Using Marion County, Indiana coroner records and deputy field officer reports to understand heroin and prescription painkiller overdoses

Abstract

Deaths due to prescription painkillers and heroin have quickly become national, state, and local public health concerns. Studies using data from Medical Examiners or Coroner Offices throughout the United States have been conducted and are contributing to the understanding of this epidemic. However, the analysis of these fatalities are specific to the communities where the study was conducted and cannot be assumed that the decedents in one community are similar to decedents in another community. Many local governments and agencies throughout the U.S. are aware that this problem exists in their communities, but are not prepared to adequately respond to and intervene in these fatalities as an analysis of those who have died has rarely been conducted. This dissertation is a replication study of longitudinal epidemiological analyses of opiate related fatalities that was implemented in a location where an analysis of opiate-related fatalities had not been conducted, Marion County, Indiana. The purpose of the dissertation was twofold: (1) to describe the demographic characteristics of the decedents using publicly available data from the Marion County Coroner’s Office to be used in informing future preventative efforts to decrease opiate-related fatalities in Marion County and (2) to inform other communities on how to conduct a similar analysis in their own community. This dissertation describes the methods of the replication study, provides descriptive results of the people who died from opiate-related overdoses, and: (a) Report the types of opiates identified in blood toxicology reports and (b) Present the histories of opiate-related decedents as reported in the Deputy Coroner Field Officer’s Reports (DCFOR). Additionally, analysis was conducted to determine if decedent characteristics deferred depending on the type of opiate fatality based on the toxicology in 1) heroin alone, 2) painkillers alone, and 3) heroin and painkillers combined.