December 18, 2018

Literal text analysis was used to identify key information

A recent report from the Centers for Disease Control and Prevention (CDC) identified the 10 drugs most frequently mentioned in overdose deaths.

Using data from the 2011 to 2016 National Vital Statistics System-Mortality files, the authors conducted a literal text analysis of death certificates to identify drugs mentioned as contributing to the cause of overdose death. They used this information to calculate which drugs were most frequently involved. “Deaths involving more than 1 drug (eg, a death involving both heroin and cocaine) were counted in all relevant drug categories (eg, the same death was included in counts of heroin deaths and in counts of cocaine deaths),” the authors explained.

Results showed that between 2011 and 2016, the 10 drugs most frequently mentioned in relation to a drug overdose death were: fentanyl (ranked first in 2016), heroin (ranked first from 2012-2015), hydrocodone, methadone, morphine, oxycodone (ranked first in 2011), alprazolam, diazepam, cocaine (consistently ranked second or third), and methamphetamine.

During the study period, the age-adjusted rate of overdose deaths involving heroin and methamphetamine tripled, while the rate of overdose deaths involving methadone decreased (1.4 per 100,000 in 2011 to 1.1 in 2016). As for fentanyl and its analogs, between 2013 and 2016, the rate of overdose deaths doubled each year (0.6 per 100,000 in 2013 to 1.3 in 2014, 2.6 in 2015, and 5.9 in 2016).

Fentanyl, heroin, and cocaine were the most frequently mentioned drugs in overdose deaths that were considered unintentional, while oxycodone, diphenhydramine, hydrocodone, and alprazolam were more likely to be involved in cases of suicide. In addition, many of the overdose deaths were linked to use of multiple drugs. 

The authors concluded that in order to improve national monitoring of drug overdose deaths, it is critically important to report the drugs involved in these deaths in the literal text of death certificates. They added that “With slight modification, the methods used in this report can be used to identify deaths involving newly approved prescription drugs and new substances of abuse.”

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For more information visit CDC.gov.