Appendix 1
Notes on the definition of 'drug-related' deaths
1. The definition of a 'drug-related death' is not straightforward. A useful discussion on the definitional problems may be found in an article in the Office for National Statistics publication Population Trends. More recently, a report by the Advisory Council on the Misuse of Drugs ( ACMD) considered current systems used in the United Kingdom to collect and analyse data on drug related deaths. In its report, the ACMD recommended that 'a short life technical working group should be brought together to reach agreement on a consistent coding framework to be used in future across England, Wales, Scotland and Northern Ireland'. GROS was represented on this group and this paper presents information on drug-related deaths using the approach agreed.
2. The baseline covers the following cause of death categories (the relevant codes from the International Classification of Diseases, Tenth Revision ( ICD10), are given in brackets):
- deaths where the underlying cause of death has been coded to the following sub-categories of 'mental and behavioural disorders due to psychoactive substance use':
- opioids (F11);
- cannabinoids (F12);
- sedatives or hypnotics (F13);
- cocaine (F14);
- other stimulants, including caffeine (F15);
- hallucinogens (F16); and
- multiple drug use and use of other psychoactive substances (F19).
- deaths coded to the following categories and where a drug listed under the Misuse of Drugs Act (1971) was known to be present in the body at the time of death:
- accidental poisoning (X40 - X44);
- intentional self-poisoning by drugs, medicaments and biological substances (X60 - X64);
- assault by drugs, medicaments and biological substances (X85); and
- event of undetermined intent, poisoning (Y10 - Y14).
3. Categories of death excluded:
- deaths coded to mental and behavioural disorders due to the use of alcohol (F10), tobacco (F17) and volatile substances (F18);
- deaths coded to drug abuse which were caused by secondary infections and related complications (for example the 20 or so deaths in 2000 caused by clostridium novyi infection);
- deaths from AIDS where the risk factor was believed to be the sharing of needles;
- deaths from road traffic and other accidents which occurred under the influence of drugs; and
- deaths where a drug listed under the Misuse of Drugs Act was present because it was part of a compound analgesic or cold remedy: specific examples are:
Co-proxamol: paracetamol, dextropropoxyphene
Co-dydramol: paracetamol, dihydrocodeine
Co-codamol: paracetamol, codeine sulphate
- All three of these compound analgesics, but particularly co-proxamol, are commonly used in suicidal overdoses.
- Note: As it is believed that dextropropoxyphene is rarely if ever available other than as a constituent of a paracetamol compound, it has been ignored on all occasions (even if there is no mention of a compound analgesic or paracetamol). However, deaths involving codeine or dihydrocodeine without mention of paracetamol have been included in the baseline as these drugs are routinely available on their own and known to be abused in this form.
Source: General Register Office for Scotland (2004) Drug related deaths in Scotland in 2003.
Appendix 2
Table A2.1: Characteristics of and trends in drug-related deaths during 1996-2003 among persons aged 15-54 years in Scotland
Characteristics of death | Calendar year of death | Total | Annual change*
% (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
All | 234 (100%) | 210 (100%) | 236 (100%) | 284 (100%) | 284 (100%) | 319 (100%) | 372 (100%) | 301 (100%) | 2240 (100%) | 6.7 (4.8, 8.7) |
|---|
Cause of death: |
|---|
Drug abuse/accidental poisoning | 183 (78%) | 153 (73%) | 191 (81%) | 239 (84%) | 230 (81%) | 244 (76%) | 294 (79%) | 228 (76%) | 1762 (79%) | 6.6 (4.4, 8.8) |
|---|
Intentional self-poisoning | 35 (15%) | 32 (15%) | 24 (10%) | 13 (5%) | 30 (11%) | 26 (8%) | 25 (7%) | 31 (10%) | 216 (9%) | -1.7 (-7.3, 4.1) |
|---|
Undetermined | 16 (7%) | 25 (12%) | 21 (9%) | 32 (11%) | 24 (8%) | 49 (15%) | 53 (14%) | 42 (14%) | 262 (12%) | 16.0 (9.8, 22.5) |
|---|
Day of week | Mon-Thurs | 121 (52%) | 101 (48%) | 123 (52%) | 137 (48%) | 153 (54%) | 165 (52%) | 206 (55%) | 154 (51%) | 1160 (52%) | 7.7 (5.0, 10.5) |
|---|
Fri-Sun | 113 (48%) | 109 (52%) | 113 (48%) | 147 (52%) | 131 (46%) | 154 (48%) | 166 (45%) | 147 (49%) | 1080 (48%) | 5.7 (3.0, 8.5) |
|---|
Gender | Male | 180 (77%) | 170 (81%) | 188 (80%) | 232 (82%) | 234 (82%) | 261 (82%) | 315 (85%) | 245 (81%) | 1825 (81%) | 7.6 (5.5, 9.8) |
|---|
Female | 54 (23%) | 40 (19%) | 48 (20%) | 52 (18%) | 50 (18%) | 58 (18%) | 57 (15%) | 56 (19%) | 415 (19%) | 3.0 (-1.3, 7.4) |
|---|
Age (years) | 15-24 | 86 (37%) | 76 (36%) | 87 (37%) | 94 (33%) | 73 (26%) | 79 (25%) | 100 (27%) | 78 (26%) | 673 (30%) | 0.3 (-3.0, 3.6) |
|---|
25-34 | 103 (44%) | 89 (42%) | 103 (44%) | 118 (42%) | 126 (44%) | 140 (44%) | 153 (41%) | 123 (41%) | 955 (43%) | 6.0 (3.1, 9.0) |
|---|
35-54 | 45 (19%) | 45 (21%) | 46 (20%) | 72 (25%) | 85 (30%) | 100 (31%) | 119 (32%) | 100 (33%) | 612 (27%) | 16.0 (11.9, 20.2) |
|---|
* Derived from Poisson regression.
Table A2.1: Characteristics of and trends in drug-related deaths during 1996-2003 among persons aged 15-54 years in Scotland (Continued)
Characteristics of death | Calendar year of death | Total | Annual change*
% (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
Health-board | Glasgow | 89 (38%) | 63 (30%) | 90 (38%) | 99 (35%) | 103 (36%) | 93 (29%) | 124 (33%) | 104 (35%) | 765 (34%) | 5.4 (2.2, 8.8) |
|---|
Lothian | 55 (24%) | 44 (21%) | 34 (14%) | 37 (13%) | 36 (13%) | 53 (17%) | 38 (10%) | 35 (12%) | 332 (15%) | -3.2 (-7.7, 1.4) |
|---|
Grampian | 28 (12%) | 21 (10%) | 25 (11%) | 38 (13%) | 31 (11%) | 45 (14%) | 45 (12%) | 36 (12%) | 269 (12%) | 8.5 (2.9, 14.4) |
|---|
Argyll & Clyde | 17 (7%) | 15 (7%) | 23 (10%) | 29 (10%) | 29 (10%) | 20 (6%) | 31 (8%) | 26 (9%) | 190 (9%) | 7.0 (0.5, 13.9) |
|---|
Lanarkshire | 11 (5%) | 11 (5%) | 21 (9%) | 22 (8%) | 28 (10%) | 24 (8%) | 36 (10%) | 25 (8%) | 178 (8%) | 13.8 (6.6, 21.6) |
|---|
Tayside | 22 (9%) | 28 (13%) | 19 (8%) | 14 (5%) | 13 (5%) | 17 (5%) | 14 (4%) | 18 (6%) | 145 (7%) | -6.7 (-13.1, 0.2) |
|---|
Ayrshire & Arran | 3 (1%) | 6 (3%) | 4 (2%) | 15 (5%) | 19 (7%) | 34 (11%) | 31 (8%) | 17 (6%) | 129 (6%) | 28.3 (18.1, 39.4) |
|---|
Elsewhere | 9 (4%) | 22 (10%) | 20 (8%) | 30 (11%) | 25 (9%) | 33 (10%) | 53 (14%) | 40 (13%) | 232 (10%) | 18.8 (12.0, 26.0) |
|---|
Drugs detected: | Heroin | 82 (35%) | 73 (35%) | 116 (49%) | 163 (57%) | 186 (66%) | 201 (63%) | 224 (60%) | 164 (55%) | 1209 (54%) | 13.8 (10.9, 16.7) |
|---|
Methadone | 99 (42%) | 86 (41%) | 64 (27%) | 63 (22%) | 55 (19%) | 69 (22%) | 98 (26%) | 86 (29%) | 620 (28%) | -0.4 (-3.7, 3.1) |
|---|
Benzodiazepines | 114 (49%) | 102 (49%) | 142 (60%) | 163 (57%) | 161 (57%) | 177 (56%) | 243 (65%) | 178 (59%) | 1280 (57%) | 9.9 (7.3, 12.6) |
|---|
Cocaine | 3 (1%) | 5 (2%) | 4 (2%) | 12 (4%) | 4 (1%) | 19 (6%) | 31 (8%) | 28 (9%) | 106 (5%) | 41.2 (27.9, 55.9) |
|---|
Alcohol | 84 (36%) | 61 (29%) | 83 (35%) | 86 (30%) | 122 (43%) | 137 (43%) | 152 (41%) | 121 (40%) | 846 (38%) | 10.9 (7.7, 14.3) |
|---|
* Derived from Poisson regression.
Table A2.2: Characteristics of and trends in heroin/morphine-related deaths during 1996-2003 among persons aged 15-54 years in Scotland
Characteristics of death | Calendar year of death | Total | Annual change* % (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
All | 82 (100%) | 73 (100%) | 116 (100%) | 163 (100%) | 186 (100%) | 201 (100%) | 224 (100%) | 164 (100%) | 1209 (100%) | 13.8 (10.9, 16.7) |
|---|
Cause of death: |
|---|
Drug abuse/accidental poisoning | 76 (93%) | 67 (92%) | 106 (91%) | 150 (92%) | 171 (92%) | 175 (87%) | 192 (86%) | 144 (88%) | 1081 (89%) | 12.6 (9.7, 15.7) |
|---|
Intentional self-poisoning | 5 (6%) | 2 (3%) | 6 (5%) | 2 (1%) | 8 (4%) | 7 (3%) | 7 (3%) | 5 (3%) | 42 (4%) | 8.1 (-5.4, 23.5) |
|---|
Undetermined | 1 (1%) | 4 (5%) | 4 (3%) | 11 (7%) | 7 (4%) | 19 (9%) | 25 (11%) | 15 (9%) | 86 (7%) | 34.3 (20.9, 49.1) |
|---|
Day of week | Mon-Thurs | 52 (63%) | 41 (56%) | 71 (61%) | 77 (47%) | 99 (53%) | 110 (55%) | 134 (60%) | 84 (51%) | 668 (55%) | 12.7 (9.0, 16.6) |
|---|
Fri-Sun | 30 (37%) | 32 (44%) | 45 (39%) | 86 (53%) | 87 (47%) | 91 (45%) | 90 (40%) | 80 (49%) | 541 (45%) | 15.0 (10.7, 19.5) |
|---|
Gender | Male | 71 (87%) | 58 (79%) | 97 (84%) | 140 (86%) | 158 (85%) | 180 (90%) | 194 (87%) | 149 (91%) | 1047 (87%) | 14.9 (11.8, 18.0) |
|---|
Female | 11 (13%) | 15 (21%) | 19 (16%) | 23 (14%) | 28 (15%) | 21 (10%) | 30 (13%) | 15 (9%) | 162 (13%) | 7.0 (0.0, 14.5) |
|---|
Age (years) | 15-24 | 23 (28%) | 22 (30%) | 36 (31%) | 53 (33%) | 51 (27%) | 49 (24%) | 51 (23%) | 35 (21%) | 320 (26%) | 8.3 (3.2, 13.7) |
|---|
25-34 | 45 (55%) | 37 (51%) | 55 (47%) | 75 (46%) | 83 (45%) | 92 (46%) | 91 (41%) | 77 (47%) | 555 (46%) | 11.2 (7.2, 15.4) |
|---|
35-54 | 14 (17%) | 14 (19%) | 25 (22%) | 35 (22%) | 52 (28%) | 60 (30%) | 82 (37%) | 52 (32%) | 334 (28%) | 24.4 (18.3, 30.8) |
|---|
* Derived from Poisson regression.
Table A2.2: Characteristics of and trends in heroin/morphine-related deaths during 1996-2003 among persons aged 15-54 years in Scotland (Continued)
Characteristics of death | Calendar year of death | Total | Annual change*
% (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
Health-board | Glasgow | 57 (70%) | 37 (51%) | 65 (56%) | 69 (42%) | 85 (46%) | 78 (39%) | 93 (42%) | 60 (37%) | 544 (45%) | 6.5 (2.6, 10.5) |
|---|
Lothian | 4 (5%) | 3 (4%) | 6 (5%) | 6 (4%) | 11 (6%) | 21 (10%) | 4 (2%) | 4 (2%) | 59 (5%) | 9.4 (-2.3, 22.4) |
|---|
Grampian | 9 (11%) | 10 (14%) | 13 (11%) | 26 (16%) | 17 (9%) | 28 (14%) | 31 (14%) | 25 (15%) | 159 (13%) | 16.8 (8.9, 25.4) |
|---|
Argyll & Clyde | 3 (4%) | 7 (10%) | 15 (13%) | 21 (13%) | 25 (13%) | 16 (8%) | 25 (11%) | 22 (13%) | 134 (11%) | 18.3 (9.5, 27.9) |
|---|
Lanarkshire | 4 (5%) | 6 (8%) | 12 (10%) | 16 (10%) | 20 (11%) | 17 (8%) | 23 (10%) | 19 (12%) | 117 (10%) | 19.2 (9.7, 29.5) |
|---|
Tayside | 2 (2%) | 1 (1%) | 0 (0%) | 1 (1%) | 3 (2%) | 4 (2%) | 2 (1%) | 8 (5%) | 21 (2%) | 35.4 (9.3, 67.8) |
|---|
Ayrshire & Arran | 2 (2%) | 2 (3%) | 2 (2%) | 7 (4%) | 13 (7%) | 20 (10%) | 22 (10%) | 11 (7%) | 79 (7%) | 35.4 (9.3, 67.8) |
|---|
Elsewhere | 1 (1%) | 7 (10%) | 3 (3%) | 17 (10%) | 12 (6%) | 17 (8%) | 24 (11%) | 15 (9%) | 96 (8%) | 25.9 (14.5, 38.4) |
|---|
Drugs detected: | Methadone | 11 (13%) | 12 (16%) | 12 (10%) | 17 (10%) | 19 (10%) | 29 (14%) | 32 (14%) | 22 (13%) | 154 (13%) | 15.7 (7.7, 24.2) |
|---|
Benzodiazepines | 37 (45%) | 37 (51%) | 70 (60%) | 97 (60%) | 109 (59%) | 117 (58%) | 166 (74%) | 103 (63%) | 736 (61%) | 18.3 (14.5, 22.3) |
|---|
Cocaine | 2 (2%) | 1 (1%) | 3 (3%) | 5 (3%) | 4 (2%) | 12 (6%) | 16 (7%) | 21 (13%) | 64 (5%) | 50.2 (31.2, 71.9) |
|---|
Alcohol | 39 (48%) | 23 (32%) | 49 (42%) | 55 (34%) | 81 (44%) | 96 (48%) | 109 (49%) | 75 (46%) | 527 (44%) | 17.1 (12.6, 21.7) |
|---|
* Derived from Poisson regression.
Table A2.3: Characteristics of and trends in methadone-related deaths during 1996-2003 among persons aged 15-54 years in Scotland
Characteristics of death | Calendar year of death | Total | Annual change* % (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
All | 99 (100%) | 86 (100%) | 64 (100%) | 63 (100%) | 55 (100%) | 69 (100%) | 98 (100%) | 86 (100%) | 620 (100%) | -0.4 (-3.7, 3.1) |
|---|
Cause of death: |
|---|
Drug abuse/accidental poisoning | 86 (87%) | 67 (78%) | 57 (89%) | 59 (94%) | 49 (89%) | 59 (86%) | 78 (80%) | 71 (83%) | 526 (85%) | -1.0 (-4.6, 2.8) |
|---|
Intentional self-poisoning | 8 (8%) | 7 (8%) | 0 (0%) | 0 (0%) | 2 (0%) | 0 (0%) | 6 (6%) | 8 (9%) | 31 (5%) | -0.9 (-15.0, 15.5) |
|---|
Undetermined | 5 (5%) | 12 (14%) | 7 (11%) | 4 (6%) | 4 (7%) | 10 (14%) | 14 (14%) | 7 (8%) | 63 (10%) | 5.1 (-5.6, 17.1) |
|---|
Day of week | Mon-Thurs | 36 (36%) | 39 (45%) | 23 (36%) | 27 (43%) | 32 (58%) | 37 (54%) | 46 (47%) | 39 (45%) | 279 (45%) | 3.6 (-1.6, 9.0) |
|---|
Fri-Sun | 63 (64%) | 47 (55%) | 41 (64%) | 36 (57%) | 23 (42%) | 32 (46%) | 52 (53%) | 47 (55%) | 341 (55%) | -3.5 (-7.9, 1.1) |
|---|
Gender | Male | 75 (76%) | 71 (83%) | 54 (84%) | 49 (78%) | 42 (76%) | 55 (80%) | 79 (81%) | 65 (76%) | 490 (79%) | -0.7 (-4.4, 3.3) |
|---|
Female | 24 (24%) | 15 (17%) | 10 (16%) | 14 (22%) | 13 (24%) | 14 (20%) | 19 (19%) | 21 (24%) | 130 (21%) | 0.7 (-6.5, 8.6) |
|---|
Age (years) | 15-24 | 46 (47%) | 40 (47%) | 31 (48%) | 27 (43%) | 16 (29%) | 21 (30%) | 29 (30%) | 25 (29%) | 235 (38%) | -9.5 (-14.5, -4.2) |
|---|
25-34 | 41 (41%) | 37 (43%) | 25 (39%) | 22 (35%) | 24 (44%) | 35 (51%) | 46 (47%) | 37 (43%) | 267 (43%) | 1.8 (-3.4, 7.2) |
|---|
35-54 | 12 (12%) | 9 (11%) | 8 (13%) | 14 (22%) | 15 (27%) | 13 (19%) | 23 (24%) | 24 (28%) | 118 (19%) | 15.0 (6.1, 24.8) |
|---|
* Derived from Poisson regression.
Table A2.3: Characteristics of and trends in methadone-related deaths during 1996-2003 among persons aged 15-54 years in Scotland (Continued)
Characteristics of death | Calendar year of death | Total | Annual change*
% (95% CI) |
|---|
1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 | 2003 |
|---|
Health-board | Glasgow | 25 (25%) | 17 (20%) | 14 (22%) | 19 (30%) | 14 (25%) | 12 (17%) | 33 (34%) | 39 (45%) | 173 (28%) | 9.7 (2.7, 17.2) |
|---|
Lothian | 38 (38%) | 31 (36%) | 23 (36%) | 19 (30%) | 9 (16%) | 14 (20%) | 22 (22%) | 19 (22%) | 175 (28%) | -11.2 (-16.9, -5.1) |
|---|
Grampian | 10 (10%) | 8 (9%) | 5 (8%) | 7 (11%) | 8 (15%) | 9 (13%) | 11 (11%) | 5 (6%) | 63 (10%) | -1.1 (-11.2, 10.2) |
|---|
Argyll & Clyde | 7 (7%) | 4 (5%) | 4 (6%) | 2 (3%) | 7 (13%) | 6 (9%) | 8 (8%) | 4 (5%) | 42 (7%) | 2.3 (-10.3, 16.7) |
|---|
Lanarkshire | 1 (1%) | 2 (2%) | 5 (8%) | 3 (5%) | 2 (4%) | 3 (4%) | 6 (6%) | 4 (5%) | 26 (4%) | 13.5 (-4.4, 34.8) |
|---|
Tayside | 14 (14%) | 17 (20%) | 9 (14%) | 7 (11%) | 7 (13%) | 12 (17%) | 2 (2%) | 2 (2%) | 70 (11%) | -19.3 (-27.7, -9.9) |
|---|
Ayrshire & Arran | 1 (1%) | 3 (3%) | 1 (2%) | 4 (6%) | 1 (2%) | 6 (9%) | 8 (8%) | 4 (5%) | 28 (5%) | 22.9 (3.4, 46.1) |
|---|
Elsewhere | 3 (3%) | 4 (5%) | 3 (5%) | 2 (3%) | 7 (13%) | 7 (10%) | 8 (8%) | 9 (10%) | 43 (7%) | 19.9 (4.5, 37.5) |
|---|
Drugs detected: | Heroin | 11 (11%) | 12 (14%) | 12 (19%) | 17 (27%) | 19 (35%) | 29 (42%) | 32 (33%) | 22 (26%) | 154 (25%) | 15.7 (7.7, 24.2) |
|---|
Benzodiazepines | 50 (51%) | 48 (56%) | 48 (75%) | 44 (70%) | 35 (64%) | 43 (62%) | 69 (70%) | 60 (70%) | 397 (64%) | 3.7 (-0.7, 8.3) |
|---|
Cocaine | 0 (0%) | 1 (1%) | 0 (0%) | 1 (2%) | 0 (0%) | 0 (0%) | 6 (6%) | 7 (8%) | 15 (2%) | 89.7 (32.6, 171) |
|---|
Alcohol | 25 (25%) | 20 (23%) | 16 (25%) | 14 (22%) | 19 (35%) | 27 (39%) | 28 (29%) | 22 (26%) | 171 (28%) | 3.2 (-3.3, 10.2) |
|---|
* Derived from Poisson regression
Appendix 3
Figure A3.1: Distribution of blood morphine concentrations (n=176)
Figure A3.2: Distribution of blood methadone concentrations (n=80)
Figure A3.3: Distribution of blood alcohol concentrations (n=153)
Table A3.4: Comparison of drug related deaths in Scotland and London
Characteristic | Scotland | London | Test of Difference |
|---|
Total | 273 | 148 | |
|---|
Sex |
|---|
% (n) male | 81.7% | (223) | 81.1% | (120) | NS* |
|---|
Age |
|---|
Mean (median) age | 31.8 | (31) | 35.7 | (34) | p < 0.001^ |
|---|
Toxicology |
|---|
Heroin/morphine | 65.6% | (179) | 66.9% | (99) | NS* |
|---|
Methadone | 30.4% | (83) | 31.8% | (47) | NS* |
|---|
Cocaine | 9.9% | (27) | 41.9% | (62) | p < 0.001* |
|---|
MDMA/Amphetamines | 9.5% | (26) | 12.2% | (18) | NS* |
|---|
Alcohol | 54.9% | (150) | 56.1% | (83) | NS* |
|---|
Benzodiazepines | 69.2% | (189) | 40.5% | (60) | p < 0.001* |
|---|
Dihydrocodeine | 18.7% | (51) | 10.8% | (16) | p = 0.03* |
|---|
Mean (median) heroin toxicology (mg/L) | 0.27 | (0.2) | 0.36 | (0.26) | p = 0.045^ |
|---|
Mean (median) methadone toxicology (mg/L) | 0.52 | (0.309) | 0.87 | (0.54) | p < 0.01^ |
|---|
Mean (median) alcohol toxicology (ml/100ml) | 119.6 | 104 | 87.1 | 59 | p = 0.01^ |
|---|
Substitute treatment |
|---|
yes | 25.6% | 70 | 27.7% | 41 | NS* |
|---|
methadone | 17.9% | 49 | 25.0% | 37 | NS* |
|---|
DHD | 8.4% | 23 | 2.7% | 4 | p=0.03* |
|---|
Deaths with positive methadone toxicology and evidence of methadone prescription | 51.8% | 43 | 55.3% | 26 | NS* |
|---|
Deaths with positive DHD toxicology and evidence of DHD prescription | 35.3% | 18 | 12.5% | 2 | NS* |
|---|
Prison history |
|---|
yes | 47.6% | 130 | 40.5% | 60 | NS* |
|---|
released < 3 months | 17.2% | 47 | 10.1% | 15 | p=0.05 |
|---|
Witness present |
|---|
yes | 48.4% | (132) | 60.8% | (90) | p < 0.01* |
|---|
Ambulance called |
|---|
yes | 81.7% | (223) | 90.5% | (134) | p < 0.05* |
|---|
If ambulance called, dead on arrival |
|---|
yes | 85.2% | (190) | 85.1% | (114) | NS* |
|---|
Known IDU |
|---|
yes | 53.8% | (147) | 60.8% | (90) | NS* |
|---|
Route of fatal dose |
|---|
Inject | 54.6% | (149) | 64.9% | (96) | p < 0.05* |
|---|
Non-inject | 43.6% | (119) | 26.4% | (39) | |
|---|
Not able to be determined | 11.7% | (32) | 10.8% | (16) | |
|---|
Usual type of accommodation |
|---|
house/flat | 81.3% | (222) | 67.6% | (100) | p < 0.01* |
|---|
hotel/motel | 2.9% | (8) | 2.7% | (4) | |
|---|
hostel resident | 7.3% | (20) | 7.4% | (11) | |
|---|
street homeless | 1.8% | (5) | 5.4% | (8) | |
|---|
caravan/camper/car | 0.7% | (2) | 2.0% | (3) | |
|---|
roofless/sofa surfer | 4.0% | (11) | 6.8% | (10) | |
|---|
other | 0.0% | | 4.1% | (6) | |
|---|
unknown | 1.8% | (5) | 4.1% | (6) | |
|---|
Place of death |
|---|
own home | 47.6% | (130) | 43.9% | (65) | NS* |
|---|
home of family/friend | 27.1% | (74) | 20.3% | (30) | |
|---|
hotel/motel/hostel | 8.8% | (24) | 11.5% | (17) | |
|---|
public space | 3.7% | (10) | 7.4% | (11) | |
|---|
hospital | 8.8% | (24) | 11.5% | (17) | |
|---|
other | 3.7% | (10) | 4.7% | (7) | |
|---|
unknown | 0.4% | (1) | 0.7% | (1) | |
|---|
Time of death |
|---|
Rapid/instant | 9.2% | (25) | 6.8% | (10) | p < 0.01* |
|---|
Within the hour | 15.4% | (42) | 6.1% | (9) | |
|---|
Several hours | 44.7% | (122) | 27.7% | (41) | |
|---|
12 hours or more | 2.9% | (8) | 3.4% | (5) | |
|---|
A number of days | 0.7% | (2) | 3.4% | (5) | |
|---|
Not able to be determined | 27.1% | (74) | 52.7% | (78) | |
|---|
Note: ^ T-test, * Chi2
Appendix 4
Table A4.1: List of potential interventions offered to cases of drug-related death in the 6 months prior to death (n=237)
A. SOCIAL | B. MEDICAL |
1. Food distribution | 20. Medical consultation |
2. Clothes washing | 21. Other medical care |
3. Clothing distribution | 22. General hospitalisation |
4. Shower/hygiene | 23. Nursing care |
5. Help finding accommodation | 24. General emergency |
6. Night shelter | 25. General prevention and health promotion |
7. Accommodation | |
8. Emergency social accommodation | D. MENTAL HEALTH |
9. Social reintegration, help finding work | |
10. Legal/administrative advice or aid | 60. Emergency psychiatric care |
11. Financial assistance | 61. Outpatient psychiatric consultation |
12. Travel expenses | 62. On-site delivery of psychotropic treatment |
13. Prison work | 63. Individual psychotherapy |
14. Prison Transitional Care/Community | 64. Psychiatric hospitalisation |
| 65. Family therapy |
C. CARE STRATEGY | 66. Group therapy |
| 67. Psychological consultation |
80. Somewhere to sit | 68. Occupational therapy |
81. A place to talk | 69. Discussion groups |
82. Low threshold/drop in | |
83. Case management | E. SUBSTANCE ABUSE |
84. To speak to Mr/Mrs X | |
85. Information and orientation | 40. Substance misuse assessment |
86. Support and training for carers | 41. Substitution programme |
87. Holistic care | 42. Detoxification (short term reduction) |
88. Street outreach work | 43. On-site needle/syringe exchange |
89. Care at client's home | 44. Outreach needle/syringe exchange |
90. Day care | 45. Counselling |
91. Advocacy | 46. Drug Treatment & Testing Order |
| 47. Put on Waiting list |
| 48. Motivational enhancement |
Interventions highlighted in bold text are those which were recorded as having been offered to individuals.
Table A4.2: Prescribing details of cases in methadone treatment at time of death (n=40)
Case ID | Dose at death (mg) | Duration of last dose (weeks) | Previous dose (mg) | Duration of methadone treatment (months) |
|---|
134 | - | - | - | - |
246 | 4 | 3 | 6 | 7 |
152 | 10 | 5 days | 12 | 5 |
8 | 16 | 6 | 15 | N/K*** |
202 | 20 | 3 | 13 | 7 |
175 | 30 | 1 day | 10 | 16 |
136 | 30 | - | nr | 82 |
144 | 30 | - | 35 | 88 |
32 | 30 | 7 days | 50 | 30 |
259 | 35 | 24 | 40 | N/K |
216 | 40 | 10 days | 30 | 2 |
169 | 45 | - | nr | N/K |
174 | 45 | 9 | 35 | 5 |
271 | 45 | 15 | 35 | 37 |
287 | 45 | - | nr | N/K |
187 | 45 | 10 days | 40 | 5 |
190 | 50 | - | 30 | N/K |
198 | 50 | 4 | 40 | 6 days |
73 | 50 | 3 days | Nr | 3 days |
132 | 50 | 12 | 40 | N/K |
282 | 50 | 20 | 55 | N/K |
252 | 50 | 4 | 40 | 5 |
262 | 50 | 21 | 45 | 6 |
232 | 50 | 7 days | 40 | 19 |
| 50 | 14 | 40 | 18 |
| 60 | 8 | 55 | 10 |
234 | 60 | 8 days | 50 | 73 |
| 65 | 2 | 58 | 84 |
166 | 65 | 4 | 60 | 5 |
76 | 70 | 2 | Nr | <1 |
54 | 80 | -* | Nr** | N/K |
204 | 80 | - | 70 | 2 |
206 | 80 | 16 | 70 | 17 |
220 | 80 | 2 days | Nr | 2 days |
118 | 80 | - | Nr | N/K |
24 | 90 | 32 | 80 | 5 |
61 | 90 | 5 | Nr | 1 |
256 | 90 | 4 | 110 | 5 |
7 | 95 | 52 | 100 | 40 |
108 | 100 | 52 | Nr | 12 |
*-=no information
**nr=no dose change recorded in notes
***N/K=not known