title: Trends in licit and illicit drug-related deaths in Florida from 2001 to 2012.
abstract: BACKGROUND
  Florida, the epicenter of the recent prescription drug epidemic in the United States, maintains a statewide drug mortality surveillance system. We evaluated yearly profiles, demographic characteristics, and correlation between drug trends to understand the factors influencing drug-induced mortality.
  
  
  METHODS
  All drug-related deaths reported to the Florida Medical Examiners Commission during 2001-2012 were included (n=92,596). A death was considered "drug-related" if at least one drug was identified in the decedent. Depending on its contribution to death, a drug could be listed as a causative agent or merely present, but not both.
  
  
  RESULTS
  Rate of drug-caused deaths was 8.0 per 100,000 population in 2001, increasing to 17.0 in 2010 and then decreasing to 13.9 in 2012. Benzodiazepines had the highest mortality rate in 2010, although <10% were solely due these drugs. Opioid-caused mortality rate also peaked in 2010 and started to decline (-28%) in 2010-2012. The heroin-caused mortality rates were negatively correlated with opioids and benzodiazepines (ρ's ≥ -0.670; P≤0.034). Ethanol- and cocaine-mortality rates stabilized to 3.0-3.1 and 2.8-3.0 per 100,000 over 2009-2012, respectively. Amphetamines, zolpidem, and inhalants-caused deaths were on the rise with rates of ≤0.6 per 100,000.
  
  
  CONCLUSIONS
  Overall declines in benzodiazepine- and opioid-caused deaths in 2011-2012 may have been related to Florida's attempts to regulate prescription drug abuse. This period, however, was also marked by a rise in heroin-caused mortality, which may reflect growing use of heroin as an alternative. Increases in amphetamines, zolpidem, and inhalants-induced mortality are an additional public health concern.
authors.affiliation: Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Dayong
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Health Outcomes and Policy and Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Delcher
authors.affiliation: Department of Health Outcomes and Policy and Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Mildred M
authors.initials: MM
authors.lastname: Maldonado-Molina
authors.affiliation: Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Lindsay A L
authors.initials: LA
authors.lastname: Bazydlo
authors.affiliation: District Six Medical Examiner's Office, Largo, FL, USA.
authors.forename: Jon R
authors.initials: JR
authors.lastname: Thogmartin
authors.affiliation: Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA. Electronic address: bruce-goldberger@ufl.edu.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Goldberger
mesh_terms: D000059:Accidents / Q000401:mortality; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D062787:Drug Overdose / Q000401:mortality*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations; D011041:Poisoning / Q000401:mortality*; D044469:Racial Groups / Q000706:statistics & numerical data; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000401:mortality*; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D004364:Pharmaceutical Preparations
keywords: Drug-related mortality; Ethanol; Florida Medical Examiners Commission; Forensic toxicology; Illicit drugs; Licit drugs