Drug-Related Mortality, Arizona, 1985-1995

This report was prepared by Christopher K. Mrela, Ph.D., Assistant Registrar of Vital Statistics

Key Findings

This section presents some illustrative findings contained in the figures and tables of the report. It is not intended to be an exhaustive analysis of the tabulated data.

It is impossible to determine how accurately the reported number of drug-related deaths reflects the true incidence of mortality from drug abuse/dependence. Some reasons for underreporting are: 1) social and family pressures to avoid stigmatization and 2) in-complete information at the time of death about the decedent's history of drug use. For these reasons drug dependence and drug abuse may not be given as the cause of death; instead another, less accurate category of underlying cause (e.g. unintentional drug misuse) is used.

• From 1985 to 1995, 2,625 Arizona residents died from drug poisoning in various circumstances. In the seven years from 1985 to 1991 there were 1,289 deaths, or an average number of 184 deaths per year. In the four years from 1992 to 1995, there were 1,336 drug-related deaths, and the annual average number of deaths of about 334 was 82 percent higher than during the previous, much longer period (the number of drug-related deaths by year is given in Table 1). This increase may reflect either improved reporting or a true increase in incidence, or both.
• The 1995 age-adjusted rate of death from drug poisoning due to all reported circumstances (9.2 drug-related deaths per 100,000 Arizona residents) was 92 percent higher than the rate of 4.8/100.000 in 1985 (Table 2). The rate of deaths from reported adverse effects and accidents in the use of drugs was 3 times higher in 1995 (5.4/100,000) as compared to the 1985 rate of 1.8/100,000, whereas the rate of deaths from drug dependence and abuse was similar to the rate seen in 1985 (Figure 1, Table 2).
• Psychostimulants (such as amphetamine) and opiates accounted for an unprecedented share of all fatal overdoses in 1995 (Figure 2). The number of deaths due to accidental overdose of amphetamines increased 9 times from 2 deaths/year in 1990-91 to an average annual number of more than 18 deaths/year in 1994-95 (Figure 2, Table 2). In 1995, 95 deaths had morphine type drug reported as the agent compared to 32 deaths in 1985 (Table 3). Since 1989, annual mortality rates for cocaine and morphine type drugs combined have consistently exceeded the rates of death due to poisoning by barbiturates, tranquilizers and other psychotropic agents (Table 4). The 1995 rate of deaths from morphine type drugs (2.3/100,000) was the highest of the eleven-year period (Table 4).
• Black residents of Arizona had the highest 1985-1995 average annual rates of drug-related death (9.1/100,000), exceeding the corresponding rates for non-Hispanic whites, Hispanics and American Indians by at least 32 percent (Figure 3, Table 8).
• The eleven-year rate of deaths from drug dependence, abuse and misuse among Blacks (7.5/100,000) was 2.1 times greater than that of American Indians (3.6/100,000; Figure 4, Table 8). In contrast, non-Hispanic whites had the highest rate of death for suicidal poisoning by drugs (Table 8).
• Cocaine-type drugs were responsible for the majority of drug-related deaths among Blacks. The eleven-year rate of cocaine-related deaths among Blacks (2.8/100,000) was 4.7 times greater than that of non-Hispanic whites or American Indians (Figure 5, Table 8).
• Morphine type drugs (heroin, methadone, opium and combination of morphine with any other drug) were responsible for the majority of drug-related deaths among Hispanics and American Indians (Figure 5, Table 8). In contrast, barbiturates, tranquilizers and other psychotropic agents accounted for the majority of drug-related deaths among non-Hispanic whites (Figure 5, Table 8).
• The average annual age-specific rates of drug-related deaths in 1985-1995 were the highest for Blacks among ethnic groups (Figure 6, Table 8).
• Among adolescents 15-19 years old, the rate for Blacks (2.8/100,000 was at least 8 percent greater than the rates for non-Hispanic whites, Hispanics and American Indians.
• Among persons aged 20-44 years (Figure 6, Table 8), Black residents of Arizona in 1985-1995 were 42.3 percent more likely to have been victims of fatal drug poisoning (16.5/100, 000) compared with the overall risk of 11.6 for all ethnic groups. Among Arizonans 45-64 years old, the overall risk of drug-related death was 96 percent greater for Blacks than their Hispanic peers (10.8 vs. 5.5, Figure 6, Table 8).
• The 1995 rate of drug-related deaths among males (13.4/100,000) was 2.4 times greater than the rate of 5.6/100,000 for females (Figure 7, Table 14). The rate of deaths from drug dependence and abuse was 6 times greater among males (1.8/100,000) than females (0.3/100,000). The male mortality rate from cocaine and morphine combined was 6 times higher than respective female rate (Figure 8, Table 15).
• Males, who accounted for 69.9 percent of all drug-related deaths in 1995 had an even greater proportional representation among reported deaths from drug dependence/ abuse and misuse (36 out of 42, or 86 percent). Their share of cocaine/morphine- related deaths was 87.2 percent.
• The 1995 rate of drug-related deaths among unmarried Arizonans (13.9/100,000) was 3.2 times greater than the rate of 4.4/100,000 for married residents of the state (Figure 9, Table 16). The rate of deaths from drug dependence and abuse was 4 times greater among single (2.0/100,000) than than married Arizonans (0.5/100,000). The mortality rate from cocaine and morphine combined among unmarried persons (4.2/100,000) was 4.7 times higher than the respective rate for married residents (0.9.0/100,000; Figure 10, Table 17).
• Seventy out of every 100 drug-related deaths in 1995 were to unmarried Arizona residents (Table 16, Table 17). The unmarried residents accounted for 83 percent of deaths due to drug dependence and abuse, 73 percent of morphine-related and 64 percent of all cocaine-related deaths.
• Eighty-four percent of deaths in 1995 attributed to drug abuse or dependence were young adults 20-44 years old. In contrast, young adults accounted for a smaller share (48 percent, or 67 out of 108, Table 10) of drug-related suicides. Drug-related deaths in which cocaine or morphine were reported as the agent were overwhelmingly (83 percent, or 97 out of 117 deaths in 1995) a young adult phenomenon (Table 11).
• In 1995, residents of the urban regions of the State (Maricopa, Pima, Pinal and Yuma counties) contributed 35 out of 42 or 83.3 percent of deaths due to drug dependence, abuse or misuse (Table 12). Urban regions also accounted for 92 percent of deaths in which cocaine or morphine were reported as the agent.
• Pima County ranked first among the 15 Arizona counties in drug-related mortality with the average annual 1986-1994 rate of 9.1/100,000, 2.9 times higher than the lowest rate of 3.1/100,000 in Santa Cruz County (Figure 11, Table 18). In 10 counties (including Santa Cruz), the average annual drug-related death rates were at least 25 percent lower than the statewide average 6.5/100,000 in the 1985-1995 period (Table 18).
• One of the objectives set by the U.S. Public Health Service for the year 2000 is that the rate of drug-related deaths should be reduced to 3.3/100,000. Arizona residents were much closer to this proposed objective in 1990 than they were in 1995 (Table 2). In 1990, the age-adjusted drug-related mortality rate (4.6/100,000) for Arizonans exceeded the year 2000 national objective by 40 percent. In 1995, the Arizona rate of drug-related deaths (9.2/100,000) exceeded the year 2000 target rate by 179 percent.

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