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Stigma & underreporting fatal ODs: Blurring addiction's toll

| Friday, Aug. 11, 2017, 11:00 p.m.
A syringe used to inject heroin sits on a bedside table as EMS workers with Washington Ambulance & Chair revive a Washington County woman on her bedroom floor after she overdosed in December. EMS workers with Washington Ambulance & Chair administered Narcan within minutes to save her life. (Trib photo)
Andrew Russell | Tribune-Review
A syringe used to inject heroin sits on a bedside table as EMS workers with Washington Ambulance & Chair revive a Washington County woman on her bedroom floor after she overdosed in December. EMS workers with Washington Ambulance & Chair administered Narcan within minutes to save her life. (Trib photo)

In fighting opioid and heroin addiction, President Trump emphasized law enforcement just before declaring a national emergency. With opioid addicts turning to street drugs after prescriptions run out, his declaration must energize a public-health approach. That requires an accurate grasp of the problem — which makes a new study suggesting dramatic underreporting of fatal overdoses so important.

Reviewing thousands of 2008-14 death certificates, University of Virginia public policy and economics professor Christopher Ruhm “concluded the mortality rates were 24 percent higher for opioids and 22 percent higher for heroin than had been previously reported,” per NBC News. He cited Pennsylvania among five states where death certificates specified fatal drugs “only around half the time.”

Addiction's stigma feeds the underreporting of fatal ODs. As a Pennsylvania State Coroners Association spokeswoman said about death certificates, “Not every family member wants the public to know what drugs were all found in the deceased.”

A public-health approach counters that stigma.

Until public perception of addiction changes and better reporting clarifies the extent of fatal ODs and the resources needed to reduce them, what Mr. Ruhm called “the lack of reliable information on the drugs causing fatal overdoses” will make winning this battle harder than it should be.

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