Poisonings among Arizona Residents, 2012

Resources for the development of this report were provided through funding to the Arizona Department of
Health Services from the Centers for Disease Control and Prevention, Cooperative Agreement 5U17CE00202301, Core Violence and Injury Prevention Program.
Permission to quote from or reproduce materials from this publication is granted when acknowledgment is
made.

Prepared by: Jennifer D. Dudek, MPH
150 North 18th Avenue, Suite 320
Phoenix, AZ 85007
Office of Injury Prevention
Bureau of Women’s and Children’s Health
Arizona Department of Health Services
March 2014

1

Table of Contents
Executive Summary................................................................................................................ 3
Overview of Poisonings Among Arizona Residents.................................................................. 4
Poison Control Centers Serving Arizona .................................................................................. 5
Five-Year Trends in Poisonings Among Arizona Residents, 2008-2012 ..................................... 6
Mortality ......................................................................................................................................6
Non-Fatal Inpatient Hospitalizations ...........................................................................................9
Poisoning-Related Mortality, 2012 ....................................................................................... 11
Non-Fatal Poisoning-Related Inpatient Hospitalizations, 2012 .............................................. 16
Non-Fatal Poisoning-Related Emergency Department Visits, 2012 ........................................ 21
Poisoning and Prescription Drug Overdoses as an Arizona Public Health Concern ................. 26
Poisoning Prevention Tips and Resources ............................................................................. 27
Methodology Section…..........................................................................................................28

2

Executive Summary
Poisoning was the leading cause of injury-related mortality among Arizona residents in 2012, 1,097 (24
percent) deaths were attributable to poisoning. Males aged 45 through 54 years had the highest rate of
poisoning-related deaths with 43.9 deaths per 100,000 residents. Poisoning mortality rates were highest
among American Indians (28.3 deaths per 100,000 residents) and non-Hispanic Whites (20 deaths per 100,000
residents). Seventy-six percent of the poisoning-related deaths in 2012 were due to unintentional injuries
(n=832); 16 percent were due to suicide (n=154); and eight percent were of an undetermined manner of death
(n=110). The poisons most commonly specified on death certificates in 2012 were alcohol (18 percent, n=198),
Oxycodone or Hydrocodone (16 percent, n=179), and Methamphetamine (10 percent, n=108). Among counties
with at least 20 poisoning-related deaths in 2012, Navajo County had the highest fatality rate (37.6 deaths per
100,000 residents).
In 2012, there were 7,154 non-fatal inpatient hospitalizations due to poisonings. Adult females had the highest
rates of non-fatal poisoning-related inpatient hospitalizations. Females 45 through 54 years of age had a rate
of 179.6 cases per 100,000 residents, and females 35 through 44 years of age had a rate of 166.3 cases per
100,000 residents. White, non-Hispanic residents had the highest age-adjusted poisoning-related rate of nonfatal inpatient hospitalizations in 2012 (138.0 per 100,000) followed closely by African-American Arizona
residents (127.6 cases per 100,000 residents). Unintentional poisoning accounted for 47 percent of non-fatal
inpatient hospitalizations (n=3,382), and intentional poisonings comprised an additional 45 percent (n=3,191).
Hospital charges for non-fatal poisoning-related inpatient hospitalizations totaled more than $120 million in
2012, and Arizona residents spent a total of 12,817 days hospitalized for these injuries. Gila County had the
highest age-adjusted rate of inpatient hospitalizations due to non-fatal poisonings (146.3 hospitalizations per
100,000 residents).
In 2012, there were 11,999 non-fatal poisoning-related emergency department visits among Arizona residents.
The highest age-specific rates of non-fatal poisoning-related emergency department visits for both males and
females were among children younger than five years of age (429.0 visits per 100,000 residents and 390.8 per
100,000 residents, respectively). Fifty-two percent of the non-fatal poisoning-related emergency department
visits were the result of unintentional poisonings (n=6,190), and 35 percent of the visits resulted from
intentional injuries (n=4,178).
The data presented in this report show that poisoning is a public health problem that impacts the lives of
thousands of Arizona residents each year. These injuries can occur throughout the life span, and like so many
injuries, poisonings are preventable. Understanding the circumstances of poisonings is an important step
towards educating and empowering communities and implementing prevention strategies.

3

Overview of Poisonings among Arizona Residents
Fatalities and injuries resulting from poisonings are significant problems in Arizona. Beginning in 2007,
poisoning-related deaths surpassed motor-vehicle crashes as the leading injury-related cause of death among
Arizonans.1 As this report shows, the burden of poisoning-related injuries has increased in recent years,
accounting for a greater percentage of injury-related morbidity and mortality. Figure 1 presents an overview of
the number of poisoning-related events by outcome and illustrates the limitations of currently available data
sources and the inability to enumerate the true number of poisonings.

Figure 1. Poisoning Outcomes Pyramid, Arizona 2012

1,097 Deaths

7,154 Non-fatal Inpatient
Hospitalizations

11,999 Non-fatal Emergency
Department Visits

??? Poisonings treated in physician's offices,
other outpatient facilities, at home, via Poison
Control Center, or not treated

This report presents a comprehensive picture of poisoning-related injuries among Arizona residents in 2012, as
well as poisoning trends during the five years since 2008. To help better understand the data, information
about poison control centers are also presented. For additional information about data sources and methods
used, please refer to the Methodology section of this report. To learn about preventing poisonings, please
refer to the Prevention Tips and Resources section of this report.

1

Please refer to the Methodology Section for a description of the types of poisonings included in this report; these numbers may not match
other publications.

4

Poison Control Centers Serving Arizona
Poison Control Centers (PCCs) are widely considered to be a cost-effective tool for reducing healthcare costs
resulting from poisoning events. It has been estimated that for every dollar invested in a PCC, seven dollars of
medical care can be avoided.2 Because of the clear benefit to citizens, the state of Arizona has mandated the
existence of a PCC since 1980. Per Arizona Revised Statutes 36-1161 through 36-1163, the Arizona Department
of Health Services is responsible for establishing a poison and drug information system consisting of two
poison control centers. While the poison control centers are charged with serving as a resource for poison
identification and treatment, they are also tasked with educating the public about poisoning prevention.
As of March 2014, two of the nation’s 57 nationally recognized PCCs were located in Arizona. The Arizona
Poison and Drug Information Center (APDIC) is affiliated with the University of Arizona College of Pharmacy
located in Tucson. The Banner Good Samaritan Poison & Drug Information Center (BGSPDIC) is located in
Phoenix. The BGSPDIC serves Maricopa County, including the metropolitan Phoenix area. The APDIC serves the
remainder of the state. While the BGSPDIC serves a smaller geographic area, it covers about 60 percent of the
state’s residents.
Similar to other nationally recognized PCCs, both Arizona centers are accessed by calling the National Poison
Control Center toll-free telephone number: 1-800-222-1222. Calls to this number are routed to the appropriate
PCC based on geography. Because calls are routed based on the telephone number from which the call is
placed, individuals with an Arizona telephone area code will speak to either BGSPDIC or APDIC, even if they are
calling from outside Arizona. Individuals are encouraged to call PCCs with any concerns, whether or not an
incident has occurred. While providing information and medical advice about poisonings, both of Arizona’s
centers provide additional services to residents, including drug information and identification, medical
consultation with clinicians, and poisoning prevention education and outreach.
In 2012, the APDIC documented 23,407 calls for human exposures to toxins and poisons, out of 49,394 total
calls (47 percent). Twenty-four of these cases resulted in death and 33 percent (n=7,681) of the calls were
managed in a healthcare facility.
In 2012, the BGSPDIC documented 46,817 calls for human exposures to toxins and poisons, out of more than
90,000 total calls (52 percent). 73 percent of calls were managed at home and eight-six percent of all human
exposure calls were accidental or unintentional.
The availability of a 24-hour poison control center allows many people who may have sought emergency care
to be treated in their own homes, resulting in financial savings for themselves and the healthcare facilities they
may have otherwise visited. BGSPDIC estimates that more than 34,000 callers may have sought medical
treatment at an emergency department in 2012 if they had not been able to consult with the poison control
center and care for themselves at home saving the community more than $30 million in emergency treatment
costs.3
A survey of patients who called a PCC found that 79 percent of the patients surveyed would have used the
local emergency medical services in the absence of a poison control hotline, at an estimated cost of more
than five times the operating costs of the PCC.4
2

Miller TR, Lestina DC. Costs of poisoning in the United States and savings from poison control centers: A benefit-cost analysis. Ann Emerg
Med February 1997; 29:239-245.
3
Banner Good Samaritan Poison & Drug Information Center 2010 Summary, accessed March 11th, 2014 at
www.bannerhealth.com/Locations/Arizona/Banner+Good+Samaritan+Poison+and+Drug+Information+Center/About+Us/By+the+Numbers.ht
m
4
Kearney TE, Olson KR, Bero LA, Heard SE, Blanc PD. Health Care Cost Effects of Public Use of a Regional Poison Control Center. West
J Med 1995; 162:499-504.

5

Five-Year Trends in Poisonings among Arizona Residents, 2008-2012
Mortality
While injuries account for approximately 10 percent of deaths among Arizonans each year, the types of injury
have changed over time. Since 2008, the proportion of poisoning-related deaths has increased from 23 percent
of all injury-related deaths (n=1,047) to 24 percent of injury-related deaths in 2012 (n=1,097). Over this fiveyear period, the number of injury-related deaths has decreased slightly, and the increase in poisoning-related
deaths was offset by decreases in motor vehicle traffic fatalities. Figure 1 shows the distribution of injuryrelated deaths by mechanism of injury over the five year period from 2008 through 2012.

Figure 1. Proportion of Injury-Related Fatalities by Mechanism of Injury
Arizona, 2008-2012
100%
90%

23%

27%

26%

25%

24%

7%

8%

7%

8%

19%

20%

21%

20%

16%

15%

16%

16%

17%

17%

17%

17%

18%

16%

14%

13%

14%

14%

2008 (n=4,553)

2009 (n=4,423)

2010 (n=4,499)

2011 (n=4,546)

2012 (n=4,496)

80%
70%
60%

7%
20%

50%
40%

18%

30%
20%
10%
0%
Other Causes

Fall

Motor Vehicle Traffic

Firearm

Suffocation

Poison

Between 2008 and 2012, the age-adjusted poisoning-related mortality rate increased five percent for Arizona
residents. This overall increase is attributable to the rate of unintentional poisoning deaths, which has
increased by nine percent since 2008. Suicide-related poisonings have been steadily decreasing since 2009 and
have decreased 28 percent overall since 2008. The most significant decrease in suicide-related poisonings
occurred from 2011 to 2012 with a 21 percent decline in mortality rate. Figure 2 shows the age-adjusted
poisoning-related mortality rates by manner of death for Arizona residents from 2008 to 2012.

6

Figure 2. Age-Adjusted Poisoning-Related Mortality Rates per 100,000 Residents by Intent, Arizona
2008-2012
16
14

14.2

13.7

14
13.2

12

12.1

10
8
6
4
3.2

2

3.3

2.9

2.9

2.3

0
2008

2009

2010
Unintentional

2011

2012

Suicide

Between 2008 and 2012, the age-adjusted poisoning-related mortality rates increased for both males and
females, though the rates for males were consistently higher than those for females. Figure 3 shows the ageadjusted poisoning-related mortality rates by sex for Arizona residents from 2008 to 2012.

Figure 3. Age-Adjusted Poisoning-Related Mortality Rates per 100,000 Residents by Sex, Arizona
2008-2012
25

22.4

22

21

20

21

20
15

12.6

14.1

15

15.1
13.4

10
5
0
2008

2009

2010
Male
Female

2011

2012

Poisoning-related mortality rates increased among Hispanic Arizonans by 44 percent over the 5-year period
but decreased 12 percent between 2011 and 2012. American Indians had the highest mortality rate with a 37
percent increase between 2008 and 2012. The 2012 rate (28.3 per 100,000) represents a 15 percent increase
from the 2011 rate, but an 11 percent decrease from 2010 when the mortality rate for this group was at its
highest. The poisoning-related mortality rates increased among African Americans and Non-Hispanic Whites by

7

two and six percent respectively. Figure 4 shows the age-adjusted poisoning-related mortality rates by
race/ethnicity for Arizona residents from 2008 to 2012. Due to small numbers, age-adjusted poisoning-related
fatality rates have not been presented for Asian residents.
Figure 4. Age-Adjusted Poison-Related Mortality Rates per 100,000 Residents by Race/Ethnicity, Arizona
2008-2012*
35
32

30

20

18.9
20.7
17.6

15

21.6

24.5

9

28.3

21.8
13.6

16.3

10
5

24.60

25.2

25

13.9
10.5

10.3

20
18

9.1

6.3

0
2008
White, Non-Hispanic

2009
Hispanic, All races

2010

2011
American Indian

2012
Black/African American

Source: WISQARS for 2008-2010 rates, Arizona Vital Statistics for 2011-2012
*Does not include 31 poisoning-related deaths among persons listed as other or unknown race/ethnicities.

While the trend is not supported in all counties, the age-adjusted rate of poisoning-related fatalities in Arizona
increased 5 percent between 2008 and 2012. Table 1 shows the age-adjusted fatality rate per 100,000
residents for poisoning-related deaths by county of residence from 2008 to 2012.
Table 1. Age-Adjusted Fatality Rate per 100,000 Residents for PoisoningRelated Deaths by County of Residence, Arizona 2008-2012
2008
2009
2010
2011
2012
Apache*
23.2
23.1
28.8
23.3
22.1
Cochise*
13.0
17.3
16.6
9.4
19.4
Coconino*
18.6
18.4
18.6
21.0
17.7
Gila*
18.0
27.1
21.2
25.4
33.6
Graham*
14.7
16.5
17.5
19.9
18.2
Greenlee*
10.1
50.1
11.4
16.2
**
La Paz*
20.0
25.2
58.4
14.0
**
Maricopa
16.0
16.7
16.6
16.7
14.9
Mohave
21.3
31.1
32.0
28.3
27.6
Navajo*
16.5
26.0
25.8
35.1
37.6
Pima
17.7
20.8
22.6
20.7
20.8
Pinal
13.6
13.4
16.3
13.0
12.3
Santa Cruz*
6.7
18.5
7.7
5.5
5.7
Yavapai
20.5
21.1
27.8
31.0
35.2
Yuma*
12.3
13.0
14.0
12.2
15.5
Statewide Total
16.4
18.1
18.7
18.1
17.2
*Rates are unstable for counties indicated, as they had fewer than 20 deaths in at least one year.
** No poisoning-related deaths were recorded for these counties.

8

Non-Fatal Inpatient Hospitalizations
Between 2008 and 2012, the age-adjusted rate of non-fatal poisoning-related inpatient hospitalizations among
Arizona residents increased 21 percent, from 91.9 cases per 100,000 residents in 2008 to 111.0 cases in 2012.
While the increase was still apparent when hospitalizations were divided by injury intent, cases resulting from
unintentional poisonings increased more than cases of intentional poisoning (a 43 percent increase and a 5
percent increase, respectively). It’s important to note, however, that there were 578 cases (about 8 percent of
all poisoning-related hospitalizations) in which the manner was undetermined. Figure 5 shows the ageadjusted poisoning-related rates for non-fatal inpatient hospitalizations by injury intent for Arizona residents
from 2008 to 2012.
Figure 5. Age-Adjusted Poisoning-Related Non-fatal Inpatient Hospitalization Rates per 100,000 residents by
Manner, Arizona 2012
60.0
50.0

48.3

52.3

51.6

47.3
40.0
30.0

49.3

51.4

50.1

50.5

39.7
36.0

20.0
10.0
0.0
2008

2009

2010
Unintentional

2011

2012

Suicide

The rates for non-fatal poisoning-related inpatient hospitalizations were higher for females then for males.
Rates increased among both males and females during the five years from 2008 through 2012, with a 26
percent increase in the rate among males and a 16 percent increase in the rate among females. Figure 6 shows
the age-adjusted rates by sex for non-fatal poisoning-related inpatient hospitalizations from 2008 through
2012.

9

Figure 6. Age-Adjusted Non-fatal Poisoning-Related Inpatient Hospitalization Rates per 100,000
Residents by Sex, Arizona 2008-2012
140
120

105.4

100
80

118.8

111.5
99.5

122.7

117.5
99.1

99.1

89.2
78.5

60
40
20
0
2008

2009

2010
Males

2011

2012

Females

The age-adjusted rate of non-fatal poisoning-related inpatient hospitalizations in Arizona increased between
2008 and 2012 among almost all counties with at least 20 hospitalizations in a given year. Yuma and Graham
Counties are the exception; the 2012 non-fatal hospitalization rates of 43.0 and 63.6 per 100,000 residents,
respectively, are a 36 and 54 percent decrease from 2008. Despite its relatively small population, Gila County
had a poisoning-related hospitalization rate consistently higher than the remainder of the state. Table 2 shows
the age-adjusted fatality rate per 100,000 residents for non-fatal poisoning-related inpatient hospitalizations
by county of residence from 2008 to 2012. Four of the state’s 15 counties had at least one year in which there
were fewer than 20 events, making the rate for that county unstable over time.
Table 2. Age-Adjusted Rate per 100,000 Residents for Non-Fatal PoisoningRelated Inpatient Hospitalizations by County of Residence, Arizona 2008-2012
2008
2009
2010
2011
2012
Apache*
45.4
55.7
58.4
43.0
61.6
Cochise
53.1
68.3
66.7
73.7
63.5
Coconino
63.1
59.2
73.8
85.2
81.8
Gila
97.8
101.3
129.6
156.0
149.2
Graham
139.2
187.6
157.4
88.4
63.6
Greenlee*
89.9
76.3
37.0
127.2
125.6
La Paz*
39.9
113.5
52.8
68.1
40.4
Maricopa
94.6
102.5
114.5
117.3
115.5
Mohave
104.3
124.9
112.8
123.2
142.5
Navajo
76.6
83.3
95.2
103.9
110.6
Pima
103.6
107.0
116.8
109.6
123.6
Pinal
90.9
117.0
109.3
92.3
113.7
Santa Cruz*
44.2
47.6
48.9
59.3
40.5
Yavapai
74.2
78.3
105.3
85.4
97.7
Yuma
67.4
68.8
67.9
38.9
43.0
Statewide Total
91.9
100.3
109.2
108.4
111.0
*Rates are unstable for counties indicated, as they had fewer than 20 cases in at least one year.

10

Poisoning-Related Mortality, 2012
There were 1,097 deaths among Arizona residents attributed to poisoning in 2012. Sixty-one percent of deaths
were among males (n=666), and 39 percent were among females (n=431). In 2012, the age-adjusted poisoning
mortality rate among Arizona females was 13.4 deaths per 100,000 residents; the rate among males was 57
percent higher (21.0 deaths per 100,000 residents). When looking at poisoning deaths by age group, males had
higher mortality rates than females in each age group, though the ratio of deaths among males and females
varied. Adults 45 through 54 years of age had the highest rate of fatalities among both males and females.
Young adults in the 15 to 24 age group had the highest ratio of deaths among males versus females. Deaths
among males 25 through 34 years outnumbered those among females in that age group by a factor of 2. Figure
8 shows the poisoning-related mortality rates per 100,000 Arizona residents by age group and sex.

Figure 8. Poisoning Mortality Rates per 100,000 Residents by Age Group and Sex, Arizona 2012
50
43.9

45
40

33.2

32.9

35

30.3

29.3

30

23.7

25

21.4

20
14.2

15
10
5

14
7

5.9

7

0 0.15

0
0-14 yrs

15-24 yrs

25-34 yrs

35-44 yrs

Males (n=666)

45-54 yrs

55-64 yrs

65+ yrs

Female (n=431)

American Indian residents had the highest age-adjusted poisoning-related mortality rate in 2012 (28.3 deaths
per 100,000 residents), followed closely by White, non-Hispanic residents (20.0 deaths per 100,000 residents).
Hispanic Arizonans had the lowest stable poisoning-related mortality rate in 2012 with 9.1 deaths per 100,000
residents. Though Asian residents had a very low mortality rate, the rate is not stable due to the low number
of deaths. Figure 9 shows the age-adjusted poisoning-related mortality rates by race/ethnicity for Arizona
residents in 2012.

11

Figure 9. Age-Adjusted Poisoning-Related Mortality Rate per 100,000 Residents by Race/Ethnicity, Arizona
2012
28.3

30
25

20
20

18

17.2

15
9.1

10

4.7

5
0

There were 31 deaths among individuals of other or unknown race/ethnicity.

As in previous years, the majority of poisoning-related deaths were determined to be unintentional. In 2012,
76 percent of poisoning-related deaths among Arizona residents were unintentional (n=883). With 154
suicides, 2012 had the lowest percentage of poisoning-related suicide deaths in any year from 2008 through
2012. Figure 10 shows the proportion of poisoning-related deaths by manner in each year from 2008 through
2012.

Figure 10. Proportion of Poisoning-Related Fatalities by Intent,
Arizona, 2008-2012
100%

8%

7%

7%

6%

8%

18%

21%

20%

18%

16%

73%

72%

74%

75%

76%

2008 (n=1,044)

2009 (n=1,175)

2010 (n=1,176)

2011 (n=1,144)

2012 (N=1097)

90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Unintentional

Suicide

Homicide

Undetermined

Every poisoning-related fatality has its own circumstances, including the type of poison used. Multiple drugs
may be listed as contributing to a single death. Table 3 lists the poisons most commonly specified on the 2012
death certificates. Because some death certificates may simply state that the cause of death was a “drug

12

overdose” or “combined drug intoxication”, the figures listed below may be an underestimate of the number
of deaths involving a particular substance.
Table 3. Poisons Commonly Listed on Death Certificates, Arizona 2008-2012
Poisons*

Alcohol
Benzodiazepines
Carbon Monoxide
Carisoprodol
Cocaine
Diphenhydramine
Fentanyl
Helium
Heroin
Methadone
Methamphetamine
Morphine
Oxycodone/Hydrocodone
Serotonin-Norepinephrine
Reuptake Inhibitors (SNRIs)
Selective Serotonin Reuptake
Inhibitors (SSRIs)
Tramadol

2008
(n=1,044)
#
%
186
18%
97
9%
41
4%
15
1%
87
8%
30
3%
37
4%
6
1%
67
6%
105
10%
91
9%
115
11%
162
16%

2009
(n=1,175)
#
%
155
15%
54
5%
36
4%
10
1%
125
12%
22
2%
22
2%
5
<1%
56
6%
79
8%
104
10%
81
8%
119
12%

2010
(n=1,176)
#
%
186
18%
97
9%
41
4%
15
1%
87
8%
30
3%
37
4%
6
1%
67
6%
105
10%
91
9%
115
11%
162
16%

2011
(n=1,144)
#
%
186
16%
99
9%
16
1%
12
1%
59
5%
18
2%
21
2%
10
1%
120
10%
53
5%
116
10%
101
9%
175
15%

2012
(n=1,097)
#
%
198
18%
103
9%
32
3%
10
1%
58
5%
23
2%
15
1%
7
1%
91
8%
40
4%
108
10%
98
9%
179
16%

11

1%

10

1%

11

1%

14

1%

10

1%

55

5%

44

4%

55

5%

49

4%

50

5%

10

1%

13

1%

10

1%

15

1%

19

2%

*More than one poison may have been identified for each death

In 2012, Saturdays had the highest number of deaths accounting for 17 percent of the total deaths,
(n=184).Wednesdays and Thursdays both had 15 percent each and Tuesdays had the lowest number of deaths,
accounting for 12.5 percent (n=137). However, as Figure 11 indicates, these differences are not statistically
significant.

Figure 11. Poisoning Mortality by Day of Week and Sex, Arizona 2012
200

184
168

180
160
140

143

156

148

137

123

120
100
80

161

86
61

60

103

96
77
57

60

Monday

Tuesday

94

87
72
58

61

62

40
20
0
Sunday

Total Deaths (n=1097)

Wednesday
Males (n=666)

Thursday

Friday

Saturday

Females (n=431)

13

Poisoning Fatalities by Manner
There were 832 unintentional poisoning deaths in 2012 (76 percent), 61 percent were among males (n=666),
and 39 percent were among females (n=431). In 2012 there were no deaths among children ages newborn
through 14 years. There were 154 poisoning-related suicides in 2012 (14 percent), 60 percent of which were
among males (n=92). There were no poisoning-related suicides among either sex below the age of 15 years.
In 2012, Males aged 45 through 54 years had the highest mortality rate for unintentional poisoning-related
deaths (32.6 deaths per 100,000 residents), although young adult males ages 25 through 34 also had high
mortality rates (26.4 deaths per 100,000 residents). Males had higher poisoning-related suicide rates in all age
groups except in the 65 through 74 year old age grouping. The highest suicide rates were among males 55
through 64 and over 85 years of age (6.5 and 7.5 suicides per 100,000 residents, respectively). Figure 12 shows
the death rates for poisonings by age group, manner, and sex per 100,000 Arizona residents in 2012.

Figure 12. Age-specific Poisoning-Related Mortality Rates per 100,000 Residents by Age, Sex, and
Manner, Arizona 2012 (n=986*)
85+

2.9

75-84

2.5 1.5

1.3

65-74

5.3

55-64

14.0

45-54
35-44

5.9 1.8
3.3

25.6

10.4

1.9

5.0

12.1

< 14
50.0

Unintentional Males

40.0

30.0

20.0

Unintentional Females

10.0

2.5

0.7 1.3
0.0

60.0

7

2.93.6

26.4

15-24

0.8

4.1 6.5

32.6
18.6

25-34

1.5 1.9 2.2

23.1

23.5

7.5

0.0

Intentional Females

0
10.0

20.0

Intentional Males

*Does not include 110 deaths due to undetermined manner or the 1 death attributed to homicide

14

Figure 13 shows the poisons most commonly specified on the 2012 death certificates for both manners of
poisoning-related fatalities. Because there were so many more unintentional deaths than suicides, the poisons
are shown in percent rather than count. Given that more than one poison may be listed on a death certificate,
the percent values will not add up to 100. Because some death certificates may simply state that the cause of
death was a “drug overdose” or “combined drug intoxication”, the figures listed below may be an
underestimate of the number of deaths involving a particular substance.

Figure 13. Poisons Commonly Listed on Death Certificates (%), by Drug Type, Arizona 2012*
25%
20%
15%
10%

20%
18%
16%
16%

15%

12%
12%
11%
9%
9%
7%

7%

8%

6% 4%
4%
2% 2%2%
2%
1% 1%
1%
1%
1%1% 1%

5%

5%

0%

Unintentional (n=832)

Suicide (n=154)

*More than one poison may have been listed for each death certificate.

15

Non-Fatal Poisoning-Related Inpatient Hospitalizations, 2012
There were 7,154 non-fatal inpatient hospitalizations among Arizona residents attributed to poisoning in 2012,
and an age-adjusted rate of 111.0 per 100,000 residents. Forty-five percent of the events were among males
(n=3,182), and 56 percent were among females (n=3,972). Unintentional and self-inflicted poisonings
accounted for 92 percent of non-fatal poisoning-related inpatient hospitalizations, but neither category
accounted for a majority of cases. Forty-seven percent of inpatient hospitalizations were attributed to
unintentional poisonings (n=3,382), 45 percent resulted from intentional poisonings (n=3,191), poisonings of
undetermined intent accounted for eight percent of hospitalizations (n=578), and there was one visit due to
poisoning-related assaults or other intents (legal intervention).
Except for children ages one through four years of age, females had higher rates of non-fatal inpatient
hospitalizations than males across the lifespan. The 45 through 54 year age group had the highest rate among
both males and females. Figure 14 shows the non-fatal poisoning-related inpatient hospitalization rates per
100,000 Arizona residents by age group and sex.

91.0

90.3

35-44
years

100.1

120

145.7

133.6

25-34
years

109.7

140

128.8

128.3
150.7

15-24
years

160

147.1

133.1

180

166.3

200

179.6

Figure 14. Non-fatal Poisoning-Related Inpatient Hospitalization Rates per 100,000 residents, by
Sex, Arizona 2012

65-74
years

75-84
years

60.3

66.7

20

26.4

11.3

40

20.1
28.2

60

52

53.3

80

74

100

0
<1

1-4
years

5-14
years

Males (n=3,182)

45-54
years

55-64
years

85+
years

Females (n=3,972)

White, non-Hispanic residents had the highest age-adjusted poisoning-related rate of non-fatal inpatient
hospitalizations in 2012 (138.0 per 100,000) followed closely by African-American Arizona residents (127.6
cases per 100,000 residents). Asian residents had the lowest poisoning-related rate of non-fatal inpatient
hospitalizations in 2012 with 23.9 cases per 100,000 residents. Figure 15 shows the age-adjusted non-fatal
poisoning-related inpatient hospitalization rates by race/ethnicity for Arizona residents in 2012.

16

Figure 15. Age-Adjusted Non-Fatal Poisoning-Related Inpatient Hospitalization Rate per 100,000 by
Race/Ethnicity, Arizona 2012
160
140

138

127.6

120

111

100.5

100
80

61.7

60
40

23.9

20
0
Black/African
American
(n=340)

White, nonHispanic
(n=5,272)

American
Indian (n=304)

Hispanic
(n=1,092)

Asian/Pacific All ethnicities
Islander (n=46)
(n=7,154)

There were 100 hospitalizations among individuals of other or unknown race/ethnicity.

Gila County had the highest rate of inpatient hospitalizations for non-fatal poisonings in 2012, with 149.2 cases
per 100,000 county residents. However, Mohave County was the only county to rank among the five counties
with the highest rate of poisonings for both fatal and non-fatal hospitalizations. The rate of non-fatal
poisoning-related inpatient hospitalizations were distributed among residents of Arizona’s counties as shown
in Figure 16.

Figure 16. Age-adjusted Non-Fatal Poisoning-Related Inpatient Hospitalization Rates per 100,000
residents by County, Arizona 2012
149.2

160

142.5

140

125.6

115.5

120

60

113.7
97.7

100
80

123.6
110.6

81.8
61.6 63.5

63.6
40.4

40.5

43

40
20
0

*Rates are unstable due to low counts (n<20); Does not include 3 cases with unknown county information

17

Among all manners of non-fatal poisoning-related inpatient hospitalization, 95 percent were due to overdoses
of a drug or medication. This percentage includes both prescription and non-prescription drugs. Unfortunately,
the lack of specificity in the data on drug type makes further analysis impossible for 2012 data.

Figure 17. Non-fatal Poisoning-Related Inpatient Hospitalizations by Poison Type, Arizona 2012 (n=7,154)

95, 1%
6,759, 95%
395, 5%

275, 4%

25, 0%
Drug-related (Rx and non-Rx)
Household/environmental/agricultural poisons

Beverage alcohol
Carbon monoxide/motor vehicle exhaust

In 2012, the average non-fatal poisoning-related inpatient hospitalization totaled $30,541 in hospital charges
and lasted for 3 days (median = $21,043, 2 days). Arizona residents spent a total of 12,817 days in the hospital
for non-fatal poisoning-related events. The longest hospital stay for a non-fatal case was 151 days. Hospital
charges for non-fatal inpatient hospitalizations due to poisonings totaled over $120 million for Arizona
residents in 2012. The single most costly hospitalization totaled $483,407 in hospital charges. Fifty-seven
percent of hospital charges for non-fatal poisoning-related inpatient hospitalizations were reportedly paid by
Medicare or the Arizona Health Care Cost Containment System (AHCCCS), (3,378 cases; more than $103.5
million). Hospital charges do not reflect hospital reimbursement rates, nor do they include charges or costs
related to emergency medical services, outpatient care, rehabilitation, legal fees, or lost work or school time.

Non-Fatal Poisoning-Related Inpatient Hospitalizations by Manner
There were 3,382 non-fatal inpatient hospitalizations among Arizona residents attributed to unintentional
poisoning in 2012 (47 percent) and 3,191 hospitalizations attributed to intentional poisoning (45 percent).
Because the vast majority of hospitalizations fall into one of these two categories, the following section will
focus on unintentional and intentional non-fatal poisoning-related hospitalizations. Figure 18 shows the
distribution of non-fatal poisoning-related inpatient hospitalizations by manner.

18

Figure 18. Non-Fatal Poisoning-Related Inpatient Hospitalizations by Manner, Arizona 2012
(n=7,154)

0% (n=3)

8% (n=578)

47% (n=3,382)
Unintentional
Intentional
Assault
Undetermined
45% (n=3191)

Unintentional poisoning-related hospitalizations were almost evenly distributed between males and females
(49 and 51 percent respectively) whereas females represented a greater percentage of intentional poisoningrelated hospitalizations (61 percent, n=1,954). Female residents aged 25 through 34 years had the highest rate
of intentional non-fatal poisoning-related inpatient hospitalizations of any age group (94.1 per 100,000) in
2012. Male residents aged 55 through 64 had the highest rate of unintentional poisoning-related
hospitalization (75.1 per 100,000). In general, the highest rates of intentional poisoning-related
hospitalizations were among adults and teenagers aged 15-54, whereas unintentional poisonings were highest
among those aged 25 and older. Surprisingly, there was one intentional poisoning-related hospitalization
among children under 5 years of age. Figure 19 shows the non-fatal poisoning-related inpatient hospitalization
rates per 100,000 Arizona residents by age group and sex, separated by manner.

Figure 19. Age-specific Non-Fatal Poisoning-Related Inpatient Hospitalization Rates per 100,000
Residents by Age, Sex, and Manner, Arizona 2012 (n=6,573)
85+

59.7

75-84

45.2 10.1

76.4

65-74

73.4

55-64

77.9

45-54

5.2

54.7

13

75.1

79.9

35-44

57.0

25-34

46.7

15-24

32.0
50.3
28.2
150.0

100.0

Unintentional Males

50.0

84.4
92.5

60.6

58.7

58.2

58.6

94.1

56.3

92

3.6 17.9

53.3

<1

55

60.5

7.6 6.0

1-4

19.7

42.2

42.9

5-14

200.0

27.8

69.7
62.0

24.8

0

20.1 0
0.0

Unintentional Females

50.0

100.0

Intentional Males

150.0

200.0

Intentional Females

19

African American Arizona residents had the highest age-adjusted non-fatal unintentional poisoning-related
inpatient hospitalization rate in 2012 (66.5 cases per 100,000 residents), followed by White, non-Hispanic
residents (61.6 cases per 100,000 residents). Conversely, White, non-Hispanic residents had the highest ageadjusted non-fatal intentional poisoning-related hospitalization rate (65.2 per 100,000 residents) followed by
American Indian (49.4 per 100,000 residents). Asian residents had the lowest age-adjusted non-fatal inpatient
hospitalization rates for both manners of poisoning. Figure 19 shows the age-adjusted non-fatal unintentional
poisoning-related inpatient hospitalization rates by race/ethnicity for Arizona residents in 2012.

Figure 20. Age-Adjusted Non-Fatal Poisoning-Related Inpatient Hospitalizations Rates per 100,000
Residents by Race/Ethnicity and Manner, Arizona 2012
66.5

70

65.2
61.6

60
50

51.450.5

49.4
45.5

47.5

40

33.3

30

23.4

20

11.3 11.2

10
0
Black/African
American

White, nonHispanic

American
Indian

Hispanic

Unintentional (n=3,382)

Asian

Total

Intentional (n=3,191)

There were 92 hospitalizations among individuals of other or unknown race/ethnicity.

Mohave County had the highest non-fatal inpatient hospitalization rate for unintentional poisonings (69.4 per
100,000 residents) while Gila County had the highest non-fatal inpatient hospitalization for intentional
poisonings (82.1 per 100.000 residents). Non-fatal poisoning-related inpatient hospitalizations were
distributed among residents of Arizona’s counties as shown in Figure 21.

Figure 21. Age-Adjusted Non-Fatal Poisoning-Related Inpatient Hospitalizations by County and
Manner, Arizona 2012
140

82.1

60.2

120

55.1

51.9

59.2

100

60

34.2

35.9

35
19.4

40
20
0

32.2
20.2 22.1

47.1

22.9

45.4

80

51

56.2

48.9
20.9

28.5

54.8

69.4
44.2

55.9 55.2
21.1

3.5

Unintentional (n=3,382)

22.7
41
13.7

Intentional (n=3,191)

*Rates are unstable due to low counts (n<20)

20

Non-Fatal Poisoning-Related Emergency Department Visits, 2012
There were 11,999 non-fatal emergency department visits among Arizona residents attributed to non-fatal
poisoning in 2012. Forty-five percent of the visits were among males (n=5,425), and 55 percent were among
females (n=6,574). Except for children aged 1 through 4 and adults 85 and older, females consistently had
higher rates of non-fatal emergency department visits than males. Children one through four years of age one
had the highest rate of emergency department visits among both sexes and the 15 to 24 year age group had
the next highest rate among adult females. One study has shown that a substantial proportion of young
children brought to an urban tertiary-care emergency department with apparent life-threatening events had
positive toxicology screenings, even when parents denied medicating the child.5 Though the rate of non-fatal
poisoning events among Arizona’s young children is very high, the results of that study suggest that the rate
may be higher still if all young children presenting in the emergency department with an apparent life-threat
were screened for potential poisons. Figure 22 shows the non-fatal poisoning-related emergency department
visits rates per 100,000 Arizona residents by age group and sex.

Figure 22. Age-Specific Rates of Non-Fatal Poisoning-Related Emergency Department Visits by Age
and Sex, Arizona 2012 (n=11,999)
500
429

450

390.8

400

347.4

350
300

266.5

250
200

207

258.8
227

239.7
203.8

165.9

154.4

150

153.6

80.3
61.2

100

138.1
106

86.5 88 83
81.9
66.7
69.3

50
0
<1yr

1-4yr

5-14yr 15-24yr 25-34
Males (n=5,425)

35-44

45-54

55-64

65-74

75-84

85+

Females (n=6,574)

African American Arizonans had the highest age-adjusted rate of non-fatal poisoning-related emergency
department visits (246.3 per 100,000 residents, n=688) followed closely by White, non-Hispanic Arizonans
(223.8.2 per 100,000 residents, n=7,744). As with inpatient hospitalizations, the lowest rate was among Asian
Americans (41.0 per 100,000 residents). Figure 23 shows the rate distribution of emergency department visits
in 2012.

5

Pitetti RD, Whitman E, Zaylor A. Accidental and Nonaccidental Poisonings as a Cause of Apparent Life-Threatening Events in Infants.
Pediatrics 2008; 122:e539-e362.

21

Figure 23. Age-Adjusted Non-Fatal Poisoning-Related Emergency Department Visit Rates per
100,000 Residents by Race/Ethnicity, Arizona 2012 (n=11,999)
300
250

246.3
223.8

212.4
188.2

200
150

129.8

100
41

50
0
White, nonHispanic
(n=7,744)

Black/African
American
American
Indian (n=644)
(n=688)

Hispanic
(n=2,682)

Asian (n=81)

All ethnicities
(n=11,999)

Navajo County had the highest rate of non-fatal poisoning-related emergency department visits in 2012 (368.6
visits per 100,000 residents, n=368), followed by Mohave County (301.5 per 100,000 residents, n=531). It is
notable that although several counties had unstable rates for deaths and hospitalizations, all Arizona counties
had enough emergency department visits to generate rates that are stable and comparable to others. Nonfatal poisoning-related emergency department visits were distributed among residents of Arizona’s counties as
shown in Figure 24.

Figure 24. Age-Adjusted Non-Fatal Poisoning-Related Emergency Department Visits by County,
Arizona 2012 (n=11,999)
400

368.6

350

184.5 188.2

200
138.4

288.9

245.2

231.3

250

150

301.5

284.4

300

205.7
174.2

197.7

172.8

172.3
141.5

100
50
0

As with hospitalizations, the vast majority of non-fatal poisoning-related emergency department visits were
due to drugs (86 percent, n=10,326). Because of the number of unspecified drugs in the data, however, we are
unable to show specifically whether these were predominantly prescription or non-prescription drugs. The
distribution of emergency visits by poison type is shown in Figure 25.

22

Figure 25. Non-Fatal Poisoning-Related Emergency Department Visits by Poison Type, Arizona 2012
(n=11,999)
1% (n=76)

86% (n=10,326)
14%

11% (n=1302)

2% (n=295)
Drug-related (Rx and non-Rx)
Beverage alcohol
Household/environmental/agricultural poison (solid/liquid substances)
Gases/Vapors (including Carbon monoxide)

In 2012, the average non-fatal poisoning-related emergency department visit resulted in $4,769 in hospital
charges (median=$4,250). Hospital charges for non-fatal emergency department visits due to poisonings
among Arizona residents totaled more than $57.2 million in 2012. Forty-seven percent of those hospital
charges were reportedly paid by Medicare or the Arizona Health Care Cost Containment System (AHCCCS)
(5,937 visits; more than $27.2 million). The single most costly emergency department visit resulted in $160,865
in hospital charges. Hospital charges do not reflect hospital reimbursement rates, nor do they include charges
or costs related to emergency medical services, rehabilitation, legal fees, or lost work or school time.

Non-Fatal Poisoning-Related Emergency Department Visits by Manner
Unlike the distribution among inpatient hospitalizations, a slight majority of non-fatal poisoning-related
emergency department visits were identified as being unintentional injuries (52 percent, n=6,190). Thirty-five
percent of emergency department visits were attributed to intentional poisonings (n=4,178), poisonings of
undetermined intent accounted for 13 percent of visits (n=1,615), and there were 16 visits from poisonings
due to assaults or other intents (legal intervention). Figure 26 shows the distribution of non-fatal emergency
department visits by manner.

Figure 26. Non-Fatal Poisoning-Related Emergency Department Visits by Manner, Arizona 2012
(n=11,999)
13% (n=1,615)
<1% (n=16)
52% (n=6,190)

Unintentional
Intentional
Assault/Other
Undetermined

35% (n=4,178)

23

Children younger than five years of age had the highest rates of non-fatal unintentional poisoning-related
emergency department visits among both males and females (417.4 per 100,000 residents and 378.8 per
100,000 residents, respectively). Males had higher rates of non-fatal, unintentional poisoning-related
emergency department visits among Arizona residents aged 15 through 34. Females in all age groups had
higher rates of intentional poisoning-related visits, with the highest rate being among females aged 15 through
24 (208.5 per 100,000). This age group also represented the highest rate among males (99.9 per 100,000
residents). Figure 27 shows the non-fatal poisoning-related emergency department visit rates per 100,000
Arizona residents by age group and sex, separated by manner.

Figure 27. Non-fatal Poisoning-Related Emergency Department Visit Rates per 100,000 Residents by
Age Group, Manner, and Sex, Arizona 2012
85+

72.8 83.0

5 4.4

75-84

71.4 59.3 3 7.6

65-74

60.150.8 7.1 14.4
76.4 62.1 27.6 40.8

55-64
45-54

88.4 74.0 48 85.6

35-44

88.6 65.6 68.5 117.7

25-34

96.9

15-24

98.4

5-14

32.0
378.8

1-4

204.8
800.0

Unintentional Males

111.8

124.2
99.9
208.5

45.0

417.4

<1
1,000.0

105.7 79.1

600.0

400.0

Unintentional Females

200.0

145.4
0.0

Intentional Males

9.8

41.2

1.6
0

1.1

200.0

400.0

Intentional Females

The highest rates of non-fatal emergency department visits were among African American and White residents
for both unintentional (136.1 per 100,000 residents and 103.8 per 100,000 residents, respectively) and
intentional (95.4 per 100,000 residents and 74.0 per 100,000 residents, respectively) poisonings. It is important
to note that American Indians are known to be under-represented in emergency department data, and
therefore the rates presented here are most likely an underrepresentation of non-fatal poisoning-related visits
for that race group. Figure 28 shows the distribution of emergency department visits by race/ethnicity and
manner.

24

Figure 28. Age-Adjusted Non-Fatal Poisoning-Related Emergency Department Visit Rates per
100,000 Residents by Race/Ethnicity and Manner, Arizona 2012
160
136.1

140
120

95.4

100

103.8

95.3
74

80

79.1

73.4

64.3

55.7

60

44.3

40

26

20

16.6

0
Black/African White, nonAmerican
Hispanic

American
Indian

Hispanic

Unintentional (n=6,190)

Asian

Total

Intentional (n=4,299)

There were 116 hospitalizations among individuals of other or unknown race/ethnicity.

Mohave and La Paz Counties had the highest non-fatal emergency department visit rates for both
unintentional poisonings (183.9 per 100,000 residents and 150.1 per 100,000 residents, respectively).Greenlee
County had the highest non-fatal emergency department visit rate for intentional poisoning (132.8 per
100,000 residents) followed closely by Yavapai County (120.9 per 100,000 residents). Non-fatal poisoningrelated emergency department visits were distributed among residents of Arizona’s counties as shown in
Figure 29.

Figure 29. Age-Adjusted Non-Fatal Poisoning-Related Emergency Department Visits by County and
Manner, Arizona 2012
93.4

300
112.2

250
92.6

200

39.1
63.5

41.6

50
50.2
0

132.8

69.8 66.8

150
100

120.9

95.1 89.1

92.2
45.1

Unintentional (n=6,190))

66.5 63.2

72

59.8

45.8

183.9

150.1

118.5
72

68.7

97.3 97.2 79.2

138.9
89

Intentional (n=4,178)

*Rates are unstable due to low counts (n<20)

25

Poisoning and Prescription Drug Overdoses as an Arizona Public Health Concern
Deaths


In 2012, poisoning was the leading cause of injury-related deaths (24 percent) accounting for more deaths
among Arizonans than car crashes, falls, or firearm injuries.



Between 2008 and 2012, the age-adjusted poisoning-related mortality rate increased 5 percent for Arizona
residents, due largely to increases in unintentional poisoning rates.



Prescription drugs, often combined with alcohol, were responsible for many poison-related deaths. The poisons
most commonly specified on death certificates in 2012 were alcohol (18 percent, n=198), Oxycodone or
Hydrocodone (16 percent, n=179), and methamphetamine (10 percent, n=108). Heroin was listed in 8 percent of
cases (n=91).



In 2012, as in previous years, poisoning-related fatality rates were highest among American Indian (28.3 per
100,000 residents) and White, non-Hispanic Arizonans (20.0 per 100,000 residents).

Non-Fatal Hospitalizations and Emergency Department Visits


Between 2008 and 2012, the age-adjusted rate of non-fatal poisoning-related inpatient hospitalizations among
Arizona residents increased 21 percent, from 99.1 cases per 100,000 residents in 2008 to 111.0 cases in 2012.



Adult women had the highest rates of non-fatal poisoning-related inpatient hospitalizations. Females 45 through
54 years of age had a rate of 179.6 cases per 100,000 residents, and females 35 through 44 years of age had a
rate of 166.3 cases per 100,000 residents.



In 2012, there were 11,999 non-fatal poisoning-related emergency department visits among Arizona residents.



The highest rates of emergency department visits were among male and female children one through four years
of age (429.0 per 100,000 for males, 390.8 per 100,000 for females). These rates represent a 4 percent increase
for males and 6 percent increase for females since 2011



Hospital charges for non-fatal poisoning-related inpatient hospitalizations totaled more than $120 million in
2012, and Arizona residents spent a total of 12,817 days hospitalized for non-fatal poisonings.



Hospital charges for non-fatal poisoning-related emergency department visits totaled over $57.2 million in 2012.

Arizona’s Response




Arizona has multi-faceted strategies in place to address each of the White House’s four approaches to countering
prescription drug abuse:
o Patient and provider education: Arizona has two nationally affiliated poison control centers providing
education and drug exposure response throughout the state.
o Prescription monitoring: Arizona’s Controlled Substances Prescription Monitoring Program is managed
by the Arizona State Board of Pharmacy. Dispensing pharmacies and practitioners are required under
Arizona law to report information on Schedule II, III, and IV prescriptions to the database.
(http://www.azpharmacy.gov/CS-Rx_Monitoring/aboutpmp.asp)
o Drug disposal: Since 2008, sites throughout Arizona have offered drug drop-off services as both
individual and ongoing events. These efforts have been expanded in 2012 under the Prescription Drug
Reduction Initiative.
o Law enforcement against improper prescribing: The federal Drug Enforcement Agency actively targets
doctors improperly prescribing potentially addictive medications in Arizona. In 2009, the Phoenix DEA’s
Tactical Diversion Squad charged a Golden Valley doctor with 14 felony charges for operating a ‘pill mill’.
(http://www.azcentral.com/news/articles/2009/07/14/20090714rxdrugbust.html)
Arizona’s Early Childhood home visitors provide education to young families, teaching them to avoid accidental
poisoning and providing resources to mitigate the harm.

26

Poisoning Prevention Tips and Resources
Call 1-800-222-1222 to be connected to a local Poison Control Center.
You can prevent poisonings!
 Store household cleaners in their original containers, away from children
o Pills, vitamins, antifreeze, nail polish remover, or insecticide may look similar to
children’s candy or beverages. Teach children not to eat or drink something without first
asking an adult.
o Teach children to identify medication, and don’t refer to pills as ‘candy’
 Identify poisonous plants around your home and remove from children’s reach
o Visit the Cornell University Department of Animal Science website on poisonous plants
at http://www.ansci.cornell.edu/plants or contact your local PCC to learn about
poisonous plants
 Read the label and follow directions for using household products or medications
 Check with your doctor or pharmacist to prevent dangerous medication interactions
 Properly discard unused, unneeded, or expired medication
o Look for drug disposal events in your community. These provide a safe, easy way to
responsibly get rid of unneeded medication. Such events may be sponsored by local
hospitals, pharmacies, police or fire departments.
o Only flush drugs down the toilet if the label specifically says to do so
 Ask your pharmacist if you’re unsure about proper disposal
o To dispose of all other medications:
 Remove the medication from the original packaging
 Crush the pills and mix them with kitty litter, coffee grounds, or sand
 Seal the mixture in a plastic bag and dispose of it with your household trash
 Properly discard unused or unneeded household poisons and their containers
o Check with your city or county for hazardous waste collection events and locations.
o Household poisons can include paints and solvents, auto fluids, household cleaners,
pesticide, and pool chemicals
 Participate in National Poison Prevention Week, held annually during the 3rd week of March
o The federal Health Resources and Services Administration (HRSA) provides an Event
Planner Kit to help your agency or business get involved. Visit
www.poisonprevention.org for more information.
Visit Arizona’s Poison Control Centers on the internet at:
Arizona Poison and Drug Information Center, Tucson, Arizona
http://www.pharmacy.arizona.edu/outreach/poison/index.php
Banner Good Samaritan Poison and Drug Information Center, Phoenix, Arizona
http://www.bannerhealth.com/Locations/Arizona/Banner+Poison+Control+Center/_Banner+Poison+Co
ntrol+Center.htm

27

Methodology
Mortality data for 2008 through 2012 were compiled from the death certificates registered with the Arizona
Department of Health Services Office of Vital Registration. Any death record for an Arizona resident assigned an
th
International Classification of Diseases, 10 Revision (ICD-10) code for poisoning as the underlying cause of death
was included in the count. Poisonings due to envenomation by animals, plants, or insects (X20 – X29) were
excluded from this report. Table 7 shows the ICD-10 codes included in this report.

Table 7. International Classification of Diseases, 10th Revision (ICD-10)
Codes Used in This Report
ICD-10 Code
X40
X41
X42
X43
X44
X45
X46
X47
X48
X49
X60
X61
X62
X63
X64
X65
X66
X67
X68
X69
X85
X86
X87
X88
X89
X90
Y10
Y11
Y12
Y13
Y14
Y15

ICD-10 Code Description
Unintentional poisoning by non-opioid analgesics, including aspirin and ibuprofen
Unintentional poisoning by sedative or hypnotic drugs, including antidepressants and
barbiturates
Unintentional poisoning by narcotic or hallucinogenic drugs, including marijuana, heroin,
and methadone
Unintentional poisoning by drugs acting on the autonomic nervous system
Unintentional poisoning by other and unspecified drugs
Unintentional poisoning by alcohol meant for ingestion
Unintentional poisoning by organic solvents
Unintentional poisoning by other gases, including carbon monoxide and motor vehicle
exhaust
Unintentional poisoning by pesticides or herbicides
Unintentional poisoning by other and unspecified chemicals
Suicide by poisoning using non-opioid analgesics, including aspirin and ibuprofen
Suicide by poisoning using sedative or hypnotic drugs, including antidepressants and
barbiturates
Suicide by poisoning using narcotic or hallucinogenic drugs, including marijuana, heroin,
and methadone
Suicide by poisoning using drugs acting on the autonomic nervous system
Suicide by poisoning using other and unspecified drugs
Suicide by poisoning using alcohol meant for ingestion
Suicide by poisoning using organic solvents
Suicide by poisoning using other gases, including carbon monoxide and motor vehicle
exhaust
Suicide by poisoning using pesticides or herbicides
Suicide by poisoning using other and unspecified chemicals
Homicide by poisoning using drugs or a biological substance
Homicide by poisoning using corrosive gas
Homicide by poisoning using pesticide
Homicide by poisoning using gas or vapors
Homicide by poisoning using other specified chemicals
Homicide by poisoning using unspecified chemicals
Poisoning by non-opioid analgesics, including aspirin and ibuprofen, undetermined intent
Poisoning by sedative or hypnotic drugs, including antidepressants and barbiturates,
undetermined intent
Poisoning by narcotic or hallucinogenic drugs, including marijuana, heroin, and methadone,
undetermined intent
Poisoning by drugs acting on the autonomic nervous system, undetermined intent
Poisoning by other and unspecified drugs, undetermined intent
Poisoning by alcohol meant for ingestion, undetermined intent

28

Y16
Y17

Poisoning by organic solvents, undetermined intent
Poisoning by other gases, including carbon monoxide or motor vehicle exhaust,
undetermined intent
Poisoning by pesticides or herbicides, undetermined intent
Poisoning by other and unspecified chemicals, undetermined intent

Y18
Y19

Inpatient hospitalization discharge data and emergency department discharge data from 2008 through 2012 were
compiled from the Arizona Hospital Discharge Database at the Arizona Department of Health Services. The
discharge database contains information from private, acute-care facilities in the state of Arizona, and do not
include visits to federal facilities, such as Veterans’ Affairs Hospitals or Indian Health Services facilities. The
discharge databases do not contain data from urgent care facilities, private physician practices, or medical clinics.
Hospital discharge data include hospital transfers and readmissions. Therefore, a single injured individual may be
counted more than once. These data should be interpreted as episodes of medical treatment, not individual
injuries.

Additionally, the data do not allow for analysis of the combined effect of two or more poisonous
agents.
th

Records for Arizona residents assigned an International Classification of Diseases, 9 Revision, Clinical Modification
(ICD-9-CM) External Cause of Injury Code (E-Code) for poisoning as the primary cause of injury were included in
this report. The following E-Code ranges were included: E850 – E858, E860 – E869, E950 – E952, E962, E972, E980
– E982. Table 15 lists the general categories of poisonings included in these ICD-9-CM E-Codes. Poisonings due to
envenomation by animals, plants, or insects (E905.0 – E905.9) were excluded from this report, as were cases in
which medications caused an adverse reaction after therapeutic use (E930 – E949). Medications were counted as
poisoning events only if they were administered incorrectly or with the intent to harm. This could include the
administration of the wrong drug, or an incorrect dose of a prescribed medication.

Table 15. International Classification of Diseases, 9th Revision, Clinical Modification
(ICD-9-CM) Codes Used in This Report
ICD-9-CM Codes
E850 – E858
E860 – E869
E950 – E952
E962
E972
E980 – E982

ICD-9-CM Category Description
Unintentional poisoning by drugs, medicinal substances, and biologicals
Unintentional poisoning by other solid and liquid substances, gases, and vapors
Suicide and self-inflicted poisoning by solid or liquid substances, gases in domestic use, and
other gases or vapors
Assault by poisoning
Injury due to legal intervention by gas, including poisoning by gas
Poisoning by solid or liquid substances, gases in domestic use, and other gases,
undetermined whether unintentionally or purposely inflicted

Rates for 2008, 2009,2011 and 2012 were calculated using Arizona population data compiled by the Arizona
Department of Health Services’ Bureau of Public Health Statistics, available on the internet at:
www.azdhs.gov/plan/menu/info/pd.htm. Rates for 2010 were calculated using the 2010 United States Decennial
Census figures for Arizona (Summary File 1), available on the internet from the U.S. Census Bureau’s American
FactFinder: http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml.
To help compare groups over time, rates have been age-adjusted. Age-adjusting is a statistical procedure used to
remove the effect of age differences between populations. All age-adjusted rates in this report were computed
using the ‘direct’ method in which the age-specific rates for a given year are weighted by the age distribution of
the 2000 standard population. For information on how to calculate an age-adjusted rate, or to see the 2000
standard age distribution, visit the National Cancer Institute Surveillance Epidemiology and End Results (SEER)
program at http://seer.cancer.gov/seerstat/tutorials/aarates/definition.html.

29