Why is it hard to get a true picture of drug deaths nationwide?

The nation’s main storehouse of information on deaths from drug overdoses is built on local death certificates. But local coroners and medical examiners frequently don’t track drug deaths the same way. Some have no medical training. Some don’t investigate drug deaths. Some don’t even list the drug causing an overdose. States track drug deaths differently, too.

Why is tracking heroin especially tricky?

Once in the body, heroin rapidly degrades into morphine. A person may have overdosed on heroin, yet lab results will show only morphine in their system.

Does that mean morphine deaths are counted as heroin deaths?

Not necessarily. In the federal database called WONDER, morphine deaths are grouped with other opioids, including oxycodone, the main ingredient in Purdue Pharma’s OxyContin. So, a change in that category could be related to heroin, as well as oxycodone.

Is heroin also grouped with oxycodone?

No. Heroin is in its own category, and reflects deaths where coroners and medical examiners have evidence of heroin in the body or at the scene, sometimes along with morphine.

Why doesn’t WONDER just use different drug categories? WONDER uses an international disease classification system created by the World Health Organization and globally accepted as the gold standard. Changes to the system have previously taken years to finalize.