Unnatural Death among Treatment Seeking Substance Users in Singapore: A Retrospective Study

Abstract

Substance use carries a higher risk of unnatural death. A retrospective analysis of 42 treatment seekers between 2011–2015 was conducted through medical record review to understand the profile and circumstances leading to premature deaths. Ninety percent of the subjects were males. The mean age at death was 44.9 (SD ± 13.1). Opioids (52.4%), benzodiazepines (45.2%) and alcohol (35.7%) were the main substances used by the group. Suicide was the most common cause of death (n = 27, 64.3%) followed by accidents (n = 15; 35.7%). Among the suicide cases, alcohol was the main substance used (33.3%) followed by opioids (25.9%). A total of 58.5% (n = 24) deaths occurred within a year of their last visit while 41.5% (n = 17) were dead more than a year after their last visit. Of the total cases (n = 41), 63% had a history of mental illness with depressive disorder (53.8%) being the most common. History of suicide attempts were reported in 34.1% (n = 14) of cases and 50% of the subjects (n = 21) had a history of suicidal ideation. Drug related offences were reported in 57.1% of the subjects, of which 60% (n = 18) committed suicide. The findings support the need for appropriate treatment resources to reduce the untimely deaths among substance users.

Clinicopathological correlates of out‐of‐hospital cardiac arrests

“…30 As such, the rate of substance abuse in Singapore is remarkably low and correspondingly, substance abuse is also an exceedingly rare cause of SCA in Singapore. 31 While only a small proportion (7.0%, n = 65) of patients in this series were eligible for a primary prevention ICD, even fewer (n = 12, 1.2% of the whole series and 18.5% of those eligible) actually had one implanted. This low rate of ICD implantation is consistent both locally and internationally.…”

“…30 As such, the rate of substance abuse in Singapore is remarkably low and correspondingly, substance abuse is also an exceedingly rare cause of SCA in Singapore. 31 …”

“…This reflects the effectiveness of the zero‐tolerance attitude that Singapore has toward substance abuse with punitive laws that extend to capital punishment 30 . As such, the rate of substance abuse in Singapore is remarkably low and correspondingly, substance abuse is also an exceedingly rare cause of SCA in Singapore 31 …”

Whole-Exome Sequencing to Identify Potential Genetic Risk in Substance Use Disorders: A Pilot Feasibility Study

“…Among these arrestees, 42% were new drug users, and 61% of this group were below 30 years of age. The majority of the treatment-seeking population in NAMS include those with either AUD or OUD [10]. The prevalence of this condition suggests a need to evaluate all potential methods of intervention possible.…”

“…In general, the risk of death is higher among polysubstance users compared to the general population accounting for both somatic diseases (58% vs. 28%, respectively) and overdose-related deaths (33% vs. 9%, respectively) [9]. A retrospective analysis of unnatural death among treatment-seeking substance abusers in Singapore showed a large proportion of suicides among subjects abusing alcohol and opiates [10]. Apart from the pervasive effects on an individual's life, health, and health care utilization, substance misuse also impacts society and the economy [11].…”