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Drug-caused deaths across Washington state

Death data from the Washington State Department of Health Center for Health Statistics are combined with population data from the Office of Financial Management to create rates of death. Data include only deaths for which the underlying cause of death was determined to be poisoning by a drug. For more information on data, see details at the end of the page. Further analyses of opioid deaths, including different comparisons with cocaine and methamphetamine, are available here.

Deaths involving major drug categories over time

We present drug deaths in counts, as a percentage of all drug poisonings, and as crude rates per 100,000 state residents. Click on "All drug poisonings" or other more common categories to turn off those series and better see trends for less common drugs.

Data sources: Washington State Department of Health (deaths), state Office of Financial Management (population)

Deaths involving drug pairs, 2017-2018

Many drug deaths involve more than one drug. In the heatmap below, we present the percentage of all drug poisonings involving the pair of drugs or drug categories listed (ignoring the presence of all other drugs). For example, if you mouse over the row marked Methamphetamine and the column marked Heroin, you can see that 12.3% of all drug poisonings involved methamphetamine and heroin, with or without any other drug mentioned here or any drug not included in the matrix. The rows and columns are ordered from largest (methamphetamine) to smallest (barbiturates) share of drug deaths, that is alone or in combination. Deaths involving only one of the types of drugs presented appear along the diagonal--note that these deaths could have also involved another drug not presented here. ("Alcohol alone" deaths are a little different: By definition these are drug poisonings, which cannot be alcohol only, so deaths in the "Alcohol alone" cell must have involved a drug either not specified/coded or not presented here.) The drugs presented here were involved in 89.0% of all drug poisonings.

Data notes

Drug-caused deaths are based on individual-level death certificate data from the state Department of Health. We restrict analysis to drug poisonings (based on ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14 as the underlying cause of death) involving Washington residents who died in Washington. This common definition excludes cases where alcohol poisoning or alcoholism, carbon monoxide poisoning, etc., was coded as the underlying cause of death. Alcohol deaths are thus drug poisonings also involving alcohol. As of this writing, death data are available through 2018. (However, the state's review and confirmation of potential opioid cases, conducted from 1999 through 2015, has been eliminated from defining opioid deaths.) Many drug deaths involve multiple drugs, and identifying the single drug out of many that resulted in death is impossible. Thus, these deaths are best described as drug poisonings involving the drug or category of drugs specified.

Identification of heroin (ICD code T40.1) as a contributing cause of death is difficult and has improved over time, due in part to the state Department of Health working with local coroners and medical examiners to improve testing and reporting. This paper describes some of the difficulties (see sidebar).

Following the lead of the CDC, among opioids we focus on deaths specifically involving heroin (T40.1), methadone (T40.3), other commonly-prescribed natural and semisynthetic opioids (oxycodone, codeine, morphine, etc.; T40.2), and other synthetic opioids (T40.4), most prominent among them being fentanyl and fentanyl analogues.

Identification of methamphetamine deaths is based on searching written information saved in the electronic death certificates for relevant words containing "meth" and/or "thamphet", including innumerable misspellings of methamphetamine. This written information ("literals") is available back to 2003. All other drug categories are based on coding of contributing causes of death to specific ICD T-codes.