Death Rates from Unintentional and Undetermined Prescription Opioid Overdoses and Dispensing Rates of Controlled Prescription Opioid Analgesics – 2011-2015

Background North Carolina, and the rest of the nation, is in the midst of an epidemic of opioid addiction, resulting in increased morbidity and mortality. Since 1999, deaths from unintentional poisonings have increased by more than 300%. The vast majority of unintentional poisoning deaths are street drug or medication-related, occurring when people misuse or abuse these drugs. Many of these drugs include historically prescribed opioid analgesics such as hydrocodone, methadone, oxycodone, and fentanyl [1]. The North Carolina Controlled Substance Reporting System (CSRS) was signed into law in 2005 and became operational in 2007. CSRS requires all outpatient controlled prescriptions to be reported within 72 hours of being dispensed. The CSRS is designed to allow prescribers and dispensers to check the system to ensure patients are not receiving multiple prescriptions from multiple resources, and to prevent dispensing of dangerous combinations. Over 19 million controlled substance prescriptions are recorded annually. An estimated 30,000 prescribers are registered to use the system. More than 3,000 queries are made in CSRS daily by practitioners. Methods Unintentional and undetermined prescription opioid deaths in North Carolina are generated from death certificate ICD10 codes (X40-X44 & Y10-Y14) and multiple cause codes for poisonings (T-codes). We excluded cases in which heroin or cocaine were involved and listed as part of the death certificate. Opioid dispensing data was provided by the CSRS for outpatient dispensing based on county of residence. Rates were generated from both data points using US census population data for each county. Rates per 100,000 persons were…