Dumb question:   Is there anything behind this besides an burst of legal 
prescriptions that created a self-reinforcing trend?
Or are people actually going crazy?

From: Friam <[email protected]> on behalf of Robert Holmes 
<[email protected]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[email protected]>
Date: Wednesday, January 2, 2019 at 10:16 AM
To: The Friday Morning Applied Complexity Coffee Group <[email protected]>
Subject: [FRIAM] Statistical poser (aka fact checking is hard)

Early this week I came across a recent press release from NM Dept of Health: 
"Governor Martinez Announces Continued Improvement in Drug Overdose Death 
Rankings"<https://nmhealth.org/news/information/2018/12/?view=728>. I've been 
tinkering round with opioid statistics, so thought it might be worth fact 
checking the release. The results were… interesting. If nothing else they've 
shown me how difficult it must be to communicate public health statistics.

So here are some of the key figures from the release:

  *   New Mexico’s national ranking has improved from the second highest death 
drug overdose death rate in the United States in 2014 to 17th highest in 2017
  *   New Mexico previously reported a 4 percent decline in death rates in 2017 
due to overdose of commonly prescribed opioids such as oxycodone compared to 
2016. In addition, deaths due to heroin decreased by 9 percent and deaths due 
to synthetic opioids such as fentanyl decreased by 6 percent over the same time 
period.
The first of these claims passed my sniff test: I know NM's ranking has been 
improving, even though individual counties rank the wort in the nation. And 
sure enough, if you pull the underlying CDC 
data<https://wonder.cdc.gov/mcd.html> you can confirm these exact numbers 
(ignoring DC).

The second claim is the one that gave me pause. Those reductions in individual 
opioids look kinda high. Yes, NM's ranking is improving but it's because our 
rate is essentially stable while other states rocket past. And when I check the 
above CDC data, yes the reduction in death rate appears to be about 2%

So there's the poser: if NM's reduction in opioid deaths (2016-2017) is 2%, how 
can this be consistent with individual opioid reductions of 9% (heroin), 4% 
(natural & semi synthetic, inc. oxycodone), and 6% (synthetic, inc. fentanyl)?

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted 
methadone: deaths due to that are down 19% in the same period.
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