--- title: The Number of Opioid Overdose Deaths May Be Underestimated description: A new study says opioid overdose deaths may have been underreported from 1999 to 2015 because of how they're coded on death certificates. canonical: https://time.com/5323377/opioid-overdose-deaths-underreported/ author: Jamie Ducharme article:opinion: false article:content_tier: free article:published_time: 2018-06-27T17:41:49.000Z article:modified_time: 2026-02-23T20:41:48.743Z article:section: Health og:title: The Number of Opioid Overdose Deaths May Still Be Underestimated og:description: Here's why og:url: https://time.com/5323377/opioid-overdose-deaths-underreported/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltce566d07ff3a42da/69893406ab6d77fd5c6b30b0/opioid-overdose-deaths.jpeg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 4288 og:image:height: 2412 og:image:alt: opioid-overdose-deaths og:type: article twitter:card: summary_large_image twitter:title: The Number of Opioid Overdose Deaths May Still Be Underestimated twitter:description: Here's why twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltce566d07ff3a42da/69893406ab6d77fd5c6b30b0/opioid-overdose-deaths.jpeg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Researchers May Have Underestimated the Number of Opioid Overdose Deaths > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's weekday health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free weekday newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-health-2026q3/newsletters?i=22b928d1-4aac-4983-99fc-fab04169f759&cr=time-nl-health-2026q3-v1)  by [Jamie Ducharme](https://time.com/author/jamie-ducharme/)  ## Jamie Ducharme Ducharme is a contributor to TIME. Jun 27, 2018 5:41 PM UTC  Used needles and other drug paraphilia litter the sidewalk at a homeless encampment in the Kensington section of Philadelphia on May 30, 2018\. (Photo by Cory Clark/NurPhoto via Getty Images) Used needles and other drug paraphilia litter the sidewalk at a homeless encampment in the Kensington section of Philadelphia on May 30, 2018\. (Photo by Cory Clark/NurPhoto via Getty Images) Getty Images  by [Jamie Ducharme](https://time.com/author/jamie-ducharme/)  ## Jamie Ducharme Ducharme is a contributor to TIME. Jun 27, 2018 5:41 PM UTC The statistics around opioid overdose deaths are staggering. More than 42,000 people died of an opioid overdose in 2016 alone, [according to recent federal estimates](https://www.hhs.gov/opioids/about-the-epidemic/index.html), and [fatal overdose rates continue to rise](http://time.com/5220372/drug-overdose-deaths-cdc/) across nearly every segment of the population. Among young adults, these drugs [accounted for about 20% of all deaths](http://time.com/5299363/opioids-young-adults-deaths/) in 2016, the Centers for Disease Control and Prevention estimates. But [a new study](http://journals.sagepub.com/doi/full/10.1177/0033354918774330) says that even those figures don’t capture the full extent of the opioid crisis. In a paper published Wednesday in _Public Health_ _Reports_, researchers find that as many as 70,000 opioid overdose deaths were unreported or misclassified between 1999 and 2015 because of the way drug overdoses are coded on death certificates. Causes of death are listed on death certificates using codes determined by the National Center for Health Statistics. Some of these codes denote specific narcotics involved in a fatal drug overdose, but a code also exists for “other and unspecified narcotics.” Of the more than 438,600 unintentional overdose deaths included in the new study’s analysis, roughly 255,500 were coded as opioid-related, approximately 85,600 were coded as non-opioid-related and about 97,100 were coded as unspecified. The researchers hypothesized that many of these other-coded deaths were actually attributable opioids. Assuming that this proportion would be roughly equal to the proportion of all overdoses involving opioids, they worked to reallocate some of the generally coded fatalities. In all, they estimated that roughly 70,000 unspecified deaths should have been marked as opioid-related. Under this new classification, the number of deaths that would be reallocated to involve opioids ranged from just nine in Vermont to more than 11,000 in Pennsylvania, according to the study. The researchers also uncovered discrepancies in the way states code and report overdose deaths. In Pennsylvania, Louisiana, Alabama, Indiana and Mississippi, for example, the drugs involved in more than 35% of all overdose deaths were unspecified. Washington, D.C., meanwhile, used specific drug codes for all of its overdose deaths, and 17 states did so in at least 95% of cases. Areas that relied on state medical examiners to determine causes of death tended to specify drugs far more frequently than states using county coroners or hybrid systems, the researchers found. Underreporting fatal opioid overdoses may both downplay the severity of the opioid epidemic and impede efforts to curtail it, the authors write. “Proper allocation of resources for the opioid epidemic depends on understanding the magnitude of the problem,” the paper says, “and incomplete death certificate reporting prevents lawmakers, treatment specialists, and public health officials from doing so.” ```json [{"@context":"https://schema.org","@type":"NewsArticle","@id":"https://time.com/5323377/opioid-overdose-deaths-underreported/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/5323377/opioid-overdose-deaths-underreported/"},"headline":"Researchers May Have Underestimated the Number of Opioid Overdose Deaths","datePublished":"2018-06-27T17:41:49.000Z","dateModified":"2026-02-23T20:41:48.743Z","description":"Here's why","url":"https://time.com/5323377/opioid-overdose-deaths-underreported/","keywords":["Research","onetime","healthytime"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/bltce566d07ff3a42da/69893406ab6d77fd5c6b30b0/opioid-overdose-deaths.jpeg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Jamie Ducharme","jobTitle":"Ducharme is a contributor to TIME.","url":"https://time.com/author/jamie-ducharme/"}],"articleSection":"Health","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/bltce566d07ff3a42da/69893406ab6d77fd5c6b30b0/opioid-overdose-deaths.jpeg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"opioid-overdose-deaths","caption":"opioid-overdose-deaths","creditText":"Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/health/","name":"Health"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/research/","name":"Research"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/5323377/opioid-overdose-deaths-underreported/","name":"Researchers May Have Underestimated the Number of Opioid Overdose Deaths"}}]}] ```