{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:50:50Z","timestamp":1784893850491,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T00:00:00Z","timestamp":1518393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Most prior estimates of opioid\u2010involved drug poisoning mortality counts or rates are understated because the specific drugs leading to death are frequently not identified on death certificates. This analysis provides corrected national estimates of opioid and heroin\/synthetic opioid\u2010involved counts and mortality rates, as well as changes over time in them from 1999 to 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on drug poisoning deaths to US residents from 1999 to 2015, obtained from the Centers for Disease Control and Prevention (CDC) Multiple Cause of Death (MCOD) files, were used with the drugs involved in fatal overdoses imputed when not identified on the death certificates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The official CDC figure that 33\u2009091 drug deaths involved opioids in 2015 is an undercount, with the actual number being approximately 39 999. Corrected counts and rates of any opioid and heroin\/synthetic opioid\u2010involved drug deaths are 20\u201335% higher in every year than reported figures. The corrections almost always raise the changes estimated to have occurred since 1999, with the largest differences observed in 2011 for any opioids (5677 deaths and 1.7 per 100\u2009000) and in 2015 for heroin\/synthetic opioids (3228 deaths and 1.0 per 100\u2009000). However, percentage growth since 1999 is sometimes slower when based on corrected rather than reported fatality data, and with sensitivity to the choice of base years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Death certificate reports understate the prevalence of and changes over time in opioid and heroin\/synthetic opioid\u2010involved drug mortality in the United States. Adjustments imputing the drugs involved for cases where none are identified on the death certificates are likely to provide more accurate estimates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14144","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T06:06:39Z","timestamp":1518415599000},"page":"1339-1344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":143,"title":["Corrected US opioid\u2010involved drug poisoning deaths and mortality rates, 1999\u20132015"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0591-0479","authenticated-orcid":false,"given":"Christopher J.","family":"Ruhm","sequence":"first","affiliation":[{"name":"Frank Batten School of Leadership and Public Policy University of Virginia  Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,12]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Drug Overdose Deaths in the United States, 1999\u20132015","author":"Hedegaard H.","year":"2017"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2012.08.009"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.272"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2014.09.001"},{"key":"e_1_2_5_6_1","unstructured":"National Center for Health Statistics.Provisional counts of drug overdose deaths as of 8\/6\/2017 [internet].2017[cited 2017 Jul 9]. Available at:https:\/\/www.cdc.gov\/nchs\/data\/health_policy\/monthly\u2010drug\u2010overdose\u2010death\u2010estimates.pdf(accessed 2 February 2018) (Archived athttp:\/\/www.webcitation.org\/6wwb0t7Yu)."},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491513000411"},{"key":"e_1_2_5_8_1","article-title":"Stateline: getting better data on which drugs are killing people","author":"Vestal C.","year":"2016","journal-title":"Pew Charitable Trusts"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-016-0071-7"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.06.009"},{"key":"e_1_2_5_11_1","unstructured":"Centers for Disease Control and Prevention.Multiple cause of death data on CDC WONDER [internet]. 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Available at:https:\/\/fred.stlouisfed.org\/series\/POPTOTUSA647NWDB(acessed 15 January 2018) (Archived athttp:\/\/www.webcitation.org\/6wUYOwSK5on 15 January 2018)."},{"key":"e_1_2_5_14_1","volume-title":"Stata Statistical Software: release 15","author":"StataCorp","year":"2017"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2017.01.009"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.12541"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12024-016-9780-2"},{"key":"e_1_2_5_18_1","first-page":"1","article-title":"Using literal text from the death certificate to enhance mortality statistics: characterizing drug involvement in deaths","volume":"65","author":"Trinidad J. P.","year":"2016","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.05.051"},{"key":"e_1_2_5_20_1","unstructured":"HallV. LynfieldR. WrightN. HiberL. PalmJ. ChristensenJ.et al.Deaths associated with opioid use and possible infectious disease etiologies among persons in the unexplained death (UNEX) surveillance system\u2014Minnesota 2006\u20132015. CDC EIS Conference. Atlanta GA 24\u201027 April2017."},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511790942"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.23907\/2013.029"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01132.x"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2013.824334"},{"key":"e_1_2_5_25_1","unstructured":"WadhwaniA.Investigation: how many lives are lost to opioids? No one knows. Tennessean 25 August2017."}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.14144","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.14144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T00:13:28Z","timestamp":1694909608000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.14144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,12]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1111\/add.14144"],"URL":"https:\/\/doi.org\/10.1111\/add.14144","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,12]]},"assertion":[{"value":"2017-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}