Non-Alcoholic, Drug-Related Deaths in St. Croix County, WI from 2010 to 2015: An Initial StudyPRESENTED BY: WARREN TAYLOR, UWRF (2016)

Special Thanks

Thanks to Patty Schachtner, ME, for allowing access to the death records through this internship and for advice on research topics

Thanks to Betsy Gerbec, PhD, for her assistance in obtaining this internship and for advice on research topics

Introduction

Purpose of Study: To determine whether or not the number of non-alcoholic, drug-related deaths occurring in St. Croix County, WI, from 2010 to 2015 was increasing

Particular emphasis was placed on sex and age distribution of deaths, as well as the type of drugs most commonly used

Data collected using death records made available by the Office of the Medical Examiner for St. Croix County

Important Notes

This study is an initial report of recent data. Much more data is needed to determine St. Croix County’s drug-related death situation.

All data obtained was kept anonymous. The author, over the course of the research, had to make

judgment calls regarding how to qualify and quantify data. Thus, this data was organized to the best of the author’s ability. However, extenuating circumstances may skew the final results.

In an attempt to maintain anonymity, the author did not notate whether these deaths were the result of accident or suicide. Moreover, many records did not indicate one way or another, so data regarding manner of death is not included in this study.

Number of Deaths in Total vs. Non-Alcoholic, Drug-Related Deaths per Year (2010-2015)

2010 2011 2012 2013 2014 2015 Total

Total Deaths Per Year

326 373 370 393 443 504 2409

Drug-Related 1 4 5 10 14 9 43

2010 2011 2012 2013 2014 20150

100

200

300

400

500

600

326

373 370393

443

504

1 4 5 10 14 9

Total Number of Deaths vs. Drug-Related Deaths from 2010 to 2015

Total Deaths Per Year Drug-Related

Year

Num

ber o

f Dea

ths

Number of Drug-Related Deaths per 100 total deaths (2010-2015)

2010 2011 2012 2013 2014 2015Per 100 0.306748

471.07238

61.35135

12.54452

93.16027

11.78571

4

2010 2011 2012 2013 2014 20150

0.5

1

1.5

2

2.5

3

3.5

0.306748466257669

1.07238605898123

1.35135135135135

2.54452926208651

3.16027088036117

1.78571428571429

Number of Drug-Related Deaths per 100 Total Deaths by Year (2010-2015)

Year

Num

ber o

f Dru

g -r

elat

ed d

eath

s pe

r 100

Tot

al D

eath

s

Drug-Related Deaths by Gender (2010-2015)2010 2011 2012 2013 2014 2015 Total

Male 1 1 4 8 11 6 31Female 0 3 1 2 3 3 12

2010 2011 2012 2013 2014 20150

2

4

6

8

10

12

1 1

4

8

11

6

0

3

1

2

3 3

Male vs. Female Drug-Related Deaths from 2010 to 2015

Male Female

Year

Num

ber o

f Dru

g-Re

late

d D

eath

s

Drug Related Deaths by Age (2010-2015)2010 2011 2012 2013 2014 2015 Total

10 to 20 0 0 1 1 2 0 420 to 30 1 3 1 1 4 2 1230 to 40 0 0 1 2 3 2 840 to 50 0 1 1 1 1 3 750 to 60 0 0 0 3 1 2 660 to 70 0 0 1 1 3 0 570 to 80 0 0 0 1 0 0 1

10 to 20 20 to 30 30 to 40 40 to 50 50 to 60 60 to 70 70 to 800

2

4

6

8

10

12

14

Total Number of Drug-Related Deaths by Age Range per Year (2010-2015)

201520142013201220112010

Age Range

Num

ber o

f Dru

g-Re

late

d D

eath

s

Deaths by Drug Type (2010-2015)Drug Type Number

of Deaths

Mixed 21Narcotics/Opioids 10

THC 4Antidepressants 3

Heroin 1Diphenhydramine 1

Methanmphetamine 1

Amphetamine 1Cocaine 1

21

10

4

3

11 1 1 1

Number of Deaths by Drug Type (2010-2015)

MixedNarcoticsTHCAntidepressantsHeroinDiphenhydramineMethanmphetamineAmphetamineCocaine

Definition of Several Terms

“Mixed” refers to a death that involved 2 or more of the following Cocaine Heroin Ethanol Antidepressants Anti-anxiety Medication Narcotics/Opioids Temazepam (Insomnia) Methamphetamine Amphetamine Diphenylhydramine (Anti-histamine) MDMA Olanzapine (Anti-psychotic) Barbituates

Definition of Several Terms

“Narcotics/opioids” can include any of the following drugs. A “death by narcotics” is a death in which the main overdose agent was 1 of the following Morphine Fentanyl Oxycodone Methadone Tramadol Oxymorphone Hydromorphone Hydrocodone

Definition of Several Terms

“Antidepressants” can refer to any of the following Trazadone Bupropin Fluoxitine Amitryptyline

“Anti-anxiety Medication” can refer to either of the following Lorazepam Diazepam

Inferences and Observations

Mixed drug overdoses were observed to primarily be the result of an opioid/narcotic mixed with another type of medication or substance.

Nearly all mixed drug overdose deaths resulting from narcotics involved medication prescribed to either the victim or someone the victim knew.

This data is concurrent with data collected by the CDC regarding opioid overdose deaths from 1999 to 2014

Comparison to National Statistics

CDC Data (1999-2014) 165,000 deaths related to prescription opioid overdose

In 2014, 14,000 deaths Most common drugs include methadone, oxycodone, and

hydrocodone Most common among persons aged 25 to 54 and non-Hispanic whites More common in men, though the gender gap is closing

http://www.cdc.gov/drugoverdose/data/overdose.html

Comparison to National Statistics Natural opioid analgesics,

including morphine and codeine, and semi-synthetic opioid analgesics, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone;

Methadone, a synthetic opioid; Synthetic opioid analgesics

other than methadone, including drugs such as tramadol and fentanyl; and

Heroin, an illicit (illegally-made) opioid synthesized from morphine that can be a white or brown powder, or a black sticky substance.

http://www.cdc.gov/drugoverdose/data/analysis.html

Comparison to National Statistics Wisconsin as a whole has not seen a significant increase in drug overdose deaths

from 2013 to 2014 Numbers are on the rise in other parts of the Midwest, indicative that drug

overdose deaths may become a more severe public health concern for WI in the near future as numbers continue to rise in the surrounding states

http://www.cdc.gov/drugoverdose/data/statedeaths.html

State 2014 Rate 2014 Number

2014 Range 2013 Rate 2013 Number

2013 Range Change Significance

WI 15.1 853 13.6 to 16.0 15 856 13.6 to 16.0 0.7 Not Significant

Comparison to National Statistics

CDC-Recommended Prevention: Strategies and Successes

Prescription Drug Monitoring Programs (PDMPs) State-run databases for tracking controlled prescription drug prescriptions

and dispensations Monitoring prescription history and identify high-risk patients

Prevention for States Prevention Strategy Program Funded by the CDC, WI has been selected as a funded state Provides money for state-wide programs

PDMPs Community or Insurer/Health System Interventions Policy Evaluations Rapid Response Projects

http://www.cdc.gov/drugoverdose/states/state_prevention.html

CDC-Recommended Prevention: Strategies and Successes

Successful State Programs Florida- 50% decrease in oxycodone deaths after establishing PDMP

and pain clinic regulation New York- 75% decrease in repeat prescriptions to patients with

multiple prescribers after enforcing PDMP referrals Tennessee- 36% decrease in repeat prescriptions to patients with

multiple prescribers after enforcing PDMP referrals Oregon-38% decrease in prescription overdose and 58% decrease in

methadone poisoning after establishing PDMP and educating lay persons and health care providers

http://www.cdc.gov/drugoverdose/policy/successes.html

Conclusion

Though this is merely an initial, cursory analysis of non-alcoholic, drug-related death trends, the findings are concurrent with data regarding the national prescription drug overdose epidemic

A number of programs, particularly PDMPs and education programs, have been shown to be beneficial in lowering incidence of prescription opioid related deaths

Though WI has not seen a significant rise in drug-related deaths over the last 2 years, it appears that the epidemic is beginning to grow in the Midwest

It is the author’s sincerest hope that this information has been helpful in evaluating St. Croix County’s drug-related death situation and in determining steps for the future

Thank you for your time and attention.

Warren Taylor (2016)