Dying for heroin: the increasing opioid-related mortality in the Republic of Ireland, 1980-1999.
BACKGROUND
Over the past 20 years there has been a steady rise in mortality associated with opioid misuse in several Western countries. We aimed to examine trends in opioid-related mortality over a 20-year period in the Republic of Ireland.


METHODS
Retrospective analysis of deaths attributed to ICD-9 codes 304.0 (morphine-type dependence) and E850.0 (accidental poisoning by opiates and related narcotics) in the Republic of Ireland between 1980 and 1999.


RESULTS
The Republic of Ireland has seen a rapid increase in the number of opioid-related deaths over the 20-year period studied, from 0.01% of total deaths in 1980 to 0.15% in 1999. This is most marked in the younger age groups where, for example, it rose to 23% of 15-19 year old male deaths for 1997. The opioid-related mortality rate in the 15-44 years age range increased by nearly 14 times between 1980-1984 and 1995-1999. Over the whole period, 87% of opioid-related deaths were amongst males. Outside Dublin there has been a considerable increase in opioid-related mortality, nearly doubling the percentage of the total from 6% in the 1980s to 11% in the 1990s.


CONCLUSIONS
Opioid-related mortality is an increasing problem in the Republic of Ireland, as in other Western countries. Today, young people have a very low mortality rate, and hence this rapid increase may need specific targeted interventions. The spread of opioid-related mortality outside Dublin to rural and other urban areas will have implications for service planning and provision.
Kelleher
Michael J A
MJ
National Addiction Centre and Maudsley Hospital, Institute of Psychiatry, London, UK. mike.kelleher@slam.nhs.uk
Keown
Patrick J
PJ
O'Gara
Colin
C
Keaney
Francis
F
Farrell
Michael
M
Strang
John
J
D000293:Adolescent; D000328:Adult; D005260:Female; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012189:Retrospective Studies
D003932:Heroin