Armed with that info, Ruhm estimated how many of those deaths could be blamed on heroin and how many on opioids.
His results? The national rate of fatal opioid overdoses jumped in 2014 from 9 per 100,000 people to 11.2 — and rate of fatal heroin overdoses climbed form 3.3 per 100,00 to 4.
Based on Ruhm’s research, the drug problem in Pennsylvania is a lot worse than the CDC figures indicate.
The Keystone state was ranked 32nd by the CDC for opioid deaths for 2014, with 8.5 per 100,000. But Ruhm concluded the Keystone State actually has the seventh highest rate of opioid deaths that year with 17.8 per 100,000. And, based on Ruhm’s calculations, it went from being the state with the 20th highest fatal heroin overdose rate to fourth.
“These numbers are alarming and underscore the need to continue expanding treatment, education, awareness, and resources for law enforcement and health professionals,” J.J. Abbott, press secretary for Pennsylvania Gov. Tom Wolf, wrote in an email to NBC News. “As part of the ongoing strategy to address the opioid crisis, the administration is working on creating a public facing data dashboard to centralize and streamline information regarding overdoses, prevention, and treatment from all of the different sources.”
That said, Susan Shanaman of the Pennsylvania State Coroners Association said “there are many reasons that a Coroner may not list all the drugs on a death certificate,” including federal and state privacy rules.
“The average family gets 20 copies of a death certificate of their loved one,” she wrote in an email to NBC News. “These are used to close out bank accounts, transfer loan accounts, transfer titles to vehicles, claim insurance and the like. Not every family member wants the public to know what drugs were all found in the deceased.”
Hard-hit Ohio’s opioid death rate went from 18.2 per 100,000 (fifth highest in the country) to 20.5 per 100,000 (fourth highest in the country) in Ruhm’s report.
Ohio also has the nation’s highest rate of fatal heroin overdoses with 10.4 per 100,000. By Ruhm’s reckoning, the rate is 11.2 per 100,000, which is also the highest in the country.
Unchanged in Ruhm’s report is West Virginia’s woeful ranking as the state with the highest rate of deadly opioid cases. But even there Ruhm concluded the death rate for opioids should have been 30.3 per 100,000 in 2014 instead of 29.9. And the state’s fatal heroin overdose rate should have been 9 per 100,000 rather than 8.8.
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Ruhm’s research also buttresses earlier studies that identified the primary victims of this plague.
“Fatal overdose rates are higher for males than females, for whites than blacks or other non-whites,” Ruhm said.
And the overdose death rates are highest for people ages 25 to 64 in the Rust Belt, in Appalachia and some western states.
“There are also pockets with high death rates in many other parts of the country as well,” Ruhm said