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Health Indicator Report of Drug Overdose and Poisoning Incidents

Drug poisoning deaths are a preventable public health problem and have outpaced deaths due to firearms, falls, and motor vehicle crashes in Utah. In 2013, Utah ranked 5th in the U.S. for drug poisoning deaths with a rate of 21.7 per 100,000 population. Every month, 49 Utahns die as a result of a drug poisoning, 82.3% of which are accidental or of undetermined intent, and of these, 74.8% involve opioids. Utah is particularly affected by prescription opioids, which are responsible for many of the drug poisoning deaths in Utah.

Poisoning Deaths by Year, Utah and U.S., 1999-2014

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.

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 2014
  • 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 among all persons
U.S. Target: 13.2 deaths per 100,000 population
State Target: 12.9 per 100,000 population

Other Objectives

{{style color:#003366 Healthy People 2020 Objective IVP-9.1:}} Prevent an increase in poisoning deaths among all persons *'''U.S. Target:''' 13.2 deaths per 100,000 population *'''Utah Target:''' 12.9 deaths per 100,000 population[[br]] [[br]] {{style color:#003366 Healthy People 2020 Objective IVP-9.2:}} Prevent an increase in poisoning deaths among persons aged 35 to 54 years *'''U.S. Target:''' 25.6 deaths per 100,000 population *'''Utah Target:''' 23.2 deaths per 100,000 population[[br]] [[br]] {{style color:#003366 Healthy People 2020 Objective IVP-9.3:}} Prevent an increase in poisoning deaths caused by 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[[br]] [[br]] {{style color:#003366 Healthy People 2020 Objective IVP-9.4:}} Prevent an increase in poisoning deaths caused by 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 deaths per 100,000 population (prevent an increase in the 2010 crude rate)[[br]] [[br]] {{style color:#003366 Healthy People 2020 Objective IVP-10:}} Prevent an increase in nonfatal poisonings *'''U.S. Target:''' 304.8 nonfatal poisonings per 100,000 population *'''Utah Target:''' 291.5 nonfatal poisonings per 100,000 population

How Are We Doing?

The 2014 age-adjusted drug poisoning death rate was 21.8 per 100,000 population. Prescription pain medications underlie many Utah poisoning deaths. In 2014, 15.6% of Utah poisoning deaths were of undetermined intent, 15.8% were self-inflicted, 68.4% were unintentional and less than 1% were homicides. From 2012 to 2014, males (25.3 per 100,000 population) had a significantly higher age-adjusted drug poisoning death rate compared to females (18.7 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 (36.6 per 10,000 population), along with 15-24 year olds (28.4 per 10,000 population), and 25-34 year olds (21.0 per 10,000 population) compared to the state (17.2 per 10,000 population) in 2011-2013.

How Do We Compare With the U.S.?

In 2013, the U.S. age-adjusted rate of drug poisoning deaths from all intents was 13.8 per 100,000 population. During this same year, Utah's age-adjusted rate of drug poisoning deaths was significantly higher at 21.7 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 [http://useonlyasdirected.org 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. In 2015, the Utah Department of Health received one-time funding to address prescription drug abuse, misuse, and overdose deaths by continuing data collection efforts to help target interventions, develop provider materials, increase naloxone awareness, expand public awareness efforts, and develop provider tools and resources to address prescription drug abuse.

Evidence-based Practices

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

Available Services

Use Only As Directed Media Campaign[[br]] [http://www.useonlyasdirected.org] The University of Utah: Utah Poison Control Center[[br]] [http://poisoncontrol.utah.edu] National Institutes of Health: National Institute on Drug Abuse[[br]] [http://drugabuse.gov] Utah Division of Substance Abuse and Mental Health (UDHS)[[br]] [http://www.dsamh.utah.gov] Partnership for a Drug-Free America [http://www.drugfree.org] Office of National Drug Control Policy[[br]] [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 12/14/2015, Published on 12/15/2015
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 05 May 2016 15:53:07 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 15 Dec 2015 13:31:25 MST