Presentation Transcript

1. Washington State’s approach to improving data on narcotic related deaths and prevention

   Amy Poel, PhC & Jennifer Sabel, PhD
2. Overview WA drug poisoning mortality trends Deaths by specific drugs & combos Limitations of ICD-10 coding History of WA opioid methodology WA opioid methods Resulting data Prevention strategies
3. Drug Poisoning Mortality TrendsWA, 1999-2012
4. Specific Drugs on Death Certificates WA, 2012Drug Overdose Deaths
5. Numbers of Drugs on Death Certificates WA, 2012, Drug Overdose Deaths
6. Limitations of ICD-10 Coding Drug specificity sometimes unclear T40.6 = Other and unspecified narcotics T50.9 = Other and unspecified drugs General drug categories Prescription vs. illicit drugs not always clear
7. History of WA Opioid Methodology Participation in 2004 11-state MMWR highlighted ICD coding limitations Workers compensation program interested in opioid deaths Interest from state nosologist & injury program
8. Query Program Morphine “Was the morphine heroin or pharmaceutical?” Drug/Opiate “Please provide the name of the drug” “Please provide the name of the opiate” 2011 3 queries 2010 67 queries 2012 9 queries 2013 1 query
9. WA Opioid Methodology: Starting Point WA resident ICD-10 T400-T404, T406, F11 Multiple cause of death fields Manner of death: natural, accident, undetermined
10. WA Opioid Methodology “morphine or heroin”=>morphine “morphine” and “opiate”-manually reviewed for medication/pharmaceutical terms All deaths not coded as accidental poisonings (X40-X49) manually reviewed and assigned to accidental poisoning category if there were overdose terms
11. Resulting Data
12. Comparing Toxicology Results and ICD codingKing County, 2012 * There were 9 cases where ‘pharmaceutical morphine’ is listed on the death certificate that were placed into the Opioid Analgesics category instead of Heroin.
13. WA Prevention Strategies Clinical prescribing guidelines & rules Emergency department prescribing guidelines & sharing of patient data Medicaid ‘lock-in’ program Prescription drug monitoring program Good Samaritan Law & overdose education Prescription drug take back program
14. Amy Poel Jennifer Sabel Amy.poel@doh.wa.govJennifer.sabel@doh.wa.gov 360-236-4326 360-236-2865