Using prescribing and toxicology data to determine non-medical prescription drug overdose

Background: Overdose deaths have increased dramatically in the United States and are often attributed to prescription opioids. This study presents a framework for “overdose typologies”, including non-medical prescription drug use, to more accurately describe drug use patterns. Methods: This study examined linked prescription drug monitoring program (PDMP) and toxicology data (2016–2018) from accidental overdose deaths from a large metropolitan coroner's office in the Midwest (Indianapolis, Indiana). Results: In total, 1,112 accidental overdose deaths occurred and over two-thirds (68.0%; n = 756) were coded as an illicit drug user with no prescription opioid present in the toxicology. The most infrequent categories were prescription opioid users 5.5% (n = 61). Conclusion: Linked PDMP and toxicology reports are useful in identifying drug use patterns that contribute to mortality.