Introduction

This tab provides additional information about select derived/analytic variables contained in the site-specific datasets and listed in the data dictionary.

The information in this tab should be used along with the SUDORS data dictionary tab and screenshot document with the variable name crosswalk.

We have included recommendations in red about the best versions of variables to use when multiple versions are included.

"Dummy" variables have 2 values indicating yes (1) or no (0).

Derived toxicology variables

1. Dummy variables to indicate detection of drugs and drugs causing death

There are several different versions of toxicology dummy variables. These variables have been created to allow for a simple way to pull out deaths with specific drugs detected or listed as a cause of death.

To create these variables, we used the "substance name", "substance class", "substance caused death", "toxicology comments", and "cause of death" text fields to look for entries for each drug.

Indicate that the given drug was entered on the Toxicology tab by selecting it from the drop-down menu

Indicate that the given drug was entered on the Toxicology tab by selecting it from the drop-down menu AND the "cause of death" box was checked for that drug

Indicate that the given drug was entered on the Toxicology tab by selecting it from the drop-down menu OR it was hardcoded in because it was entered in the toxicology comments or cause of death text fields

Indicate that the given drug was entered on the Toxicology tab by selecting it from the drop-down menu OR OR it was hardcoded in because it was entered in the toxicology comments or cause of death text fields, AND the "cause of death" box was checked

Indicate that the given drug or its known metabolites were entered on the Toxicology tab by selecting it from the drop-down menu OR hardcoded in because it was entered in the toxicology comments or cause of death text fields

Indicate that the given drug or its known metabolites were entered on the Toxicology tab by selecting it from the drop-down menu OR hardcoded in because it was entered in the toxicology comments or cause of death text fields AND the "cause of death" box was checked

*_t and _t_cod versions are only available for heroin, fentanyl, and cocaine, because detection of metabolites of these parent drugs, either along with the parent drugs or alone, can provide information (e.g., recency of use, rapidity of overdose)

*We recommend using the _r and _r_cod versions, or the _t and _t_cod versions for heroin, fentanyl, and cocaine, as they include the most complete information.

Please note, we reviewed results of searching the toxicology comments box and the cause of death text fields to remove false positives so they are not included in these versions.

2. Defined heroin/morphine/codeine variables

Description

Categorical variable classifying detection of 6-MAM and/or morphine (using scene, witness, and toxicology information) as confirmed heroin, probable heroin, suspected heroin,

suspected Rx morphine, or unknown morphine source. Deaths with no 6-MAM or morphine are classified as missing.

Categorical variable classifying detection of 6-MAM and/or morphine (using scene, witness, and toxicology information) as confirmed/probable/suspected heroin, suspected Rx morphine, or unknown morphine source.

Deaths with no 6-MAM or morphine are in category 0

Categorical variable classifying cause of death for 6-MAM and/or morphine (using scene, witness, and toxicology information) as confirmed/probable/suspected heroin, suspected Rx morphine, or unknown morphine source.

(category 3). A final category (4) indicates heroin was listed as a cause of death without 6-MAM or morphine detected. Deaths with no 6-MAM or morphine as cause of death are in category 0.

Dummy variable indicating confirmed/probable/suspected heroin or not

Dummy variable indicating confirmed/probable/suspected heroin or not, as cause of death

Dummy variable indicating probable prescription morphine or not

Dummy variable indicating probable prescription morphine or not, as cause of death

Dummy variable indicating morphine of unknown source or not

Dummy variable indicating morphine of unknown source or not, as cause of death

Dummy variable indicating codiene or not, after subtracting out confirmed/probable/suspected heroin from the codeine total

Dummy variable indicating codiene or not as cause of death, after subtracting out confirmed/probable/suspected heroin from the codeine total

Evidence used to indicate confirmed heroin:

detection of 6-MAM (heroin's main metabolite)

Evidence used to indicate probable heroin:

detection of morphine without 6-MAM, plus scene/witness evidence indicating likely heroin use (injection drug use, history of heroin use) or detection of common heroin cutting agents/impurities on toxicology

Evidence used to indicate suspected heroin:

detection of morphine without 6-MAM, no scene/witness evidence indicating likely heroin use (injection drug use, illicit drug use, history of heroin use), no detection of common heroin cutting agents/impurities on toxicology, but other illicit drugs detected (cocaine, methamphetamine, illicit fentanyl or illicit fentanyl analogs) or evidence of illicit drug use at the scene

Evidence used to indicate suspected Rx morphine:

detection of morphine without 6-MAM, plus scene/witness evidence of prescription morphine use

3. Defined fentanyl source variables

Description

Categorical variable classifying detection of fentanyl (using scene, witness, and toxicology information) as probable IMF, suspected IMF, probable Rx fentanyl, or unknown source fentanyl.

Deaths with no fentanyl detected are classified as missing

Categorical variable classifying detection of fentanyl (using scene, witness, and toxicology information) as probable/suspected IMF, probable Rx fentanyl, or unknown source fentanyl.

Deaths with no fentanyl detected are in category 0

Categorical variable classifying cause of death for detection of fentanyl (using scene, witness, and toxicology information) as probable/suspected IMF, probable Rx fentanyl, or unknown source fentanyl

Deaths with no fentanyl as cause of death are in category 0

Dummy variable indicating probable/suspected IMF or not

Dummy variable indicating probable/suspected IMF or not, as cause of death

Dummy variable indicating probable prescription fentanyl or not

Dummy variable indicating probable prescription fentanyl or not, as cause of death

Dummy variable indicating fentanyl of unknown source or not

Dummy variable indicating fentanyl of unknown source or not, as cause of death

Dummy variable indicating defined illicit or unknown source fentanyl, or any illicit fentanyl analog, or not

Dummy variable indicating defined illicit or unknown source fentanyl, or any illicit fentanyl analog, or not, as cause of death

Evidence used to indicate probable IMF:

detection of fentanyl and detection of any illicit fentanyl analog or precursor

Evidence used to indicate suspected IMF:

detection of fentanyl and scene/witness evidence of illicit fentanyl use (injection, snorting, illicit drug use, counterfeit pills, history of heroin use) or detection of illicit substance use (heroin, heroin cutting agents/impurities, cocaine, methamphetamine)

Evidence used to indicate probable Rx fentanyl:

detection of fentanyl and scene/witness evidence of prescription fentanyl use (patches, lozenges, transdermal drug use, fentanyl prescription)

4. Rx/Illicit opioid variables

Description

Dummy variable indicating any prescription opioid(s) or not

Dummy variable indicating any prescription opioid(s) or not, as cause of death

Dummy variable indicating any illicit opioid(s) or not

Dummy variable indicating any illicit opioid(s) or not, as cause of death

Categorical variable indicating prescription opioid(s) only, illicit opioid(s) only, both prescription and illicit opioids, or neither

Categorical variable indicating prescription opioid(s) only, illicit opioid(s) only, both prescription and illicit opioids, or neither, as cause of death

*Note that the prescription and illicit opioid variables incorporate the defined heroin, morphine, and fentanyl source variables described in sections 2 and 3 above. Def_heroin, susp_imf_v3, and unk_fent_v3 are incorporated into the illicit_opioid_v3 variable. Def_heroin_cod, susp_imf_cod_v3,

and unk_fent_cod_v3 are incorporated into illicit_opioid_cod_v3. Def_morphine and susp_rxfent_v3 are incorporated into rx_opioid_v3, and def_morphine_cod and susp_rxfent_cod_v3 are incorporated into rx_opioid_cod_v3.

Derived OD tab variables

Several derived variables were created from system variables on the OD tab to assist in analyses. These variables take the information from the system variables and therefore either version can be used.

Dummy variable indicating that the overdose occurred in a house/home/apartment setting or not (created from "injurylocation")

Dummy variable indicating that there was evidence that the decedent was treated for chronic or acute pain at the time of the overdose or not (created from "treatedforpain")

Dummy variable indicating that there was evidence that the decedent was treated for chronic or acute pain at the time of the overdose AND evidence of prescription drugs was found at the scene or not (created from "treatedforpain" AND "hasevidenceofprescriptiondrug")

Dummy variable indicating that there was evidence that the decedent had experienced a nonfatal overdose prior to the fatal overdose or not (created from "previousoverdose")

Dummy variable indicating that the decedent had been released from an institutional setting in the month before the fatal overdose or not (created from "recentrelease")

Dummy variable indicating that the decedent had been released from jail/prison in the month before the fatal overdose or not (created from "recentrelease")

Dummy variable indicating that there was evidence that the decedent had experienced opioid use relapse before the fatal overdose or not (created from "recentopioiduse")

Dummy variable indicating that there was evidence that the decedent was prescribed buprenorphine or methadone at the time of the fatal overdose or not (created from "indicationsbuprenorphine")