Statement of purpose Drug poisoning is a leading cause of death from injuries within the US. Nationally, deaths from opiate use and abuse have quadrupled in the past ten years (CDC)_. Public health officials and educators are left scrambling to find effective evidence-based strategies for prevention and risk reduction. The goal of this project is to analyse demographic and toxicology data provided by Chester County Coroner’s Office to inform opiate abuse and overdose prevention efforts

Methods/Approach The Chester County Coroner’s Office shared identified demographic data and toxicology reports for 2010–2012 death investigations. Chester County Health Department staff conducted statistical analyses using SPSS v21.

Results From 2010 to 2012, the Chester County Coroner’s Office investigated 452 deaths. The deceased were primarily white (87.6%) males (63.3%) with a mean age of 45 years. Toxicological panels indicate that 383 of the deceased (84.7%) had opiates in their system. Of those positive panels, 299 had only prescription opiates (no heroin) in the system at the time of death (78.1%), 51 were positive for heroin and some form of prescription opiate (13.3%), and 33 indicated only heroin (8.6%). Of those testing positive for opiates, 110 were positive for recent cannabis use (28.7%) and 68 were positive for ethanol (17.8%).

Conclusions The vast majority (91.4%) of opiate-positive panels indicated use of prescribed opiates, while 8.6% were positive for heroin only (n = 33). These findings run contrary to the popular narrative of prescription opiates as the pathway to addiction with heroin often becoming the illicit, lethal end point. Public health education efforts must communicate the lethality of misusing any opiate, especially when combined with alcohol or other drugs.

Significance and contribution to the field This investigation demonstrates how data and resource sharing between local government agencies can spur data-driven decision making for public health education while adding value to other public serving departments. Additionally, public health officials can monitor trends in toxicology reports as an evaluation measure for drug abuse prevention and treatment efforts.