New methodology to improve tracking of Veteran overdose deaths and characterization of a population of Veteran overdose decedents in San Diego County

Comparing VA records to county ME records revealed that VA records missed over 80 % of drug-related overdose deaths-4 out of every 5 deaths. While accurate for intentional overdoses, accidental overdoses-which comprise the vast majority of drug overdose deaths-were missing over 90 % of the time. Given that drug toxicology results were consistent with county trends, this suggests that VA records severely underestimate drug overdose deaths. Approximately two-thirds of VA patients who died of drug overdose access VA and most were seen in the emergency department and over half in primary care-identifying these as important intervention targets for overdose prevention. Given the gaps in capturing drug overdose deaths, other healthcare systems looking to prevent overdose deaths, and especially other VA systems, may want to consider adopting similar methods to better capture and understand factors that impact drug overdose deaths among their patient populations.