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Preliminary drug death trends in Washington state

What you will find on this page

Here we present preliminary drug overdose deaths based upon Washington State Department of Health quarterly data. These have yet to be finalized, so they will change somewhat, most likely increasing. We provide detailed discussion of data issues at the bottom of this page. As we discuss further there, the Washington Department of Health implemented count suppresion measures beginning with Q1 and Q2 of 2021 (published together).

Drug categories are based on ICD-10 codes with one exception:

Statewide deaths involving drug types of interest

In the time trends graph below, click on "All drug poisonings" and other collective series in the legend in order to better see less aggregated or common drug categories.

Data sources: Washington State Department of Health. Q = quarter.
Data sources: Washington State Department of Health. Q = quarter.

County-specific increases in deaths involving drug types of interest

Only one county, King, saw notable jumps in any type of drug death in Q2 2021, in the overlapping fentanyls and other synthetic opioids categories (to 77 deaths in the quarter). By "notable" we mean the count in the most recent quarter is more than double the average over the prior 3 years (12 quarters).

Data notes

Certification of deaths in the United States relies on a devolved, usually county-based process. As we discuss elsewhere in these pages (see our opioid deaths page and major drug deaths page for more information) deaths involving drugs are a particular challenge. This New York Times Magazine article addresses some of the myriad issues inherent in the US death certification system through the lens of the opioid crisis.

Whereas the "official" death certificate data we use elsewhere go through a centralized process designed to create a more uniform national dataset, on this page we use a different data source. The Washington state Department of Health publishes preliminary drug death counts for recent quarters. Drug deaths take longer to certify than most other deaths, and so pending death certificates at any point in time will be disproportionately drug deaths. As such, some counts presented for more recent quarters will almost certainly increase.

Drug-caused deaths are compiled by the state Department of Health based on individual-level death certificate data. They represent reported drug poisonings (based on ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14 as the underlying cause of death) involving Washington residents who died in Washington. This common definition excludes cases where alcohol poisoning or alcoholism, carbon monoxide poisoning, etc., was coded as the underlying cause of death. Many drug deaths involve multiple drugs, and identifying the single drug out of many that resulted in death is impossible. Thus, these deaths are best described as drug poisonings involving the drug or category of drugs specified.

Although identification of drugs in deaths has improved over time, for heroin as well as fentanyls in particular, the time period presented here entails fairly constant accuracy of drug classification within jurisdiction. There may remain important differences across jurisdictions, particularly to the extent that death determination does not involve enlisting the aid of the state toxicology lab. Furthermore, some counties have recently put special emphasis on fentanyl deaths and are identifying those deaths more quickly than other deaths. Again, the data presented here are preliminary and will change.

The Department of Health, beginning with Q1 and Q2 2021, now suppresses counts between 1 and 9. This means that we can no longer witness a particular drug in a particular county jump from an average of 2 to 5, or from 9 to 19 etc. This means we will no longer present maps of jumps, as in the prior version of this page, because smaller counties are being censored. The absence of discussion of a particular drug category (e.g., fentanyls) in a particular county (e.g., Mason) should not be taken as meaning that drug is not growing in threat in that county.