Prescription drug deaths in Texas have been widely undercounted even as officials try to crack down on overprescribing and prescription drug-dealing.
Data from the Texas Department of State Health Services only counts overdose deaths involving certain painkillers, not all prescription drugs, a joint investigation by the Houston Chronicle and the Austin American-Statesman has found. The newspapers reported that the data does not include information from medical examiners whose drug screenings identify many more overdoses.
The state's method of tracking cases undercounts deaths in every major county across Texas, and often does not include deaths that involve multiple medications or prescription drugs mixed with alcohol or other illegal substances, the newspapers reported.
Carrie Williams, a spokeswoman for the health services department, said the agency is not trying to obscure the numbers. There is no death certificate code that captures all prescription overdoses, she said.
"We are in public health, and we have no reason to undercount the problem," she told the newspapers.
According to the newspapers, medical examiner reports in Harris, Travis, Dallas, Tarrant and El Paso counties, as well as some smaller counties, attribute many more deaths to prescription drug overdoses than the state has counted in opioid overdoses.
In 2013, only 622 deaths in Texas were specifically blamed on opioids, mostly painkillers, according to the health services department. But the newspapers tallied 798 prescription-drug related deaths recorded by local medical examiners that year in just 17 of the state's 254 counties.
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The state tallied 179 deaths from painkillers in Harris County, which includes Houston, but the medical examiner's office reported 275 deaths involving all prescription drugs in 2013. In Travis County, which includes Austin, the state reported 17 deaths from prescription painkillers in its preliminary count of death certificates, but the administrator of the county's Medical Examiner's Office hand-counted 114 deaths involving all prescription drugs that year, the newspapers reported.
It's not just Texas that is having trouble accounting for prescription drug deaths. It's a nationwide problem, Bob Anderson, chief of mortality statistics for the National Center for Health Statistics at the Center for Disease Control Prevention, told the newspapers. The federal government has no way to capture complete data from approximately 2,300 medical examiners, justices of the peace and coroners all over the country, he said.
"It's clear we're missing a lot of prescription drug deaths," Anderson said. "It's important to communicate that we need the specificity, we need the detail. If we can't adequately identify which drugs caused the death, we don't know where to focus prevention efforts."
