Maybe I\u2019ve grown callous from a career as a family\nphysician. I hope not. Years of talking to people about their aches and pains,\ntheir bodily functions, their private feelings and fears might have made me so.\nI sense people\u2019s shame and I respect their privacy. But I believe somethings\nneed to be talked about and sometimes publicly. One of those is how we die.<\/p>\n\n\n\n
The number of people dying from accidental prescription\noverdose deaths started climbing in 1999. We have all heard how the big drug\ncompanies started pushing their drugs on the medical profession in the mid\n1990\u2019s. It wasn\u2019t until 2006 that a CDC data analyst saw some numbers and\nthought there might be a problem. Interestingly, there were also murmurings\nfrom state medical examiners that reinforced the impression. But the rate of\ndeaths has only recently begun declining.<\/p>\n\n\n\n
Some states have a medical examiner system, unlike Idaho\nwhere we have county coroners who are only responsible for their own\njurisdiction. I have written before about the variation in Idaho\u2019s county\ncoroner death investigations. The Canyon County coroner only specified type of\ndrug overdose death in 35% of death certificates. Next door Ada County\nspecified 91%. There is little doubt Idaho has undercounted our problem.<\/p>\n\n\n\n
But that is the official government system responsible for death investigation and reporting. I appreciate that some are looking to change that system. <\/p>\n\n\n\n
But I wonder how the change in local reporting of deaths\nalso might have contributed to the rise in accidental overdoses. <\/p>\n\n\n\n
Some of you may remember when obituaries were written by the\nlocal newspapers. They were \u201creported\u201d. I\u2019m sure the youngest or newest\nreporter got the tedious and uncomfortable job of calling the family and doing\nsome background on the recently deceased. It might have been mundane, but it\nwould have required some sensitivity too. We all deserve that. I believe the\nprofession of journalism has lost some sensitivity. But the balance of privacy,\nsensitivity and public awareness is the job of a journalist.<\/p>\n\n\n\n
In my hometown paper the formula always included age and\ncause or manner of death. I noticed many times the death was referred to as\n\u201cnatural causes\u201d, which I took to mean cancer, since back then, there was some\nshame associated with that dreaded disease. That has changed. But that is truly\na \u201cmanner of death\u201d, since there are only five categories: natural, accidental,\nhomicide, suicide, or indeterminate. I can appreciate skipping the details of\n\u201ccause\u201d. But sometimes the cause, say pneumonia or heart attack, was specified.\nI suppose this was sensitive. <\/p>\n\n\n\n
The official report, the death certificate is required to be\ncomplete and detailed, but death certificates are not public record. They are\nshared with people who can demonstrate a need to know, like family or an estate\nagent. Life insurance companies demand a death certificate.<\/p>\n\n\n\n
But in the early 2000\u2019s many papers stopped reporting on\ndeaths and obituaries became paid-for family written pieces. Most families\ndon\u2019t want to share such a tragedy as an accidental overdose or a suicide\npublicly. I can\u2019t blame them. But it might have helped our communities have an\nearlier awareness of this wave of deaths.<\/p>\n\n\n\n
I have asked some old newspaper guys and they explained this\nchange with the simplest answer: money. Newspapers were being starved for\nrevenue; Craigslist siphoned off the want ad revenue, online news depleted\nsubscriptions, readership declined. They couldn\u2019t afford to hire those young\nreporters and break them in on writing obituaries.<\/p>\n\n\n\n
I really don\u2019t know if more accidental overdose deaths would\nhave been reported locally. Would the community benefit from knowing the young\nman died from an overdose? Would our awareness of the lethal effect of these\ndrugs have made us a little less likely to demand them from our prescribers?\nIt\u2019s a sensitive question. We should all be a little more sensitive.<\/p>\n","protected":false},"excerpt":{"rendered":"
Maybe I\u2019ve grown callous from a career as a family physician. I hope not. Years of talking to people about their aches and pains, their bodily functions, their private feelings and fears might have made me so. I sense people\u2019s … Continue reading