non-fatal and fatal drugpoisoning with illicit drugs and methadone in denmark
DESCRIPTION
Non-Fatal and fatal drugpoisoning with illicit drugs and methadone in Denmark. March 2011 Henrik Saelan. Types of drugs and codes in the mixt and unspecified group. Now we move to the dead, drug related death - and poisonings among them. - PowerPoint PPT PresentationTRANSCRIPT
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
0
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!