Deaths among drug addicts in East Denmark 1992-1999.

A drug addict is defined as a person with a present or former abuse of illegally acquired euphoriants comprising opioids, central stimulants and hallucinogens. In Denmark the first deaths among drug addicts were registered in 1968. At the Institute of Forensic Medicine in Copenhagen deaths among drug addicts in East Denmark are investigated, the number of which comprises about 60 per cent of the total number in Denmark. East Denmark has a population of 2.3 million.

Material

The material comprises all fatalities among drug addicts in the period 1992-1999 investigated at the Institute of Forensic Medicine in Copenhagen.

Results

In the eight-year period a total of 1187 fatalities among drug addicts were investigated. The annual number and the sex distribution appear from fig. 1. Since 1994 a decrease in the annual number of deaths has taken place. Males constituted 83 per cent of the material. The median age increased from 32 to 36 years in the period.

The number of police seizures of heroin, amphetamine and cocaine is seen in fig 2. The heroin seizures have decreased markedly since 1996, while amphetamine and cocaine seizures have increased slightly through the period.

About 66 per cent of the cases lived in Copenhagen, 25 per cent in other cities, 5 per cent in rural districts and finally 5 per cent in other countries.

The main drug of abuse was heroin, in most cases in connection with other drugs and/or alcohol, and in almost all cases taken intravenously.

Figure 1. Yearly number of deaths.

Figure 2. Number of police seizures.

The cause of death appears from fig 3. Poisoning constituted more than 80 per cent of the cases each year, traumatic lesions and diseases about 6 per cent each and "other" about 4 per cent. The number of the poisoning cases has decreased since 1994, while the number with other causes of death has been almost constant in the period.

The drugs of poisoning can be seen in fig. 4. Morphine/heroin was the most frequent drug of poisoning throughout the period, however, with a marked decrease since 1996. The annual number of Methadone poisoning cases as well as the other shown drugs has been almost constant. Among other drugs amphetamine and cocaine were the main drugs of poisoning in a very few cases each year. In the period Ecstasy was not detected.

Figure 3. Cause of death.

Figure 4. Drug of poisoning.

The manner of death appears from fig 5. Accident was the most frequent manner of death constituting about 80 per cent each year. Suicide, accident/ suicide? and natural death accounted for about 5-7 per cent each and finally there was a very few cases of homicide each year.

Figure 5. Manner of death.

Discussion/conclusion

The number of drug deaths in East Denmark has decreased since 1994, mainly due to a decrease in the number of morphine/heroin poisoning cases. The distribution of sex, cause and manner of death was almost the same throughout the period. The median age increased by four years. The main drug of poisoning was morphine/heroin, however, a marked decrease has taken place since 1996. One possible explanation could be a decreased availability of heroin on the illegal market. As regards other drugs of poisoning the annual number has been almost constant. The number and kind of drug deaths indicate the extent of drug abuse, trends in the drug scene and are a parameter of the effectiveness of the control (police and custody) and therapeutic procedures.

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