UNINTENDED CONSEQUENCES
OF THE KENTUCKY KASPER DRUG
LAW OF APRIL 2012
Stanley A. Gall, MD, FACOG
Alfred B. Jensen, MD
T
he Kentucky Maternal Mortality Committee is charged by the State of Kentucky to investigate maternal deaths
in the state of Kentucky, report the results to
the Kentucky Department of Public Health,
Mother – Child Division and the Kentucky
Medical Association (KMA). The results are
published in the KMA Journal and the committee makes recommendations to address
the causes of maternal deaths. The Kentucky Death Certificate
addresses maternal death in box 38 and is signed by the attending
physician or medical examiner.
•
Not pregnant within the past year.
•
Not pregnant, but pregnant within 42 days of death.
•
Not pregnant, but pregnant within 43 days to 1 year before
death.
•
Pregnant at the time of death.
•
Unknown if pregnant within the past year.
In an attempt to identify maternal deaths, the death certificates
of all females aged 13-50 years who die in the State of Kentucky are
sent to the chairman of the Kentucky Maternal Mortality Commit20
LOUISVILLE MEDICINE
tee for review. The death certificates for the years 2013, 2012 and
portions of 2011 were reviewed and fewer than 10 maternal deaths
were identified for each year. However, in reviewing all the death
certificates it became glaringly obvious that drug overdoses were
the most frequent cause of death.
In females aged 13-50 years, however box 38 indicated, no pregnant females died of a drug overdose. The purpose of this report
is to determine whether the passage of the KASPER Drug Law of
April 2012 [House Bill 1] had an impact on the number of females
aged 13-50 years who died from drug overdoses, and the types of
drugs they used. The information regarding the cause of death
was taken from the death certificate. Drugs were either listed by
name or simply stated as multiple narcotics or multiple opiates.
The pregnancy status of each patient, as well as marital status race,
place of death, manner of death and county of death were reviewed.
The period of May 2012 through 2013 (Post KASPER) with 1316
death certificates was compared to the pre-KASPER Drug Law
(2011 to April 2012) of 510 death certificates. The pre-KASPER
sample is incomplete as portions of the death certificate from 2011
had been discarded.
The first striking result is the significant increase in heroin deaths
after passage of the KASPER law (table 1). On the pre-KASPER
period 3/97 (3.1%, P=<0.001, 95% CI .063-9.12) heroin deaths were