INVESTIGATION & CERTIFICATION OF

DRUG TOXICITY DEATHS

Guidance for thorough death investigation and appropriate reporting on the death certificate

This activity will provide death investigators with the most current best practices, including updated information on drug trends and methods of ensuring a complete and necessary death investigation, that improve specificity for drugs causing overdose deaths on death certificate data to better inform public health surveillance and epidemiologic efforts.

Course: Investigation & Certification of Drug Toxicity Deaths

Course Objectives:

At the conclusion of the activity, the participant should be able to:

  1. Identify the key investigative stages that teams use for conducting a necessary and appropriate death investigation when there is a suspected drug-related death.
  2. Describe best practices and challenges related to performing autopsies when there is a suspected drug related death.
  3. Describe the best practices and challenges associated with using toxicological testing for establishing cause of death.
  4. Explain the essential components for consideration when determining the cause and manner of drug-related deaths.
  5. Summarize how to classify an accurate death associated with prescription and illicit drugs.
FACULTY/CREDENTIALS:
Daniel Dye, MD; Associate Professor of Pathology, University of Alabama at Birmingham School of Medicine
Gregory Davis, MD, Professor of Pathology, University of Alabama at Birmingham School of Medicine
Nichole Bynum, MS, Research Forensic Scientist, RTI International
Nicole Jones, MS; Director, RTI International Center for Forensic Sciences
CE ORIGINATION DATE:
November 1, 2024
CE RENEWAL DATE:
November 1, 2026
CE EXPIRATION DATE:
November 1, 2028
MATERIALS:
None
TARGET AUDIENCE:
Physicians, Medical Examiners, Coroners
PREREQUISITES:
N/A
FORMAT:
This activity is Web-based.
CONTACT INFORMATION:
Office of Carri Cottengim, wsh2@cdc.gov
CDC’s CE Accreditation Team has a policy for grievances that is available upon request.

Recommended browser: For optimal functionality, we recommend that you use Google Chrome (latest version) as your viewing browser. If you are using a different browser, the program may not work as expected.

Module 1: Overview of Medicolegal Death Investigation

The ultimate goal of the medicolegal death investigation is to provide information to determine a truthful, logical, and scientifically unbiased statement of the cause and manner of death. The medical examiner or coroner may issue the death certificate for deaths within their jurisdiction.

Note: This module will open in a new window. You must return to this page upon completing the module. 

Launch Module

Module 2: Introduction to Scene Investigation

The scene investigation of any drug-related death requires a complete investigation of the circumstances of death, the death scene, and past medical history. When prescription and illicit drugs are suspected, there are special considerations that apply to the investigation of the death scene.

Note: This module will open in a new window. You must return to this page upon completing the module. 

Launch Module

Module 3: Autopsy & Postmortem Toxicology

In this module, you will cover specifics on the significance of autopsy and postmortem toxicology in the investigation of suspected drug toxicity deaths. Medical examiners/coroners and toxicologists must work together to evaluate all circumstances as they relate to a case.

Note: This module will open in a new window. You must return to this page upon completing the module. 

Launch Module

Module 4: Death Certification for Drug Toxicity Deaths

This module provides instructions on completing the medical section of the certificate of death for acute drug toxicity deaths, sometimes referred to as overdose or poisoning deaths.

Note: This module will open in a new window. You must return to this page upon completing the module. 


Launch Module

Resources & Glossary:

Course Credit

certificate icon

 

 

Interprofessional Continuing Education logo

In support of improving patient care, this activity has been planned and implemented by the Centers for Disease Control and Prevention and RTI International. The Centers for Disease Control and Prevention is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

CME: The Centers for Disease Control and Prevention designates this enduring activity for a maximum of (3.75) AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

CEU: The Centers for Disease Control and Prevention is authorized by IACET to offer (0.4) CEU's for this program. 

DISCLOSURE: In compliance with continuing education requirements, all planners and presenters must disclose all financial relationships, in any amount, with ineligible companies during the previous 24 months as well as any use of unlabeled product(s) or products under investigational use. 

CDC, our planners, and content experts, wish to disclose they have no financial relationship(s) with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.  

Content will not include any discussion of the unlabeled use of a product or a product under investigational use. 

The Centers for Disease Control and Prevention (CDC) complies with applicable Federal civil rights laws and does not discriminate based on race, color, national origin, age, disability, religion, or sex. To learn more visit: HHS Nondiscrimination Notice. 

Instructions for Obtaining Continuing Education (CE)

To receive continuing education (CE) for WB4884 - Investigation & Certification of Drug Toxicity Deaths, please visit CDC TRAIN and search for the course in the Course Catalog using WB4884. Follow the steps below by 11/1/2028. 

  1. Register for and complete the course. 
  2. Pass the post-assessment at 80%.
    • All CDC continuing education courses allow two attempts to pass the post-assessment. If you do not pass on the first attempt, you have 30 days to retake it. Failing both attempts will result in a failed course status, and the course cannot be retaken during the current accreditation period. Please refer to the course description page for specific start and end dates.
  3. Complete the evaluation.
  4. Visit Your Learning to access your certificates and transcript.

FEES: No fees are charged for CDC’s CE activities. 

Course References & Annotated Bibliography:

Download PDF containing references for all modules

Download PDF containing the annotated bibliography for the Opioid Position Paper

Acknowledgement: We would like to express great appreciation to all the individuals who made this project possible. We would like to offer special thanks to Dr. Daniel Dye of the University of Alabama at Birmingham School of Medicine, who provided extensive knowledge and expertise to the content development for this training. We would also like to thank the National Association of Medical Examiners (NAME) for their support during the development of the position paper and this training. We are particularly grateful for the assistance given by the CDC staff who worked so hard on this project, including Dr. Margaret Warner and Dr. Kelly Brown. We also wish to acknowledge the help provided by the pilot test participants' who volunteered to evaluate the training, to ensure its effectiveness.

Disclaimer: CDC, our planners, our content experts, and their spouses/partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Planners have reviewed content to ensure there is no bias. CDC did not accept commercial support for this continuing education activity.