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Toxicology Surveillance

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Between 1999 and 2017, drug overdose deaths increased by 907 percent in Indiana. The recent surge in the supply of illicit fentanyl is contributing to the rapid rise of drug overdose deaths. This highlights the need for timely and accurate data to monitor changes in the types of opioids involved in overdose deaths.

The Indiana State Department of Health’s (ISDH’s) ability to respond quickly and appropriately to the drug overdose epidemic depends on complete and timely data. Historically, drug overdose deaths have too often been classified on death certificates as resulting from “multi-drug toxicity” or simply “drug overdose” without specifying the drug that caused the fatal overdose. Comprehensive toxicology testing is essential to properly identify which drugs, specifically opioids, are associated with overdose deaths.

ISDH is improving fatal drug overdose reporting by funding standardized toxicology testing on suspected drug overdose deaths. Under Indiana Code 36-2-14-6 (b), all Indiana coroners are required to conduct toxicology screenings to gather information on suspected controlled substances in fatal overdose cases.

Coroners must take the following steps if they reasonably suspect the cause of a person’s death to be an overdose of a controlled substance, whether it was accidental or intentional:

1. Obtain any relevant information about the decedent maintained from the INSPECT program;

2. Extract and test certain bodily fluids of the decedent;

3. Report test results to ISDH; and

4. Provide the department notice of the decedent's death, including any information related to the controlled substances involved, if any.

This legistlation has enhanced the state's ability to respond quickly and appropriately to control the drug overdose epidemic by providing more rapid, consistent and extensive data.

As part of this new law, coroners will also be required to create an account to access the INSPECT records of a person who has died of a suspected drug overdose. An INSPECT report summarizes the controlled substances a patient has been prescribed, the practitioner who prescribed them, and the dispensing pharmacy where the patient obtained them. To read more about INSPECT, visit the website and scroll down to the section on Law Enforcement utilizing INSPECT to review the policies regarding coroners and law enforcement.

If you have questions about the toxicology program, please email indianatrauma@isdh.in.gov or contact the Trauma and Injury Prevention Division director, Katie Hokanson, at khokanson@isdh.in.gov or 317-234-2865.

Click here to view the latest Multi-Drug Toxicology Report, created by partners at the Wayne State University Center for Behavioral Health and Justice.

Page last updated 11/06/2019