Fatal poisoning in drug addicts in the Nordic countries in 2007

Abstract

The frequency of medico-legally examined fatal poisonings in 2007 among drug addicts was investigated in five Nordic countries; Denmark, Finland, Iceland, Norway, and Sweden. The number of deaths, age, sex, place of death, main intoxicant, and other drugs present in blood samples were recorded to obtain national and comparable Nordic data, as well as data to compare with earlier studies in 2002, 1997, and 1991. Norway had the highest incidence of drug addict deaths by poisoning followed by Denmark, with 8.24 and 6.92 per 100,000 inhabitants, respectively. The death rates in Finland (4.02), Iceland (4.56), and Sweden (3.53) were about half that of Norway and Denmark. Compared with earlier studies, the death rates were unchanged in Denmark and Norway, but increased in Finland, Iceland, and Sweden. In all countries, fewer deaths (29-35%) were recorded in the capital area compared with earlier studies. Females accounted for 11-19% of the fatal poisonings. Iceland deviates with a more equal distribution between men and women (40%). Deaths from methadone overdoses increased in all Nordic countries, and methadone was the main intoxicant in Denmark in 2007, accounting for 51% of the poisonings. In Norway and Sweden, heroin/morphine was still the main intoxicant with a frequency of 68% and 48%, respectively. In Iceland, 3 deaths each were due to heroin/morphine and methadone, respectively. Finland differs from other Nordic countries in having a high number of poisonings caused by buprenorphine and very few caused by heroin/morphine. The total number of buprenorphine deaths in Finland doubled from 16 in 2002 to 32 in 2007, where it constituted 25% of deaths. The general toxicological screening program showed widespread multi-drug use in all countries. The median number of drugs per case varied from 3 to 5. The most frequently detected substances were heroin/morphine, methadone, buprenorphine, tramadol, amphetamine, cocaine, tetrahydrocannabinol, benzodiazepines and ethanol.

Legevaktkontakter på grunn av forgiftning i Norge 2006 – 15

“…Most deaths from poisoning occur outside hospitals and are caused by narcotic substances, most often heroin and various combination poisonings (1,14,15). These types of poisonings are most often dealt with by ambulance personnel.…”

Fatalities involving illicit drug use in Pretoria, South Africa, for the period 2003 - 2012

“…These results are consistent with findings from other studies. [24][25][26]31] It is likely that these drugs are over-represented in samples from decedents, as opiates and cocaine are addictive and carry a greater risk of fatal outcome owing to the risk of central nervous system depression or cardiovascular afflictions, among other complications due to chronic use. [32] Globally, differences exist in patterns of illicit drug use: in Australia, opioids are believed to be responsible for most drug-related deaths, while cocaine has been reported as most commonly detected in drug-related deaths in Florida, USA.…”

Surveillance of abused drugs in forensic autopsy cases in Norway

“…An earlier study has shown an increase in fatal drug poisonings among drug addicts in Norway from 1991 to 2007 (2). Drug findings were reported for all forensically examined overdoses in 1991, 1997, 2002 and 2007.…”

“…Drug findings were reported for all forensically examined overdoses in 1991, 1997, 2002 and 2007. The overdose mortality in that study was attributed to consumption of illicit drugs, medicinal drugs including opioids and benzodiazepines, as well as of ethanol (2,3). Misuse of illicit drugs had the highest effect on drug related mortality in young and middleaged individuals.…”