Data Source

Texas Vital Statistics (VSTAT)

Data Description

Death Certificate data are collected by the DSHS Vital Statistics Section during the death registration process. Each death certificate includes literal causes of deaths provided by medical certifiers. Literal causes of deaths are coded by the NCHS coding software which is using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) - Mortality, implemented in 1999. The NCHS coding software identifies a single underlying cause-of-death that is defined as disease or injury that initiated the events resulting in death.

Death data for this module are derived from information collected on death certificates. The data contains all deaths that either occurred in Texas, including deaths of non-Texas residents, or deaths of Texas residents that occurred outside of Texas. The demographic, geographic, and medical information included in this module are: county of occurrence, county of residence, age, race/ethnicity, sex, year of death, and underlying cause of death.

Texas adopted the new U.S. Standard Certificate of Death in 2006. Users are cautioned that some data items might not be directly comparable with previous years.

Measure Information

Drug Type

The type of psychoactive substance involved is indicated by the following ICD-10 cause of death codes: all opioids (T40.0, T40.1, T40.2, T40.3, T40.4, T40.6), heroin (T40.1); commonly prescribed opioids (natural and semisynthetic opioids (T40.2); methadone (T40.3)); synthetic opioids other than methadone (T40.4); opium (T40.0); other and unspecified narcotics (T40.6); benzodiazepines (T42.4); cocaine (T40.5); psychostimulants (T43.6); Cannabis (T40.7); Psychotropic (T43).

The inclusion of ICD-10 code T40.6 is based on guidance from the Centers for Disease Control and Prevention (2017). This code is used in cases where the death certificate does not contain enough information to assign a specific ICD-10 code (e.g., the cause of death is listed as “opioid”). Natural and semisynthetic opioids include natural opioid analgesics (e.g., morphine and codeine) and semisynthetic opioid analgesics (e.g., oxycodone, hydrocodone, hydromorphone, and oxymorphone). Synthetic opioids, other than methadone, include opioids such as tramadol and fentanyl. It is not possible to determine whether an opioid was illegally produced or pharmaceutical, nor how it was obtained; for example, deaths from fentanyl include both legally prescribed and illegally produced fentanyl.

Poisoning deaths involving psychoactive substances may involve more than one type of substance (e.g., heroin and cocaine), so users should avoid adding totals by drug type category.

Circumstance of Death

“Accidental and Intentional Drug-Related” are those deaths which include one of the following ICD-10 codes among the underlying causes of death: X40-X44 (accidental), X60-X64 (intentional), X85 (homicide), Y10-Y14 (undetermined intent), and at least one of the following ICD-10 codes identifying substances: T40.0, T40.1, T40.2, T40.3, T40.4, T40.5, T40.6, T40.7, T42.4, T43 and T43.6.

“Accidental Drug-Related” are those deaths which include at least one of the following ICD-10 codes among the underlying causes of death: X40-X44, and at least one of the following ICD-10 codes identifying substances: T40.0, T40.1, T40.2, T40.3, T40.4, T40.5, T40.6, T40.7, T42.4, T43 and T43.6.

Additional Information

Overview and Demographics Further Reading:

Texas DSHS Vital Statistics: https://www.dshs.texas.gov/vs/default.aspx

Center for Disease Prevention and Control (CDC), Opioid Overdose Data: https://www.cdc.gov/overdose-prevention/data-research/facts-stats/?CDC_AAref_Val=https://www.cdc.gov/drugoverdose/dashboards/index.html

Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016: https://pubmed.ncbi.nlm.nih.gov/30237320/