Alcohol and Drugs |
Dying for heroin: the increasing opioid-related mortality in the Republic of Ireland, 1980–1999
Michael J.A. Kelleher, Patrick J. Keown, Colin O'Gara, Francis Keaney, Michael Farrell and John Strang** National Addiction Centre and Maudsley Hospital, Institute of Psychiatry, London, UK
Correspondence: Michael J.A. Kelleher, MRCPsych, National Addiction Centre and Maudsley Hospital, Institute of Psychiatry, 4 Windsor Walk, Denmark Hill, London SE5 8AF, UK, tel: +44 207 740 5701, fax: +44 207 740 5765, e-mail: mike.kelleher{at}slam.nhs.uk
Background: Over the past 20 years there has been a steady rise in mortality associated with opioid misuse in several Western countries. We aimed to examine trends in opioid-related mortality over a 20-year period in the Republic of Ireland. Methods: Retrospective analysis of deaths attributed to ICD-9 codes 304.0 (morphine-type dependence) and E850.0 (accidental poisoning by opiates and related narcotics) in the Republic of Ireland between 1980 and 1999. Results: The Republic of Ireland has seen a rapid increase in the number of opioid-related deaths over the 20-year period studied, from 0.01% of total deaths in 1980 to 0.15% in 1999. This is most marked in the younger age groups where, for example, it rose to 23% of 15–19 year old male deaths for 1997. The opioid-related mortality rate in the 15–44 years age range increased by nearly 14 times between 1980–1984 and 1995–1999. Over the whole period, 87% of opioid-related deaths were amongst males. Outside Dublin there has been a considerable increase in opioid-related mortality, nearly doubling the percentage of the total from 6% in the 1980s to 11% in the 1990s. Conclusions: Opioid-related mortality is an increasing problem in the Republic of Ireland, as in other Western countries. Today, young people have a very low mortality rate, and hence this rapid increase may need specific targeted interventions. The spread of opioid-related mortality outside Dublin to rural and other urban areas will have implications for service planning and provision.
Keywords: drug dependence, heroin, Ireland, mortality, opiates, opioids
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  J. Strang, M. Kelleher, D. Best, S. Mayet, and V. Manning Emergency naloxone for heroin overdose BMJ, September 23, 2006; 333(7569): 614 - 615. [Full Text] [PDF]
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