Skip to contents

narcan

No Maintenance Intended

An R package for working with multiple cause of death micro-data.

Warning

This package is not intended for public use. It is occasionally maintained for personal use only, so bugs may abound. User beware.

Development and maintenance are assisted by Claude (Anthropic).

What it does

narcan implements the Injury Surveillance Workgroup (ISW7) definitions for drug- and opioid-involved deaths in US multiple-cause-of-death (MCOD) data. A drug death is a drug-poisoning underlying cause (ICD-10 X40-X44, X60-X64, X85, Y10-Y14) together with a contributory poisoning T-code (T36-T50); opioid involvement adds the opioid T-codes (T40.0-T40.4 and T40.6). The package also covers the ICD-9 era (1979-1998), harmonizes race/Hispanic-origin and county recodes across NCHS coding changes, and computes age-standardized rates.

Start here

New to the package? Begin with the Getting started vignette for an overview and the raw-data-to-rate pipeline. Then follow the path for your task:

  • Compute an overdose death rate: Classifying overdose deaths -> Population denominators -> Age-standardized synthetic-opioid death rates by sex.
  • See it run on a real file: End-to-end on real public-use data (2004).
  • Recode age, sex, and race across eras: Demographic recodes across coding eras.
  • Stratify by Hispanic origin: Hispanic origin: the two recode pairs.
  • Work with sub-national geography: Harmonizing geography with FIPS.
  • Understand unspecified-drug coding over time: Trends in unspecified drug overdose deaths.

All vignettes are under Articles on the pkgdown site.

Installation 

# install.packages("remotes")
remotes::install_github("mkiang/narcan")

Example

Flag drug- and opioid-involved deaths from a set of cause-of-death records:

library(narcan)

deaths <- data.frame(
  year = 2019,
  ucod = c("X42", "I250", "X44"),
  f_records_all = c("T401 T402", "I250", "T436")
)

deaths |>
  flag_drug_deaths(year = 2019) |>
  flag_opioid_deaths(year = 2019)
#>  year ucod f_records_all drug_death opioid_death
#>  2019  X42     T401 T402          1            1
#>  2019 I250          I250          0            0
#>  2019  X44          T436          1            0

The X42 death is drug- and opioid-involved (heroin, T40.1); the X44 death is a drug poisoning but not an opioid (psychostimulant, T43.6); the I250 death is neither.

Full function reference: https://mkiang.github.io/narcan/.