One Drug Can Appear in Four Databases and Produce Four Different Counts

by Brandon Burley

The Redemption Project Newsroom

The Drug Enforcement Administration reported at least 89 cychlorphine findings.

The Tennessee Bureau of Investigation reported 20 seized-drug submissions.

A specialized laboratory confirmed the substance in 25 blood specimens from fatal overdoses and said another laboratory had tentatively identified it in more than 100 toxicology cases.

The Knox County Regional Forensic Center later said the drug had been linked to more than 50 deaths in East Tennessee.

Those numbers describe the same emerging opioid.

They do not count the same thing.

Adding them together would produce a larger number.

It also would be wrong.

A laboratory report involving seized powder is not a patient. A positive clinical toxicology result is not a death. A blood specimen from a fatal overdose is not necessarily a finalized cause-of-death determination. A regional death count may include cases already represented in laboratory data.

The numbers can overlap. They can measure different stages of the same event. They can also describe entirely separate encounters with the drug.

That distinction sits at the center of the third article in this series.

The first article explained why cychlorphine could be present before routine testing systems were prepared to identify it.

The second explained why detecting the drug in someone’s blood does not, by itself, establish that it caused the death.

The next problem is counting.

Before asking how many cychlorphine cases exist, the reader needs to know what the word “case” means.

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“Case” may describe different events

Public reports frequently use the word

“case” without defining the unit being counted.

A case might mean a package of powder seized by police, one item of evidence tested by a crime laboratory, a urine or oral-fluid specimen from a living patient, a blood specimen collected during an autopsy, a death investigation, a finalized death certificate or one report entered into a national database.

Those units are related.

They are not interchangeable.

One police investigation can contain several bags, pills or other evidence items. Each item may contain several drugs. One person can provide more than one clinical specimen. A death investigation can generate a local toxicology result, an outside laboratory confirmation, a medical examiner ruling and a later entry in a federal surveillance system.

The same event may therefore create several records.

The record count grows.

The number of people does not.

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Seized-drug systems count substances found in evidence

The DEA’s National Forensic Laboratory Information System Drug database, known as NFLIS-Drug, collects confirmed drug-identification results from evidence analyzed by participating federal, state and local forensic laboratories.

Those laboratories examine substances obtained through law-enforcement operations.

They are testing powder, pills, liquids, residue and other evidence.

They are not counting overdose patients or deaths.

NFLIS explains that one count represents one documented occurrence of a drug in its database.

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