The findings need to be considered in light of some additional data limitations. First, BAC testing rates vary across the states participating in the NVDRS [8]. Fortunately, only a few states (Alaska, Georgia, and Oregon) had testing rates below 50%. A supplementary sensitivity analysis showed that the exclusion of these states did not alter the findings (Appendix 3). Second, toxicology testing is often determined by availability of state funding. Unfortunately, current federal resources provided to the NVDRS states do not cover toxicological testing. However, in a follow-up analysis, all demographic subgroups except those aged 60 years and older had toxicological testing rates at or above 65% (for decedents 60 years and older, the testing rate was 62%; Appendix 4). Third, the information regarding the precipitating circumstances, including APs, is derived from family, friends, health care professionals, and death scene investigations [13]. Fourth, the NVDRS, as noted, is limited to 17 states and may not be nationally representative [13]. Fifth, the time periods between NESARC and NVDRS differ. A separate analysis of National Survey on Drug Use and Health (2002-2011) data
