Heroin OD? Painkiller OD? No One Knows
Americans are abusing opioids like never before. They’re crushing and sniffing painkillers, cooking and injecting heroin, illicitly buying and detoxing with Suboxone, and overdosing left and right.
The exact nature of these fatal overdoses is often left a mystery. NPR recently reported on how Pennsylvania has no legal requirement for reporting which substances actually killed someone.
While this might seem crazy, it’s actually the norm. In fact, a majority of the states in this country don’t require an exact chemical analysis in the case of overdoses.
This has led to some confusion surrounding drug related deaths. In Pennsylvania, for example, it’s believed that heroin overdose claimed the lives of 1,300 residents in 2014. For Massachusetts, that number stands at 1,000.
These are only rough estimates, though, since the exact cause of death is still unknown in many cases. Enter Stacy Emminger, whose son Anthony overdosed on heroin. Despite a clear-cut case, Anthony’s death certificate lists “multidrug toxicity” as the cause of death.
Gary Tennis, the Acting Secretary for the Pennsylvania Department of Drug and Alcohol Programs, believes those 1,300 deaths should be even higher. He believes the Center for Disease Control is under diagnosing the problem, which, in turn, leads to even more drug induced fatalities.
Another public official, Dr. Kurt Nolte of the National Association of Medical Examiners, offered a similar opinion regarding the murky waters of overdose classification. He said,
“The interventions for whether it’s heroin or other illicit substances are different than, for example, if they are prescription drugs…and if you can’t tell the difference because everybody’s classified as multi-drug toxicity, you have no idea what’s killing people” (NPR).
The Problem Gets Worse
As if inaccurate death certificate reporting wasn’t enough, there’s also a lag in the availability of information. Using Pennsylvania once more as an example – the most recent overdose statistics they have are for 2012.
A gap that large, three long years, between quantifiable statistics and what’s currently happening isn’t acceptable. And I’m certainly not trying to knock Pennsylvania alone. Many other states are just as guilty.
New York’s most recent overdose statistics are from 2012. New Jersey boasts statistics from 2013. California and Florida also have 2013’s numbers in. That’s still two years, almost two and a half years, of missing data.
It’s clear this lack of up to date information is a widespread problem. And it’s understandable why. With more and more people abusing opioids, and more and more people dying from that abuse, it’s hard to accurately monitor these numbers.
It’s also worth noting that multiple government branches, both the Executive and the Legislative, have called for real time overdose and ER monitoring in their 2016 anti-drug budgets.
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The Negative Impact of This Information
Apart from simply offering no solace to grieving families, inaccurately reported overdose information has some serious negative implications.
Take, for example, how paramedics and other first responders deal with an apparent opioid overdose. By now most first responders carry naloxone. The dose needed to reverse heroin and painkiller overdoses are different though.
Heroin, oxycodone, hydrocodone, hydromorphone (Dilaudid), and even fentanyl all require different amounts of naloxone to counteract their effects. So, in certain instances, this lack of information can hamper medical professionals attempting to save lives.
Beyond offering help to EMTs and other first responders, accurate overdose information can be used by police to help identify and target emerging drug trends. Advocacy organizations, nonprofits, addiction treatment centers, and even politicians can also use this information to shape their response to specific drugs of abuse.
Something needs to be done, something needs to change, that much is 100% clear. Perhaps the answer lies in increased funding to local and state hospitals and coroners. Perhaps the answer lies in mandating medical examiners to determine a specific lethal drug.
Perhaps the answer’s none of the above. One thing is for sure though – if nothing changes, well, then nothing will change. People across the country will continue to die and that’s simply unacceptable.