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Study prompts change in dramatic under-counting of opioid-related deaths in Indiana

A newly-published study on Indiana's drug epidemic shows we are losing even more Hoosiers to opioids than first thought.

INDIANAPOLIS (WTHR) - A newly-published study on Indiana's drug epidemic shows we are losing even more Hoosiers to opioids than first thought.

This is an update to a story we first brought you in February about dramatic under-counting of opioid-involved deaths.

Now, there are changes underway to better track the crisis.

The changes involve coroners all across the state and policies that will tell us more accurately how many Hoosiers are dying and which drugs are killing them.

Marion County's Chief Deputy Coroner Alfarena Ballew has seen Indiana's drug crisis firsthand.

She knew it was bad. But it wasn't always made clear on death certificates exactly how bad.

Toxicology testing was expensive, so people who had fentanyl in their systems, for example, weren't always counted as opioid deaths - just an unspecified overdose.

It's why Ballew requested help from researchers at Indiana University to dig deeper into the numbers.

"It was really hard to capture what's actually causing people to die. Was it the prescription meds? Was it actually heroin? Was it the synthetic fentanyls that we're seeing? And so it this was a significant help for us to actually have this research done," Ballew said.

13 Investigates first shared initial findings from that research in February. It's now been published in the American Journal of Public Health. The six-year study showed that Marion County (and likely the entire state) had been grossly under-counting opioid deaths.

"A much larger portion of our drug overdose deaths are opioid-involved than what we're currently putting out there," explained Brad Ray, Director of the Center for Health and Justice Research, who helped conduct the study.

In fact, the number of opioid deaths more than doubled.

Opioid-involved deaths in Marion County went from 34% to 86% when toxicology results were taken into account. That's a staggering difference when trying to save lives. It's also prompting concern that Indiana could miss out on federal funding to help stem the crisis because of underreported deaths.

"If I'm compiling data for a grant, for example, I would say Indiana's ranked 19th or 16th in opioid-related deaths, but I know it should be higher. If we actually had accurate data, then we would sort of be able to be more aggressive in getting some of the federal dollars that are coming down right now," Ray said.

But this research, along with help from lawmakers, the Indiana State Department of Health and Deputy Coroner Ballew, prompted a recent change.

"The state's been doing quite a bit in getting accurate data," Ray said.

A new law took effect in July, SEA 139, which now enhances and expands toxicology testing for all county coroners. Federal grant money pays for that testing, in a state-contracted lab.

"If we suspect it, we can send it and that cost is not going to really hit our budget like it did in the past," Ballew said. "That is really going to make a big difference."

Every death certificate involving a drug overdose in Indiana now lists specifics, giving a clearer picture of Indiana's crisis.

"So that we can actually look at, 'Was it a fentanyl? Are there more fentanyl deaths? Or are there more heroin related deaths? Are there more methamphetamine deaths?'," Ballew said. "So we can look at those numbers from the death certificate and we can take that information and compile that data and see what our real problem is."

Now researchers are trying to get an accurate count of opioid deaths statewide.

The ISDH says by understanding trends of drug use in each county, they can get effective, community-targeted programs in each county to save lives.