Pain medicine : the official journal of the American Academy of Pain Medicine
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Current data collected by medical examiners and coroners are incomplete and inadequate to evaluate the factors that lead to fatalities involving prescription opioids. Determining cause of death is critically important. Two methods are proposed to improve consistency and accuracy in the collection and analysis of decedent data in opioid-related poisoning deaths. ⋯ Patient characteristics for analysis include age, gender, race/ethnicity, geographic area (particularly whether urban or rural), body mass index, duration of opioid usage and daily average dose during the last 2 weeks of life, and histories of chronic pain/medical conditions, substance abuse, and mental illness/psychiatric diagnoses. Second, expanding the scope of opioid toxicology categories used to classify and code cause-of-death data reported by death investigators would improve identification of individual drugs and classes most often associated with overdose deaths. Formulation-specific codes should be added to facilitate consistent recording of findings by death investigators and entry into national vital statistics databases.
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Utah undertook a multipronged effort to reverse an epidemic of deaths among patients taking prescription opioids. This article describes the provider detailing portion of the effort. ⋯ Provider detailing was associated with a decrease in Utah's prescription opioid death rate and improvements in provider self-reported prescribing behaviors. Other simultaneous interventions may have contributed to the decline in death rates. This intervention's effect was limited by short-term funding.