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Monitoring drug related overdose and mortality in Europe

Monitoring drug related overdose and mortality in Europe. Dr. Eva Keller. Importance of Mortality. Mortality directly or indirectly related to drug use is one of the main cause of death among young people in Europe Yearly approximatelly 7-9000 death occours in connection with drug use.

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Monitoring drug related overdose and mortality in Europe

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  1. Monitoring drug related overdose and mortality in Europe Dr. Eva Keller

  2. Importance of Mortality • Mortality directly or indirectly related to drug use is one of the main cause of death among young people in Europe • Yearly approximatelly 7-9000 death occours in connection with drug use

  3. DRD and Mortality indicator • Core component • Population statistics • DRD indicator • Characteristics of people who die directly due to use illicit drugs • GMR, SR

  4. Second component • Estimation of overall and cause-specific mortality based on mortality cohort studies in connection with treatment centers • Death indirectly related mortality (Infectious diseases, accidents, suicide etc.)

  5. Problems • Typology of death • Methodological challenges • Death certificate • Difference in investigation of death • Weather further statistics based on death investigation result or not.

  6. EMCDDA definition of DRD “those deaths that are caused directly by the consumption of drugs of abuse. These deaths occur shortly after the consumption of the substance(s)” “In addition to deaths directly related to the use of drugs, also deaths indirectly related to drug use (AIDS, accidents, suicides, violence…) should also be taken in account”

  7. Factors influencing DRD • Law –legal system • Determination of cause of death • Scene investigation • Autopsy • Data collection system • Toxicology in ER, hospitals • Coding

  8. Factors influencing DRD • Law –legal system • Anglosax • Continental • Coroner-medical examiner-forensic expert-police

  9. Factors influencing DRD • Determination of cause of death • Examination of the dead body to determine the nature of death • Physician, GP • Ambulance doctor • Medical examiner

  10. Factors influencing DRD • Scene investigation • Data collection • Surroundings • Shame in the family

  11. Factors influencing DRD • Autopsy • To be or not to be • Money • International autopsy protocoll • Toxicology

  12. Autopsy rate versus number of poisoning

  13. Autopsy rate versus number of poisoning

  14. Mortality due to drug-induced deaths among all adults (15 to 64 years) in European countries EMCDDA

  15. Drug related death in Hungary and in Budapest 1996-2008 80% 79% 94% 96% 92% 38% 38% 89% 61% 25% 118% 34%

  16. DRD in Budapest

  17. Drug types in accidental OD cases

  18. Pure heroin cc and DRD

  19. Age distribution

  20. Trends in mean age of drug-induced deaths in some of the EU-15 Member States, 1990 to 2006 EMCDDA EMCDDA

  21. Infectious diseases 99% 64% 93% 95% 1% 36% 7% 5%

  22. EMCDDA

  23. Data collection system • National statistic office/GMR • Forensic Institute/SR • National focal points/SR

  24. Toxicology in ER, hospitals • Direct – Indirect cause of death • Synthetic drugs and cocaine • Importance of toxicology • Live • Death

  25. Coding • ICD-9-ICD-10 • Automatic coding versus manual • Coding before toxicology

  26. Summery-conclusion • To improve understanding drug related death and mortality • To develope and improve policies and intervention • To provide information on health issues to health authorities and policy makers

  27. Thank you for your attention! Eva Keller M.D. PhD Semmelweis University Department of Forensic & Insurance Medicine Budapest, Hungary keller_e@yahoo.com

  28. Mean age of drug-induced deaths in EU Member States, last year with available data EMCDDA

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