Non-Fatal and fatal drugpoisoning with illicit drugs and methadone in Denmark

March 2011Henrik Saelan

0

100

200

300

400

500

600

700

800

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Num

ber

Poisonings admitted to emergency rooms in Denmark, 1999-2009.

Note: Change in classification from 2004.

Opioids

Stimulants

Hallucinogenes

Mixtures&Unspec

Substance name CodeOther synthetic opioid T40.4Other and unspecified opioids T40.6Opioids without specification T40.6WOther and unspecified hallucinogen T40.9

Acute intoxication due to multiple drugs and use of other psycjhoactive substances F19.0

Types of drugs and codes in the mixt and unspecified group

0

50

100

150

200

250

300

350

400

450

500

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Num

ber

Stimulant poisonings admitted to emergency rooms in Denmark, 1999-2009.

Note: Change in classification from 2004.

Designer drug

Ecstasy

Amfetamin

Cocain

Other stimulant

Total

0

100

200

300

400

500

600

700

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Num

ber

Opioid poisonings admitted to emergency rooms in Denmark, 1999-2009.

Note: Change in calssification from 2004.

Heroin

Other opioid (+morfin + codein)

Metadon

Opioids (acute poisoning as disease)

Total

0

100

200

300

400

500

600

700

800

900

1000

2005 2006 2007 2008 2009

Num

ber

Age and number of persons attending emergency rooms for drug poisoningin Denmark, 2005-2009.

<20-29 years

>= 30 years

Now we move to the dead, drug related death- and poisonings among them

0

50

100

150

200

250

300

1970

1971

1972

1973

1974

1975

1976

1977

1978

1979

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Num

ber o

f dea

ths

DRD´s in Demark

DRD

0

50

100

150

200

250

1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Num

ber o

f DRD

´s

DRD in Copenhagen and other Denmark

Cph, l iving

Other Denmark

AgeHeroine/Morphine Benzo. Methadone Cannabis Ampheta. Cocaine No. of drugs

15-19 1 3 4 2 2 1 4

20-24 11 12 5 3 5 3 3,4

25-29 14 18 12 7 6 4 3

>= 30 72 108 101 49 14 25 3

2009 % 48 68 59 30 13 16

2007 % 40 55 61 26 10 15

Age Alcohol Ecstasy Ketobemi-done Other No.of drugs

15-19 0 0 0 3 4

20-24 2 0 2 13 3,4

25-29 8 0 0 16 3

>= 30 55 1 6 105 3

2009 % 32 1 4 67

2007 % 34 2 5 80

Drugs found in 206 DRD poisonings in 2009, mean number of drugs, and per cent in 2009 and 2007

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10

20

30

40

50

60

70

80

1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Num

ber o

f dea

ths

DRD´s, poisonings and methadone deaths in Copenhagen

Total

Pois.

Meth+

0

50

100

150

200

250

2003 2004 2005 2006 2007 2008 2009

Num

ber o

f dea

ths

DRD´s, poisonings and methadone deaths in Other Denmark

Tatal

Pois.

Metha+

0

10

20

30

40

50

60

70

80

90

100

2003 2004 2005 2006 2007 2008 2009

Per c

ent

Per cent poisoning and Methadone deaths, Copenhagen (C ) and Other Denmark (D)

C % Pois.

C % Metha+

D % Pois.

D % Metha+

0

20

40

60

80

100

120

140

160

180

200

2003 2004 2005 2006 2007 2008 2009

Num

ber

DRD poisonings by age, 2003-2009

< 30 years

>= 30 years

0

50

100

150

200

250

2007 2009

Med

ian

dose

Lowest and highest median Methadone dose in treatment institutions in Copenhagen, 2007 and 2009

Treatment1

Treatment 2

Conclusions 1

• Stimulants, drug mixtures and opioids are dominating findings among intoxivated in the emergency rooms

• The number of Methadone intoxications is slowly rising, but not very high at the moment

• In the old epidemic of Copenhagen, the total number of DRD´s is slowly going down, but at the same time the proportion of methadone poisonings is substantially rising

Conclusion 2

• We do not really know the optimal trade off point of methadone doses in treatment when comparing retention in treatment to mortality.

• Is there a kohort effect due to old methadone users?

Thank you for your attention!