title: Personally prescribed psychoactive drugs in overdose deaths among drug abusers: a retrospective register study.
abstract: OBJECTIVE
  Psychoactive prescription drug (PPD) abuse-related overdose deaths have increased in many countries in recent decades. We aimed to investigate the role of personally prescribed psychoactive drugs in abuse-related overdose mortality and explore any associations with level of social disadvantage.
  
  
  METHODS
  This register linkage study included all 243 people who had died of abuse-related drug-induced poisoning in Finland in 2000 and 2008. Data on registered purchases of psychoactive drugs within one and three years of death were linked to data on the psychoactive drug/s contributing to death in each case. Social disadvantage was measured by receipt of income support, long-term unemployment and disability pension.
  
  
  RESULTS
  Thirty-six percent of those abusers who had died of a drug overdose had purchased a similarly acting drug within three years of death. In all overdoses, the proportion increased from 20% in 2000 to 49% in 2008 (P < 0.001). A similar increase was seen in purchases within one year of death; from one-tenth in 2000 to one-third of all cases in 2008 (P < 0.001). The majority (83%) of the deceased had received income support, while only 13-14% were long-term unemployed or on disability pension. Disability pension recipients had significantly more prescribed psychoactive drug purchases than non-recipients (P < 0.001 for three and one years within death).
  
  
  CONCLUSIONS
  Personally prescribed PPDs pose a potential threat to people who abuse drugs. Health-care services should invest greater effort in identifying people who abuse drugs and in monitoring their drug prescriptions.
authors.affiliation: Department of Social Research, University of Helsinki, Helsinki, Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Rönkä
authors.forename: Karoliina
authors.initials: K
authors.lastname: Karjalainen
authors.forename: Erkki
authors.initials: E
authors.lastname: Vuori
authors.forename: Pia
authors.initials: P
authors.lastname: Mäkelä
mesh_terms: D000293:Adolescent; D000328:Adult; D062787:Drug Overdose / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063487:Prescription Drug Misuse / Q000401:mortality*; D011619:Psychotropic Drugs / Q000506:poisoning*; D012042:Registries; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000401:mortality*; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: drug poisoning; psychoactive prescription drug; register-based study; social disadvantage