INTRODUCTION Due largely to ambiguous or incomplete information provided on death certificates, the widely cited Multiple Cause of Death (MCOD) data reported by the U.S. Centers for Disease Control and Prevention has been shown to undercount the number of fatal overdoses caused by specific drugs. However, the extent of the undercounts is unclear. METHODS We obtained the number of fatal overdoses from 2003 to 2017 in Florida caused by the three drug groups (amphetamines, benzodiazepines, and opioids) and three drugs (methadone, cocaine, and heroin) that we could map across the MCOD data and data reported by the Florida Medical Examiners Commission (FMEC). The FMEC data are based on state-mandated reporting of the causal drugs in overdose deaths. We analyzed the differences across all deaths and by gender, age group, and race. RESULTS Depending on the drug, the numbers of deaths across all individuals reported in the FMEC data ranged from 19 %-39 % higher than the counts in the MCOD data. The differences varied over time and by some demographic factors. CONCLUSIONS The MCOD data appear to undercount the number of fatal overdoses caused by the drugs we investigated. Our analysis did not identify a cause or pattern to explain the differences. Efforts to improve the reporting of fatal overdoses may enhance our understanding of and subsequently may improve the response to the drug overdose epidemic.

中文翻译：

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生命统计数据中由特定药物引起的过量死亡的潜在低估：佛罗里达州的分析。

引言很大程度上由于提供了有关死亡证明的模棱两可或不完整的信息，美国疾病控制与预防中心报告的被广泛引用的多重死亡原因（MCOD）数据已显示出低估了由特定药物引起的致命性药物过量的数量。但是，计数不足的程度尚不清楚。方法我们获得了2003年至2017年在佛罗里达州由三类药物（安非他命，苯二氮卓和阿片类药物）和三类药物（美沙酮，可卡因和海洛因）引起的致命过量研究的数据，这些数据可用于MCOD数据和报告的数据由佛罗里达州医学检查员委员会（FMEC）提供。FMEC数据基于国家对过量死亡中的致病药物的报告。我们按性别，年龄组和种族分析了所有死亡人数之间的差异。结果根据药物的不同，FMEC数据中报告的所有个体死亡人数比MCOD数据中的死亡人数高19％-39％。差异随时间和某些人口因素而变化。结论MCOD数据似乎低估了我们研究的药物引起的致命性药物过量。我们的分析未找到解释差异的原因或模式。改善致命过量报告的工作可能会增进我们对药物过量流行的理解，并可能随后改善对药物过量流行的反应。结论MCOD数据似乎低估了我们研究的药物引起的致命性药物过量。我们的分析未找到解释差异的原因或模式。改善致命过量报告的工作可能会增进我们对药物过量流行的理解，并可能随后改善对药物过量流行的反应。结论MCOD数据似乎低估了我们研究的药物引起的致命性药物过量。我们的分析未找到解释差异的原因或模式。改善致命过量报告的工作可能会增进我们对药物过量流行的理解，并可能随后改善对药物过量流行的反应。