjusted rate of drug poisoning deaths was significantly higher at 20.3 per 100,000 population. Data Source: NCHS Vital Statistics System for numbers of death. Bureau of Census for population estimates.

What Is Being Done?

In July 2007, the Utah State Legislature passed House Bill 137 appropriating funding to the Utah Department of Health (UDOH) to establish a program to reduce deaths and other harm from prescription opiates. Since 2007, the Utah Department of Health launched a media campaign, Use Only As Directed, to educate the public about how to use prescription pain medication safely (visit useonlyasdirected.org for more information). UDOH also launched a statewide provider education intervention where physicians have the opportunity to receive CMEs for participation in small and large group presentations. In 2009, the Utah Pharmaceutical Drug Crime Project was established to further efforts to reduce prescription drug overdose deaths. This project works with law enforcement and other organizations on initiatives such as the National Take Back Days, which collect thousands of pounds of unused medications, turned in by community members who have cleaned out their medicine cabinets. For information about where to dispose of unused prescriptions visit: http://www.useonlyasdirected.org/drop-off-locator/. In 2010, Utah State Legislature passed House Bill 28, requiring all prescribers of controlled substances to register to use the Utah Controlled Substance Database, take a tutorial, and pass a test on the use of the database and the prescribing guidelines of controlled substances when applying for or renewing their license. In 2011, the Legislature passed Senate Bill 61, which requires prescribers renewing or applying for a controlled substance license to take four hours of controlled substance prescribing classes each licensing period. Information about this program can be found at: http://www.dopl.utah.gov/programs/csdb/index.html. In 2013, the Utah State Legislature passed H.B. 214. This law requires certain controlled substance prescribers to complete at least four hours of continuing education as a requisite for license renewal and requires that at least 3.5 hours of the required continuing education hours be completed in controlled substance prescribing classes. In 2014, the Utah State Legislature passed the Good Samaritan Law (H.B. 11) and the Naloxone Law (H.B. 119). The Good Samaritan Law enables bystanders to report an overdose without fear of criminal prosecution for illegal possession of a controlled substance or illicit drug. The Naloxone Law permits physicians to prescribe naloxone to third parties (someone who is usually a caregiver or a potential bystander to a person at risk for an overdose). It also permits individuals to administer naloxone without legal liability.

Evidence-based Practices

Here are some relevant programs using evidence-based practices. Strengthening Families Program Evidence-based family skills training program http://strengtheningfamiliesprogram.org HALO: Healthy Alternatives for Little Ones Health education and prevention program for children aged 3-6 years http://haloforkids.org/ Programs of Prevention, PRIME for Life Alcohol and drug prevention program for all ages http://www.primeforlife.org Find other evidence-based programs online at nrepp.samhsa.gov.

Available Services

Use Only As Directed Media Campaign www.useonlyasdirected.org The University of Utah: Utah Poison Control Center http://poisoncontrol.utah.edu National Institutes of Health: National Institute on Drug Abuse http://drugabuse.gov Utah Division of Substance Abuse and Mental Health (UDHS) www.dsamh.utah.gov Partnership for a Drug-Free America www.drugfree.org Office of National Drug Control Policy http://www.whitehouse.gov/ondcp

Health Program Information

The Violence and Injury Prevention Program (VIPP) is a trusted and comprehensive resource for data related to violence and injury. Through education, this information helps promote partnerships and programs to prevent injuries and improve public health. VIPP goals are to a) focus prevention efforts on reducing intentional and unintentional injury, b) conduct education aimed at increasing awareness and changing behaviors that contribute to the occurrence of injury, c) strengthen local health department capacity to conduct local injury prevention programs, d) promote legislation, policy changes, and enforcement that will reduce injury hazards and increase safe behaviors, e) collaborate with private and public partners, and f) improve the Utah Department of Health capacity to collect mortality and morbidity data from multiple sources and conduct injury epidemiology for use in prevention planning, implementation, and evaluation.
Page Content Updated On 01/22/2015, Published on 01/23/2015
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Content updated: Tue, 28 Jul 2015 19:46:13 MDT