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Fatal poisoning in drug addicts in the Nordic countries in 2012.
Forensic Sci Int. 2015 Mar; 248:172-80.FS

Abstract

This report is a follow-up to a study on fatal poisoning in drug addicts conducted in 2012 by a Nordic working group. Here we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on sex, number of deaths, places of death, age, main intoxicants and other drugs detected in the blood were recorded. National data are presented and compared between the Nordic countries and with data from similar studies conducted in 1991, 1997, 2002 and 2007. The death rates (number of deaths per 100,000 inhabitants) increased in drug addicts in Finland, Iceland and Sweden but decreased in Norway compared to the rates in earlier studies. The death rate was stable in Denmark from 1991 to 2012. The death rate remained highest in Norway (5.79) followed by Denmark (5.19) and Iceland (5.16). The differences between the countries diminished compared to earlier studies, with death rates in Finland (4.61) and Sweden (4.17) approaching the levels in the other countries. Women accounted for 15-27% of the fatal poisonings. The median age of the deceased drug addicts was still highest in Denmark, and deaths of addicts >45 years old increased in all countries. Opioids remained the main cause of death, but medicinal opioids like methadone, buprenorphine, fentanyl and tramadol mainly replaced heroin. Methadone was the main intoxicant in Denmark and Sweden, whereas heroin/morphine caused the most deaths in Norway. Finland differed from the other Nordic countries in that buprenorphine was the main intoxicant with only a few heroin/morphine and methadone deaths. Deaths from methadone, buprenorphine and fentanyl increased immensely in Sweden compared to 2007. Poly-drug use was widespread in all countries. The median number of drugs per case varied from 4 to 5. Heroin/morphine, medicinal opioids, cocaine, amphetamines, benzodiazepines and alcohol were the main abused drugs. However, less widely used drugs, like gamma-hydroxybutyric acid (GHB), methylphenidate, fentanyl and pregabalin, appeared in all countries. New psychotropic substances emerged in all countries, with the largest selection, including MDPV, alpha-PVP and 5-IT, seen in Finland and Sweden.

Authors+Show Affiliations

Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V's vej 11, 3, DK-2100 Copenhagen, Denmark. Electronic address: kirsten.wiese@sund.ku.dk.Norwegian Institute of Public Health, Division of Forensic Sciences, PO Box 4404 Nydalen, N-0403 Oslo, Norway.Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Artillerigatan 12, SE-587 58 Linköping, Sweden.Department of Forensic Medicine, University of Helsinki, PL 40 (Kytösuontie 11), FI-00014 Helsinki, Finland.Department of Pharmacology and Toxicology, University of Iceland, Hagi-Hofsvallagata 53, IS-107 Reykjavik, Iceland.Department of Forensic Medicine, University of Aarhus, Brendstrupgaardsvej 100, DK-8200 Aarhus, Denmark.Department of Forensic Medicine, University of Helsinki, PL 40 (Kytösuontie 11), FI-00014 Helsinki, Finland.Norwegian Institute of Public Health, Division of Forensic Sciences, PO Box 4404 Nydalen, N-0403 Oslo, Norway.Institute of Forensic Medicine, University of Southern Denmark, Winsløwparken 17B, DK-5000 Odense, Denmark.Norwegian Institute of Public Health, Division of Forensic Sciences, PO Box 4404 Nydalen, N-0403 Oslo, Norway; Institute of Forensic Medicine, University of Oslo, N-0027 Oslo, Norway.Department of Clinical Pharmacology, St. Olavs Hospital - Trondheim University Hospital, Professor Brochs gate 6, N-7030 Trondheim, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25645132

Citation

Simonsen, K Wiese, et al. "Fatal Poisoning in Drug Addicts in the Nordic Countries in 2012." Forensic Science International, vol. 248, 2015, pp. 172-80.
Simonsen KW, Edvardsen HM, Thelander G, et al. Fatal poisoning in drug addicts in the Nordic countries in 2012. Forensic Sci Int. 2015;248:172-80.
Simonsen, K. W., Edvardsen, H. M., Thelander, G., Ojanperä, I., Thordardottir, S., Andersen, L. V., Kriikku, P., Vindenes, V., Christoffersen, D., Delaveris, G. J., & Frost, J. (2015). Fatal poisoning in drug addicts in the Nordic countries in 2012. Forensic Science International, 248, 172-80. https://doi.org/10.1016/j.forsciint.2015.01.003
Simonsen KW, et al. Fatal Poisoning in Drug Addicts in the Nordic Countries in 2012. Forensic Sci Int. 2015;248:172-80. PubMed PMID: 25645132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fatal poisoning in drug addicts in the Nordic countries in 2012. AU - Simonsen,K Wiese, AU - Edvardsen,H M E, AU - Thelander,G, AU - Ojanperä,I, AU - Thordardottir,S, AU - Andersen,L V, AU - Kriikku,P, AU - Vindenes,V, AU - Christoffersen,D, AU - Delaveris,G J M, AU - Frost,J, Y1 - 2015/01/13/ PY - 2014/10/06/received PY - 2014/12/17/revised PY - 2015/01/03/accepted PY - 2015/2/4/entrez PY - 2015/2/4/pubmed PY - 2015/12/23/medline KW - Drug addict deaths KW - Fatal poisonings KW - Medicinal opioids KW - New psychoactive substances KW - Nordic countries SP - 172 EP - 80 JF - Forensic science international JO - Forensic Sci Int VL - 248 N2 - This report is a follow-up to a study on fatal poisoning in drug addicts conducted in 2012 by a Nordic working group. Here we analyse data from the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. Data on sex, number of deaths, places of death, age, main intoxicants and other drugs detected in the blood were recorded. National data are presented and compared between the Nordic countries and with data from similar studies conducted in 1991, 1997, 2002 and 2007. The death rates (number of deaths per 100,000 inhabitants) increased in drug addicts in Finland, Iceland and Sweden but decreased in Norway compared to the rates in earlier studies. The death rate was stable in Denmark from 1991 to 2012. The death rate remained highest in Norway (5.79) followed by Denmark (5.19) and Iceland (5.16). The differences between the countries diminished compared to earlier studies, with death rates in Finland (4.61) and Sweden (4.17) approaching the levels in the other countries. Women accounted for 15-27% of the fatal poisonings. The median age of the deceased drug addicts was still highest in Denmark, and deaths of addicts >45 years old increased in all countries. Opioids remained the main cause of death, but medicinal opioids like methadone, buprenorphine, fentanyl and tramadol mainly replaced heroin. Methadone was the main intoxicant in Denmark and Sweden, whereas heroin/morphine caused the most deaths in Norway. Finland differed from the other Nordic countries in that buprenorphine was the main intoxicant with only a few heroin/morphine and methadone deaths. Deaths from methadone, buprenorphine and fentanyl increased immensely in Sweden compared to 2007. Poly-drug use was widespread in all countries. The median number of drugs per case varied from 4 to 5. Heroin/morphine, medicinal opioids, cocaine, amphetamines, benzodiazepines and alcohol were the main abused drugs. However, less widely used drugs, like gamma-hydroxybutyric acid (GHB), methylphenidate, fentanyl and pregabalin, appeared in all countries. New psychotropic substances emerged in all countries, with the largest selection, including MDPV, alpha-PVP and 5-IT, seen in Finland and Sweden. SN - 1872-6283 UR - https://www.unboundmedicine.com/medline/citation/25645132/Fatal_poisoning_in_drug_addicts_in_the_Nordic_countries_in_2012_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0379-0738(15)00008-0 DB - PRIME DP - Unbound Medicine ER -