Drug-related deaths between 2002 and 2013 with accent to methadone and benzodiazepines.
OBJECTIVE
The aim of the study is to assess the trends of overdose and drug related fatalities in the Republic of Macedonia during the 11 years.


METHODS
Cross-sectional retrospective survey and reviewed of postmortem toxicological analyses which examined fatal poisonings with illegal drugs in years 2002-2013. Information about gender, age, drug consumption, reported years were analyzed. Narcotics were confirmed with toxicological semi quantitative fluorescence polarization immunoassay (FPIA) in urine (range 250-4000 ng/ml).


RESULTS
Total of 165 deaths were observed. Out of them 145 (87.9%) were male. There is statistical significant differences between male and female DRD due to age (Mann-Whitney U Test = 925, Z = -2626, p = 0.0087). For p < 0.05 there is significant differences between genders due to cause of overdose (Pearson Chi-square = 9743, df = 4, p = 0.0449). DRD among male were mainly because of overdose due to heroin in 80 (51.17%) cases followed by DRD due to combination of methadone and BZD in 25 (11.72%) cases. Out of all DRD cases 50 (30.3%) are related to polydrug use. For p < 0.01 there is a significant differences between analyzed age groups due to cause of overdose (Pearson Chi-square = 33,886, df = 12, p = 0.0007).


CONCLUSIONS
Death cause analysis reveals the difficulties in determining the role of substitution drugs, as many other factors may be involved. The findings also highlight the importance of further enhancing treatment interventions for benzodiazepine misuse among patients on methadone substitution treatment.
Ministry of Health, Head of Sector for Controlled Substances, National Focal Point for EMCDDA, Macedonia. Electronic address: tanja.petrusevska@gmail.com.mk.
Tatjana
T
Petrushevska
Institute of Forensic Medicine, Criminology and Medical Deontology at the Medical Faculty in Skopje, University "Sv.Kiril and Metodij", Skopje, Macedonia.
Zlatko
Z
Jakovski
Institute of Forensic Medicine, Criminology and Medical Deontology at the Medical Faculty in Skopje, University "Sv.Kiril and Metodij", Skopje, Macedonia.
Verica
V
Poposka
Institute for Epidemiology and Medical Biostatistics, Head of Cathedra, Medical Faculty "Ss. Cyril and Methodius" University of Skopje, Skopje, Macedonia.
Vesna Velik
VV
Stefanovska
D000293:Adolescent; D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects / Q000506:poisoning*; D003430:Cross-Sectional Studies; D062787:Drug Overdose / Q000401:mortality*; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects / Q000506:poisoning*; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000506:poisoning*; D018843:Republic of North Macedonia / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000401:mortality*; D055815:Young Adult
D009294:Narcotics; D001569:Benzodiazepines; D008691:Methadone
Benzodiazepines; Drug-related deaths; Methadone; Opioids; Overdose; Toxicity