title: Concomitant drugs of misuse and drug using behaviours associated with fatal opiate-related poisonings in Sheffield, UK, 1997-2000.
abstract: OBJECTIVE
  To examine the degree of involvement of concomitant drugs of misuse and other previously identified behavioural risk factors in acute accidental opiate-related poisoning fatalities in Sheffield, 1997-2000.
  
  
  METHODS
  Retrospective analysis of coroners' records.
  
  
  METHODS
  Sheffield, UK.
  
  
  METHODS
  All those who died from an acute accidental opiate-related poisoning in Sheffield between 1 January 1997 and 31 December 2000.
  
  
  METHODS
  Coronial data were collated under the headings: demographic characteristics, circumstances of death and toxicological findings.
  
  
  RESULTS
  Ninety-four deaths occurred over the study period. The majority of cases were regular users of illicit drugs. Approximately 20% of deaths were preceded by a period of abstinence from drug use, with imprisonment and hospitalization as the most common reasons. Sixty-one per cent of cases had concomitant drugs of misuse detected from toxicology most commonly benzodiazepines and/or alcohol. These were, however, found in relatively small concentrations and opiate blood concentrations were no lower in deaths where multiple substances were involved. Despite evidence to suggest that smoking is the preferred route of heroin administration in this region, the vast majority of cases involved injecting.
  
  
  CONCLUSIONS
  Administration of an opiate via intravenous injection was the most consistent factor associated with these deaths over the period of this study. Co-administration of other central nervous system depressants, at least in lower quantities appear to be a feature rather than a risk factor per se in such fatalities.
authors.affiliation: Addiction Research Unit, Institute of General Practice and Primary Care, University of Sheffield, Northern General Hospital, Sheffield, UK. phillip.oliver@sheffield.ac.uk
authors.forename: Phillip
authors.initials: P
authors.lastname: Oliver
authors.forename: Jenny
authors.initials: J
authors.lastname: Keen
mesh_terms: D000328:Adult; D001569:Benzodiazepines / Q000097:blood; D062787:Drug Overdose / Q000097:blood; D004739:England / Q000453:epidemiology; D000431:Ethanol / Q000097:blood; D005260:Female; D006556:Heroin Dependence / Q000401:mortality; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000097:blood / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000097:blood / Q000401:mortality*
chemical_list: D001569:Benzodiazepines; D000431:Ethanol