title: Trends in opioid-related fatal overdoses in Massachusetts, 1990-2003.
abstract: Since 1997, poisoning, particularly from heroin and other opioids, has been the leading cause of injury mortality in Massachusetts. Our aim was to describe recent trends in opioid-related poisoning deaths among Massachusetts residents.
  
  
  METHODS
  Massachusetts death files for the years 1990-2003, as coded by International Classification of Disease, Ninth Revision and International Classification of Disease, Tenth Revision, were used to identify all poisoning deaths and opioid-related poisoning deaths; rates were age-adjusted and grouped by year, sex, and race/ethnicity.
  
  
  RESULTS
  From 1990 to 2003, opioid-related fatal poisoning rates increased by 529% from 1.4 per 100,000 in 1990 to 8.8 per 100,000 in 2003. The proportion of total poisoning deaths associated with opioids rose from 28% in 1990 to 69% in 2003.
  
  
  CONCLUSIONS
  Massachusetts experienced a significant increase in opioid-related poisoning death rates. To guide future public health interventions, further investigation is necessary to better delineate the specific opioids involved, the circumstances surrounding these deaths, and the medical and behavioral health care options available.
authors.affiliation: Department of Emergency Medicine, Boston University School of Medicine, MA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Fernandez
authors.forename: Holly
authors.initials: H
authors.lastname: Hackman
authors.forename: Loreta
authors.initials: L
authors.lastname: McKeown
authors.forename: Teresa
authors.initials: T
authors.lastname: Anderson
authors.forename: Beth
authors.initials: B
authors.lastname: Hume
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D062787:Drug Overdose; D005260:Female; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*