Review of deaths related to analgesic- and cough suppressant-opioids; England and Wales 1996-2002.
OBJECTIVE
The data on England and Wales voluntarily supplied by Coroners to the National Programme on Substance Abuse Deaths for the August 1996-December 2002 time frame were analyzed.


METHODS
All cases in which at least one analgesic- and cough suppressant-opioid other than heroin/morphine, methadone or buprenorphine was identified were extracted from the database. We hypothesized that: a) populations of addicts and non-addicts presented differences in patterns of drugs involved; and b) within the population of addicts and non-addicts, intentional and non-intentional deaths presented different patterns of substance consumption.


RESULTS
A total of 2024 deaths related to selected opioids, either alone or in combination, were included in the analysis. Typically, non-addicts were older than 45 and died as a result of intentional poisoning whilst majority of addicts were young, males and victims of accidental deaths. In about 93% of cases the selected opioids were reported in combination with another substance. Most frequently identified narcotics were propoxyphene, codeine and dihydrocodeine. Co-proxamol, Co-codamol and Co-dydramol were typically prescribed for non-addicts, whilst dihydrocodeine was mostly given to addicts. In non-addicts, alcohol was mostly represented in accidental deaths and antidepressants were typically represented in intentional deaths. Conversely, illicit drugs and hypnotics/sedatives were typically reported in addicts' accidental deaths.


CONCLUSIONS
The present report constitutes the largest available collection of analgesic- and cough suppressant-opioid mortality data in the UK. Users should be educated about risks associated with polydrug misuse.
Schifano
F
F
National Programme on Substance Abuse Deaths, Division of Mental Health, Addictive Behaviour, St George's, University of London, London, UK. fschifan@sgul.ac.uk
Zamparutti
G
G
Zambello
F
F
Oyefeso
A
A
Deluca
P
P
Balestrieri
M
M
Little
D
D
Ghodse
A H
AH
D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000401:mortality*; D000701:Analgesics, Opioid / Q000506:poisoning*; D000996:Antitussive Agents / Q000506:poisoning*; D003334:Coroners and Medical Examiners; D004347:Drug Interactions; D062787:Drug Overdose / Q000401:mortality; D011307:Drug Prescriptions; D004363:Drug Utilization; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009293:Opioid-Related Disorders / Q000401:mortality*; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D017678:Sex Distribution; D014852:Wales / Q000453:epidemiology
D000701:Analgesics, Opioid; D000996:Antitussive Agents