Opioid overdoses in Texas: Possible undercounting

In May and June of 2017, the Prevention Resource Center 7 held an Opioid Training and a Town Hall Meeting in the Bryan/College Station area.

Although a year has passed, recognition and prevention of the opioid epidemic has remained a top priority for the state of Texas.

Some people may ask why Texas is focusing on such a topic, especially if the number of overdoses is "low" compared to other states.

According to the Centers for Disease Control and Prevention, Texas remains in the bottom three with the lowest death rate for opioidrelated deaths.

In other words, data shows that Texas does not have an issue with opioids.

However, due to the size of the state and the limited number of medical examiners (ME), there may be underreporting or undercounting of opioid overdose deaths.

Across the entire state, there are only 12 ME offices that are able to thoroughly conduct an autopsy.

Each of these offices are located in major counties, such as Harris, Tarrant, Bexar, and Travis County.

These offices serve the county they are located in as well as several other counties which surround it.

For instance, Travis County Medical Examiner's Office (TCMEO) serves a total of 43 counties, including Travis.

In 2016, 940 cases out of 5, 677 were accepted under the ME jurisdiction (Travis County) and their bodies were examined.

Only 612 cases from outside of Travis County were received by TCMEO for examination.

The remaining 4, 125 reported and referred cases did not meet jurisdiction and bodies were not examined.

These numbers show that the TCMEO is unable to perform autopsies for every case, as well as other cases that are never referred to them.

If cases are not referred to an ME then a Justice of the Peace decides the cause of death, which in most cases is a county judge.

In these cases an autopsy is not performed unless the deceased is a child, foul play is suspected, or a family member requests to have one done.

The lack of performed autopsies is most likely due to the requirement of resources such as time and money.

Given the size of the state and the short supply of ME, it is likely that numerous bodies are never properly examined.

If an autopsy is not performed, how can we be sure that the cause of death was not an overdose?

If Texas is undercounting opioid-related overdoses, then how do we really compare to other states? These questions may never be answered until more resources, like additional ME offices, are put in place to provide an accurate cause of death. The Brazos Valley Council on Alcohol and Substance Abuse provides prevention, intervention and treatment services to the Brazos Valley.