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An Overview of Drug Related Deaths in Scotland

An Overview of Drug Related Deaths in Scotland. Andy Rome Director Figure 8 Consultancy Services Ltd. Overview - Knowledge and Action. What do we know? What do we not know? What are we doing? What could we be doing?. Knowledge.

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An Overview of Drug Related Deaths in Scotland

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  1. An Overview of Drug Related Deaths in Scotland Andy Rome Director Figure 8 Consultancy Services Ltd

  2. Overview - Knowledge and Action • What do we know? • What do we not know? • What are we doing? • What could we be doing? Figure 8 Consultancy Services Ltd

  3. Knowledge • 51,582 problem drug users in Scotland in 2003 (Hay et al 2004) • 317 people died in 2003 of a drug related death • 51,265 problem drug users did not die of a drug related death in 2003 (99.4%) Figure 8 Consultancy Services Ltd

  4. Number of drug related deaths in Scotland 1996-2003 Figure 8 Consultancy Services Ltd

  5. Knowledge • Why did 317 people die? • Why did 51,265 not die? • Why did 317 people die that day? Figure 8 Consultancy Services Ltd

  6. What is a Drug Related Death? • “The definition of a drug related death is not straightforward” (GROS 2003) • ACMD working group “To reach agreement on consistent coding framework to be used in England, Wales, Scotland and Northern Ireland.” Figure 8 Consultancy Services Ltd

  7. Classifications of DRDs • Mental and behavioural disorders due to psychoactive substance use (F11-F19) • Accidental poisoning (X40-X44) • Intentional self-poisoning (X60-X64) • Assault by drugs, medicaments and biological substances (X85) • Event of undetermined intent (Y10-Y14) Figure 8 Consultancy Services Ltd

  8. What is not a Drug Related Death? • Deaths coded to mental and behavioural disorders due to the use of alcohol (F10) tobacco (F17) and volatile substances (F18) • Deaths coded to drug abuse which were caused by secondary infections and related complications (e.g. clostridium novyi) • Deaths from AIDS where the risk factor was believed to be the sharing of needles Figure 8 Consultancy Services Ltd

  9. What is not a Drug Related Death? • Deaths from road traffic or other accidents which occurred under the influence of drugs • Deaths where a drug listed under the Misuse of Drugs Act was present because it was part of a compound analgesic or cold remedy. (GROS, 2003) Figure 8 Consultancy Services Ltd

  10. Deaths by category 1996-2003 (GROS, 2003) Figure 8 Consultancy Services Ltd

  11. Research - International Australia • D. Zador 23 articles (at least!) • Zador DA, Sunjic SD (2002) • Darke S, Zador D. (1996) Fatal heroin ‘overdose’: A review • Coleridge J. et al (1992) Figure 8 Consultancy Services Ltd

  12. Research - International • Europe • Davids E, et al (2003)1 • Davids E, et al (2003)2 • Kraus L, Muller-Kalthoff T. (2002) • Risser D, et al (2001) • Risser D, et al (1996) • Marx A, et al (1994) Figure 8 Consultancy Services Ltd

  13. Research - UK • Shah R, et al (2001) • Webb L, et al (2003) • Hickman M, et al (2003) • Ghodse H, et al (1998) Figure 8 Consultancy Services Ltd

  14. Research - Scotland • Stenhouse G, Grieve JH (2003) • Bird SM, et al (2003) • Seymour A, et al (2000) • Seymour A, et al (2001)1 • Seymour A, et al (2001)2 • Seymour A, et al (2003) Figure 8 Consultancy Services Ltd

  15. Knowledge - Monitoring • Good national monitoring systems • Good analysis of data • By drug • By Age/Gender • Classification • Locality • Good prevalence data Figure 8 Consultancy Services Ltd

  16. Action • Strategies to fill knowledge gaps • Strategies to prevent deaths Figure 8 Consultancy Services Ltd

  17. Strategies to fill knowledge gaps National • National Investigation into Drug Related Deaths in Scotland, 2003 • STRADA training programme Local • DAAT sub-groups Figure 8 Consultancy Services Ltd

  18. Aims of National Investigation • To collect and analyse information relating to the clinical and social circumstances surrounding all drug-related deaths in Scotland for the period January – December 2003. • To identify patterns in social and clinical circumstances surrounding the deaths, and the associations between them. • To make recommendations for policy and practice which may lead to a future reduction in drug-related deaths. Figure 8 Consultancy Services Ltd

  19. Aims of National Investigation • A comparison of the service utilisation and other characteristics of a group of living injectors in Glasgow with a comparable sample of deceased cases also resident in Glasgow prior to death. • Extended interviews with a sub-sample of living injectors who had survived an overdose in the 6 months prior to interview to obtain more information about survivors’ beliefs, experience and knowledge of overdose. • A comparison of the characteristics of Scottish drug related deaths with a sample of London drug deaths for the same year (2003). Figure 8 Consultancy Services Ltd

  20. Local strategic planning Figure 8 Consultancy Services Ltd

  21. Causes of death by Health Board Figure 8 Consultancy Services Ltd

  22. Strategies to prevent deaths • National framework • Realistic, meaningful goals • Local implementation plans sensitive to local needs Figure 8 Consultancy Services Ltd

  23. Sources of information • Drug-related deaths in Scotland in 2003 www.gro-scotland.gov.uk • Estimating the National and Local Prevalence of Problematic Drug Misuse in Scotland, 2003 www.drugmisuse.isdscotland.org • All research articles www.ncbi.nlm.nih.gov Figure 8 Consultancy Services Ltd

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