ArticleAnnals of epidemiology2025
Misclassification of opioid-involvement in drug-related overdose deaths in the United States: A scoping review.
Article in Annals of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Enhancing identification of suspected unregulated drug toxicity deaths in administrative health records: a case study among people with HIV in British Columbia, Canada.BMC public health · 2026Article
- Extreme vulnerability to overdose mortality: Intersections of detailed race/ethnicity, educational attainment, age, sex, and nativity.Drug and alcohol dependence · 2025Article
- Multimodal Breathing Control: Pontomedullary Mechanisms and Current Perspectives.BioEssays : news and reviews in molecular, cellular and developmental biology · 2025Review
- Drug involvement variations in overdose death spikes: county-level analysis in Massachusetts.BMJ public health · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeMost drug-related deaths in the United States (US) in 2022 involved opioids. However, methodological challenges in overdose surveillance may contribute to underestimation of opioid involvement in the overdose crisis. This scoping review aimed to synthesize existing literature to examine the breadth and contributing sources of misclassification of opioid-related overdose deaths.
methodsIn October 2022, we searched PubMed, Web of Science, and Scopus for studies on overdose surveillance, death certificates, and medicolegal death investigation (MDI) systems in the US published in 2013-2022. Two reviewers independently screened abstracts, reviewed full-texts, and performed data extraction of study characteristics.
resultsWe identified 17 studies examining misclassification in drug-related deaths. Across studies, opioid involvement in drug-related deaths was underestimated nationally by 20-35 %. Unspecified drug-related deaths differed by geographic areas and MDI systems and decreased over time. States/counties with coroner MDI systems were more likely to report unspecified overdose deaths than those with medical examiners. Integrating toxicology testing, death scene investigations, and other data with death certificates identified additional opioid-related overdose deaths, particularly those involving heroin.
conclusionsFindings highlight the need for additional resources for surveillance efforts, training for coroners, and data integration to improve reporting of opioid involvement in overdose deaths to inform interventions.
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Registered trials
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