Heroin Overdose Deaths and Heroin Purity Between 1990 and 2000 in Istanbul, Turkey*

Abstract

Turkey has continuously experienced problems with abuse of, and addiction to, opium derivatives. In this study, we analyzed the relationship between heroin overdose deaths and the characteristics of seized opium derivatives. Data were gathered from the Council of Forensic Medicine of the Ministry of Justice in Istanbul from 1990 to 2000. There were 636 heroin-related deaths during this period, 595 of which were classified as heroin overdose deaths. Mean crude and weighted heroin purities remained relatively constant and were calculated to be 46% (57-34%) and 51% (39-59%), respectively. The weight of heroin and the number of heroin seizures, but not the heroin purity, were significantly associated with the number of heroin-related deaths. Prevention strategies are needed to reduce the number of deaths caused by overdoses in countries situated on drug trafficking routes. These strategies should focus on drug trafficking, by providing increased levels of, and support for, law enforcement, stopping the supply of precursor chemicals, and combating corruption among border officials.

Postmortem data related to drug and toxic substance use in the Federal District, Brazil, from 2006 to 2008

“…This trend is completely different from that found in other countries, where alcohol, illegal drugs or CO are involved in most fatal poisoning cases [9][10][11]30,32]. However, this is typical for the Brazilian case, as reported in other data sources [29,33].…”

“…In Brazil, about half of traffic accidents with fatalities are associated with the use of alcohol [8]. In many countries, fatal overdoses involve mostly illegal drugs, such as heroin/morphine, alone or in combination with other drugs [9][10][11].…”

Heroin poisoning deaths with 6-acetylmorphine in blood: demographics of the victims, previous drug-related offences, polydrug use, and free morphine concentrations in femoral blood

“…Studies have shown that the purity of illicit heroin might impact on toxicity and increase the risk of an overdose death [3,18]. Moreover, street heroin contains other opiates, such as 6-acetylcodeine, which accounts for the presence of codeine in the blood of heroin users [19].…”

“…Much has been written about heroin-related deaths including demographics of the victims, purity of the heroin used, the role of coingested drugs, and degree of tolerance to opiates [1][2][3][4]. Heroin is arguably the most dangerous illicit drug, not only because of its acute toxicity, but also because of its powerful reinforcing effects making it difficult to rehabilitate people addicted to heroin.…”

Predictors of Relapse in Patients with Opioid Addiction during Buprenorphine–Naloxone Maintenance Treatment

“…It is well-known that the use of opioids such as heroin is one of the most serious social and health problems in the world and 0.4% of the global population is estimated to abuse opioid drugs [1,2]. Opioid abuse is an important public health issue for Turkey as well [3]. The treatments of opioid dependence and withdrawal symptoms are of clinical importance.…”