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Trends in heroin and pharmaceutical opioid overdose deaths in Australia.
Drug Alcohol Depend. 2017 10 01; 179:291-298.DA

Abstract

BACKGROUND

There has been international concern over the rise in fatal pharmaceutical opioid overdose rates, driven by increased opioid analgesic prescribing. The current study aimed to examine trends in opioid overdose deaths by: 1) opioid type (heroin and pharmaceutical opioids); and 2) age, gender, and intent of the death assigned by the coroner.

METHODS

Analysis of data from the National Coronial Information System (NCIS) of opioid overdose deaths occurring between 2001 and 2012.

RESULTS

Deaths occurred predominantly (98%) among Australians aged 15-74 years. Approximately two-thirds of the decedents (68%) were male. The heroin overdose death rate remains unchanged over the period; these were more likely to occur among males. Pharmaceutical opioid overdose deaths increased during the study period (from 21.9 per million population in 2001-36.2), and in 2012 they occurred at 2.5 times the incident rate of heroin overdose deaths. Increases in pharmaceutical opioid deaths were largely driven by accidental overdoses. They were more likely to occur among males than females, and highest among Australians aged 45-54 years. Rates of fentanyl deaths in particular showed an increase over the study period (from a very small number at the beginning of the period) but in 2012 rates of morphine deaths were higher than those for oxycodone, fentanyl and tramadol.

CONCLUSIONS

Given the increase in rates of pharmaceutical opioid overdose deaths, it is imperative to implement strategies to reduce pharmaceutical opioid-related mortality, including more restrictive prescribing practices and increasing access to treatment for opioid dependence.

Authors+Show Affiliations

National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia. Electronic address: a.roxburgh@unsw.edu.au.National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia; University of Queensland Clinical Centre for Research, University of Queensland, Brisbane, QLD, 4072, Australia; University of Queensland Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, 4006, Australia; National Addiction Centre, Kings College London, WC2R 2LS, United Kingdom.National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia.National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia.National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia.Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, 2052, Australia.National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia; School of Population and Global Health, University of Melbourne, VIC, 3010, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28826104

Citation

Roxburgh, Amanda, et al. "Trends in Heroin and Pharmaceutical Opioid Overdose Deaths in Australia." Drug and Alcohol Dependence, vol. 179, 2017, pp. 291-298.
Roxburgh A, Hall WD, Dobbins T, et al. Trends in heroin and pharmaceutical opioid overdose deaths in Australia. Drug Alcohol Depend. 2017;179:291-298.
Roxburgh, A., Hall, W. D., Dobbins, T., Gisev, N., Burns, L., Pearson, S., & Degenhardt, L. (2017). Trends in heroin and pharmaceutical opioid overdose deaths in Australia. Drug and Alcohol Dependence, 179, 291-298. https://doi.org/10.1016/j.drugalcdep.2017.07.018
Roxburgh A, et al. Trends in Heroin and Pharmaceutical Opioid Overdose Deaths in Australia. Drug Alcohol Depend. 2017 10 1;179:291-298. PubMed PMID: 28826104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in heroin and pharmaceutical opioid overdose deaths in Australia. AU - Roxburgh,Amanda, AU - Hall,Wayne D, AU - Dobbins,Timothy, AU - Gisev,Natasa, AU - Burns,Lucinda, AU - Pearson,Sallie, AU - Degenhardt,Louisa, Y1 - 2017/08/14/ PY - 2017/03/03/received PY - 2017/07/18/revised PY - 2017/07/19/accepted PY - 2017/8/22/pubmed PY - 2018/5/2/medline PY - 2017/8/22/entrez KW - Drug overdose KW - Fentanyl KW - Heroin KW - Morphine KW - Mortality KW - Opioid analgesics KW - Oxycodone KW - Prescription opioids SP - 291 EP - 298 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 179 N2 - BACKGROUND: There has been international concern over the rise in fatal pharmaceutical opioid overdose rates, driven by increased opioid analgesic prescribing. The current study aimed to examine trends in opioid overdose deaths by: 1) opioid type (heroin and pharmaceutical opioids); and 2) age, gender, and intent of the death assigned by the coroner. METHODS: Analysis of data from the National Coronial Information System (NCIS) of opioid overdose deaths occurring between 2001 and 2012. RESULTS: Deaths occurred predominantly (98%) among Australians aged 15-74 years. Approximately two-thirds of the decedents (68%) were male. The heroin overdose death rate remains unchanged over the period; these were more likely to occur among males. Pharmaceutical opioid overdose deaths increased during the study period (from 21.9 per million population in 2001-36.2), and in 2012 they occurred at 2.5 times the incident rate of heroin overdose deaths. Increases in pharmaceutical opioid deaths were largely driven by accidental overdoses. They were more likely to occur among males than females, and highest among Australians aged 45-54 years. Rates of fentanyl deaths in particular showed an increase over the study period (from a very small number at the beginning of the period) but in 2012 rates of morphine deaths were higher than those for oxycodone, fentanyl and tramadol. CONCLUSIONS: Given the increase in rates of pharmaceutical opioid overdose deaths, it is imperative to implement strategies to reduce pharmaceutical opioid-related mortality, including more restrictive prescribing practices and increasing access to treatment for opioid dependence. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/28826104/Trends_in_heroin_and_pharmaceutical_opioid_overdose_deaths_in_Australia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(17)30404-0 DB - PRIME DP - Unbound Medicine ER -