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Opioid Epidemic May Be Worse Than It Appears, Pitt Study Finds Fatalities Vastly Underreported

Mel Evans

A new study from the University of Pittsburgh School of Public Health finds that opioid-related overdose deaths are being underreported, and this means the epidemic may be worse than it appears.

Potentially 70,000 opioid-related overdose deaths were not included in national estimates between 1999 and 2015. Researchers estimates that 1,307 of those deaths where in Pennsylvania, the largest number of any state.

“States like Pennsylvania that have a decentralized-hybrid system had higher levels of unspecified drug information,” said lead author Jeanine Buchanich. “That means that in the medical-legal system there’s no kind of overseeing, governing body at the state level. And that there are both coroners and medical examiners at the county level.”

Allegheny County Chief Medical Examiner Karl Williams is one of the paper’s contributing authors. He said because there is no statewide authority there is no standardization for how to complete a death certificate and as a result many coroners do not specify the drugs that contribute to a cause of death.

“If we want to know what’s happened, if we want to have an evidenced-based approach to anything, then we need the evidence,” he said. “The evidence is the specific patterns of overdoses.”

Because it has its own toxicology lab, Willaims said Allegheny County has more accurate records then most of Pennsylvania. In more rural areas, many county coroners aren’t as well funded and have been further stressed by the opioid crisis.

“All the coroners have to send out their toxicology ... to a lab outside of Philadelphia,” said Williams. “It’s complex.”

The study was published in Public Health Reports, a journal from the Office of the U.S. Surgeon General.