Fatal poisoning in drug addicts in the Nordic countries

Abstract

The study includes medicolegally examined fatal poisonings among drug addicts in 1997 in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden, and the results are compared to a similar investigation from 1991. A common definition of "drug addict" was applied by the participating countries. The highest death rate by poisoning in drug addicts was observed in Denmark, where it was 6.54 per 10(5)inhabitants, followed by Norway with 6.35, Sweden with 2.21, Finland with 1.63 and Iceland with 1.20 per 10(5)inhabitants. All countries showed a higher death rate in 1997 than in 1991. For all countries the distribution of deaths according to geographical regions showed a decreasing number of drug deaths in the metropolitan area and an increasing number in other cities. Heroin/morphine dominated as the cause of death and was responsible for about 90% of the cases in Norway. In Sweden and Denmark, however, heroin/morphine caused only about 70% of the fatal poisonings. About 30% of the fatal poisonings in Denmark and Sweden were caused by other group I drugs, in Denmark mainly methadone and in Sweden mainly propoxyphene. Apart from two cases in Sweden methadone deaths were not seen in the other Nordic countries. In Finland heroin/morphine deaths have increased from about 10% in 1991 to about 40% in 1997. Forty-four percent of the fatal poisonings in Finland were caused by other group I drugs, mainly codeine and propoxyphene. The two fatal poisonings in Iceland were caused by carbon monoxide. Only few deaths in this investigation were caused by amphetamine and cocaine. A widespread use of alcohol, cannabis and benzodiazepines, especially diazepam, was seen in all the countries.

Fatal Poisonings in the South Marmara Region of Turkey

“…The distribution of drugs causing fatal poisonings varies depending on the region. In Nordic countries poisoning among drug addicts take the first place in fatal poisonings (46,47). Steentoft et al (46) reported that the greatest number of drug addict deaths in Nordic countries was seen in Denmark, followed in descending order by Norway, Sweden, Finland and Iceland.…”

“…In Nordic countries poisoning among drug addicts take the first place in fatal poisonings (46,47). Steentoft et al (46) reported that the greatest number of drug addict deaths in Nordic countries was seen in Denmark, followed in descending order by Norway, Sweden, Finland and Iceland. In Denmark, Norway and Sweden heroin and morphine was the most frequently encountered drug (47).…”

Carisoprodol intoxications: a retrospective study of forensic autopsy material from 1992–2003

“…Previous studies of fatal carisoprodol intoxications have also reported frequent detection of additional drugs [17,21]. A large degree of polydrug abuse is also reported from fatal intoxications with other drugs, where an average of 2.4-3.5 drugs are found [35,36], as well as studies of drugged drivers showing an average number of 2.6 additional drugs [37].…”

Difficulties in Recording Mortality Resulting from Drug Abuse

“…They are a valuable indicator of dimensions of the drug abuse problem in a country or a region, especially when interpreted along with other indicators (1,2). Studies have shown that, similarly to other mortality causes (3)(4)(5), certification of drug abuse deaths presents a significant problem in the world, whether they are overdose related deaths or other deaths resulting from drugs misuse (6,7).…”