title: A description of Medical Examiner prescription-related deaths and prescription drug monitoring program data.
abstract: BACKGROUND
  The Centers of Disease Control and Prevention have declared prescription drug abuse an epidemic in the United States. However, demographic data correlating prescription-related deaths with actual prescriptions written is not well described. The purpose of this study is to compare toxicology reports on autopsy for prescription-related deaths with Prescription Drug Monitor Program (PDMP) data.
  
  
  METHODS
  This is a retrospective analysis comparing 2013 San Diego Medical Examiner data on 254 unintentional prescription-related deaths obtained for 12 months before death with data from the California PDMP. Data were analyzed on age, sex, whether there was information on the PDMP, types and quantities of prescribed medications, number of pharmacies and providers involved, and whether there was a match between the Medical Examiner toxicology report and data from the PDMP.
  
  
  RESULTS
  In 2013, there were 254 unintentional prescription-related deaths; 186 patients (73%) had PDMP data 12 months before death. Ingesting prescription medications with illicit drugs, alcohol, and/or over-the-counter medications accounted for 40% of the unintentional deaths. Opioids were responsible for the majority of single medication deaths (36; 70.6%). The average number of prescriptions was 23.5 per patient, and the average patient used 3 pharmacies and had 4.5 providers. Chronic prescription use was found in 68.8% of patients with PDMP data.
  
  
  CONCLUSIONS
  The PDMP data highlight important patterns that can provide valuable insight to clinicians making decisions regarding types and amounts of medications they prescribe. Although there is no guaranteed solution to prevent prescription-related deaths, PDMP data can be useful to prevent coprescribing and medication interaction and by following best clinical practices.
authors.affiliation: Department of Emergency Medicine, Scripps Mercy Hospital, San Diego, CA.
authors.forename: Roneet
authors.initials: R
authors.lastname: Lev
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Sean
authors.initials: S
authors.lastname: Petro
authors.affiliation: University of Arizona, Tucson, AZ.
authors.forename: Oren
authors.initials: O
authors.lastname: Lee
authors.affiliation: San Diego County Medical Examiners Office, San Diego, CA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lucas
authors.affiliation: Department of Emergency Medicine, University of California, San Diego, San Diego, CA.
authors.forename: Amy
authors.initials: A
authors.lastname: Stuck
authors.affiliation: Department of Emergency Medicine, University of California, San Diego, San Diego, CA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Vilke
authors.affiliation: Department of Emergency Medicine, University of California, San Diego, San Diego, CA. Electronic address: emcastillo@ucsd.edu.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Castillo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D002423:Cause of Death; D003334:Coroners and Medical Examiners; D004347:Drug Interactions / Q000502:physiology; D016903:Drug Monitoring / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000401:mortality*; D063487:Prescription Drug Misuse / Q000401:mortality*; D055553:Prescription Drugs / Q000506:poisoning*; D012189:Retrospective Studies; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D055553:Prescription Drugs