title: Patterns and trends in accidental poisoning death rates in the US, 1979-2014.
abstract: The purpose of this study was to examine US accidental poisoning death rates by demographic and geographic factors from 1979 to 2014, including High Intensity Drug Trafficking Areas.
  
  
  
  Crude and age-adjusted death rates were formed for age group, race, sex, and county for accidental poisonings (ICD 9th revision: E850-E869; ICD 10th revision: X40-X49) from 1979 to 2014 using the Mortality and Population Data System housed at the University of Pittsburgh. Rate ratios were calculated comparing rates from 2014 to 1979, overall, by sex, age group, race, and county. Joinpoint regression detected changes in trends and calculated the average annual percentage change (AAPC) as a summary measure of trend.
  
  
  
  Drug poisoning mortality rates have risen an average of 6% per year since 1979. Increases are occurring in all ages 15+, and in all race-sex groups. HIDTA counties with the highest mortality rates were in Appalachia and New Mexico. Many of the HIDTA border counties had lower rates of mortality.
  
  
  
  The drug poisoning mortality epidemic is continuing to grow. While HIDTA resources are appropriately targeted at many areas in the US most affected, rates are also rapidly rising in some non-HIDTA areas.
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, United States. Electronic address: jeanine@pitt.edu.
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Buchanich
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, United States.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Balmert
authors.affiliation: School of Pharmacy, University of Pittsburgh, United States.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Pringle
authors.affiliation: Office of the Medical Examiner of Allegheny County, United States.
authors.forename: Karl E
authors.initials: KE
authors.lastname: Williams
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, United States.
authors.forename: Donald S
authors.initials: DS
authors.lastname: Burke
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, United States.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Marsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011041:Poisoning / Q000209:etiology; D019966:Substance-Related Disorders / Q000401:mortality; D014481:United States
keywords: Mortality; Public health; Substance abuse