By studying the records of coroners who did record specific drugs for overdose deaths, Ruhm was able to impute a corrected count of opioid overdoses. According to Ruhm’s research, if all coroners accurately reported opioid overdose deaths, official counts would be substantially higher. For example, the CDC figure for 2016 was 42,249 opioid overdose deaths nationwide, but with accurate data the count would have been 49,562, Ruhm said.
The CDC cannot control local coroners, so it’s up to states and counties to improve overdose reporting practices. Although some of them have been doing so, the political incentives are not well-aligned. For example, if a state or county spends money on better recording of overdose deaths it will be “rewarded” by looking as if its opioid problem is getting worse.
More important, Ruhm’s research shows that the severity of the opioid epidemic is being underestimated. This makes it all the more urgent for the president and Congress to take significant steps to curb the worst public health disaster in decades.