title: [Discrepancies in the number of deaths from an acute reaction to psychoactive substances recorded in Spain].
abstract: OBJECTIVE
  The National Mortality Register (NMR) is used to monitor and prioritize health problems, but it may underestimate deaths from external causes, among which are deaths from acute reaction to psychoactive substances (ARPS). To evaluate the discrepancies between death from ARPS collected in the NMR and those collected in the specific register of the State Information System for Drug Addiction (SEIT).
  
  
  METHODS
  We evaluated the discrepancy between ARPS deaths in 15-49 years olds registered in the NMR (code E850-858) and deaths from acute reaction to opium and cocaine in the SEIT, in Barcelona, Bilbao, Madrid, Sevilla, Valencia and Zaragoza, between 1984-93.
  
  
  RESULTS
  3,491 ARPS deaths were registered in SEIT, 1,285 in NMR. Varying degrees of discrepancies appeared between the two registers in all six cities. The NMR in Madrid showed 92% fewer deaths than the SEIT, while in Barcelona the NMR figure was 23% lower. Between 1984 and 1993 the differences between registers in all cities, except Madrid and Seville, narrowed (p < 0.01).
  
  
  CONCLUSIONS
  Even though detection of ARPS deaths in the NMR has been improving, it still underestimates the real situation, and is therefore not a useful tool in the evaluation of temporal-spatial variations. To improve detection of ARPS deaths (and those from other external causes) a systematic linkage with data from the coroners' registers must be done.
authors.affiliation: Servicio de Epidemiología, Instituto Municipal de Salud Pública, Barcelona, 08023, España. tbrugal@imsb.bcn.es
authors.forename: M T
authors.initials: MT
authors.lastname: Brugal
authors.forename: G
authors.initials: G
authors.lastname: Barrio
authors.forename: E
authors.initials: E
authors.lastname: Regidor
authors.forename: M
authors.initials: M
authors.lastname: Mestres
authors.forename: J A
authors.initials: JA
authors.lastname: Caylà
authors.forename: L
authors.initials: L
authors.lastname: de la Fuente
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D062787:Drug Overdose / Q000401:mortality; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012042:Registries / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000401:mortality*; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D013287:Illicit Drugs; D011619:Psychotropic Drugs