New data from the IU Public Policy Institute’s Center for Health and Justice Research shows a drop in the number of opioid-related overdose deaths in Marion County. Despite the decline, opioids were still present in 78 percent of the county’s 361 overdose deaths in 2018. That same year, the number involving fentanyl, a synthetic opioid, was found in 54 percent of the deaths.
There are other concerning trends as well. Both methamphetamines and cocaine are being found in overdose victims at higher rates than in previous years.
These numbers come from a unique analysis done by PPI’s CHJR research team. It’s an analysis that takes into account both coroners’ reports as well as police reports to reveal a realistic picture of what’s happening.
That analysis is currently headed up by Philip Huynh, a PPI project analyst. In 2016, Huynh sat in an office in Fort Wayne combing through police and coroner reports. He was an intern with the Allen County Health Department at the time, helping them get a better handle on what people were dying from so they could address the problem.
“At the time, nothing there was electronic so it was very tedious,” he recalls. “There was also no standardized process to collect drug information across the state.”
The lack of standardization came from counties using different toxicology companies, each with different thresholds for categorizing drug-related deaths. There was also a lack of coding options for coroners, which limited how specific they could be in their reports.
“We found that a significant number of the deaths at the time—80 to 90 percent—were coded to opioids, but we didn’t know what kind of opioids,” he says.
So Huynh built a process for categorizing drug overdose deaths by analyzing not only the coroner’s report but also each incident’s police report, including evidence found at the scene and witness testimony.
Huynh says that once he combined the police and coroner reports, they had a better picture of what was really going on.
“We determined many of the deaths were actually fentanyl-related, but there was no coroner code for fentanyl at the time.”
That would change in 2018. The same year that Huynh joined PPI, Indiana legislators passed a law altering how coroners code drug overdose deaths and making them more specific. Research from the CHJR team contributed to that change.
Coroners in Indiana are now required to do toxicology reports on all suspected drug overdose deaths. They now test for 289 different indicators of various substances, including fentanyl. In addition, all county health departments should use the same toxicology companies to allow for consistent comparison across county lines.
Analyzing information from various sources takes a high level of expertise. Huynh says once he collects all the data, the team begins the difficult work of assesses it.
“We use toxicology datasets to analyze trends and to inform other projects,” Huynh says. “We can use what we learn from these numbers to link up with other data sources, giving us more holistic view of overdose deaths.”
This analysis provides critical updates to state and local leaders, first responders, and other groups on the front lines of the opioid epidemic. It also gives them an early warning when trends start to shift.
“This work helped us learn that prescription opioids weren’t the primary problem anymore—we saw when fentanyl started being combined with heroin,” he adds. “By being the first ones to actually look at toxicology data, we were the first ones to know about the recent rise in cocaine deaths. That doesn’t happen unless you’re analyzing the toxicology data and information from the scene.”
This specialized process is one the CHJR team will continue providing while working with Indiana State Department of Health to further expand the department’s efforts statewide. And there is more work to be done. Drilling down into this data provide a first informed step toward action and toward saving lives.
*Additional data and analysis provided below
