How many people die because of drug overdose in Hungary?
In 2015 25 deaths directly related to drug use were reported to the special register of deaths, which means a return to the number experienced in previous years after the high number of cases in 2013 (2014: 23; 2013:31; 2012: 24; 2011:14, 2010:17 cases).
What are the characteristics of direct overdose cases?
Of the 25 deaths, in 4 cases the deceased was a woman. Among cases of fatal overdose, the mean age of the men was 34 years and of the women it was 29.5 years, and together 33.2 years. Deaths linked to opioids and methadone were characteristic in the age group over 34.8 years. Of the 25 deaths 10 (40%) – including the deaths of three women – happened in Budapest, one deaths took place in county seats or large towns, two in small towns, and six happened in villages. In four cases the deceased was a homeless person, and in two other cases the deceased was a foreign citizen, a citizen of an EU Member State.
Before the appearance of the new psychoactive substances in 2010, direct drug-related deaths were characteristically linked to opioid use and, within this, to heroin use. In parallel with the drastic reduction of the availability of heroin in 2010, the number of deaths linked to this substance also dropped, while at the same time the number of deaths linked to methadone showed a slow rise. In recent years the use of the new psychoactive substances can also be seen in the biological samples of the corpses.
The substance use patterns of the deceased people include injecting substance use and polydrug use, frequently methadone and a benzodiazepine were detected in the biological samples in addition to other illicit drugs, as well as alcohol. There was no death exclusively related to heroin use in 2015. The polydrug use of an opioid and other illicit drugs was fatal in 8 cases. There were ten cases of death caused by other, non-opioid illicit drugs. In five cases amphetamine was found to be present beside other drugs. The use of GHB/GBL was the cause in three drug-related deaths, cocaine was present in one case and in two cases antipsychotics were to be found in the biological samples. New psychoactive substances that are under legal control are classified under the category of ‘non-opiate drugs’, of which the followings were identified: α-PVP, 3-MMC, pentedrone, 4F-PEP, TH-PVP, α-PVT. Three cases fall under the category of ‘other drugs’, that cover new psychoactive substances that were not under legal control at the time of the death, in all the three cases α-PHP could be identified among other substances in the biological samples.
How many indirect death cases were there in Hungary in 2015?
In 2015 40 indirect drug-related death cases were reported to the mortality special register. Among the deceased, 37 were men and 3 were women.
What are the characteristics of indirect death cases?
Two groups of indirect drug-related deaths could be distinguished: health deterioration caused by long-term drug use is in the background of natural death cases. In 2015 9 deaths could be traced back to a natural cause related to previous drug use. The cause of death was most frequently of cardiologic nature (myocardial degeneration).
The other group is formed by deaths by violence, where tests performed on biological samples confirmed the use of drugs before death. An illicit drug was found in the biological samples of 11 suicides. Violent death occurred in 20 cases (murder, accident or self-harm where intent could not be determined).
What characterizes the trend of mortality among the EU member states?
Drug use is a recognised cause of avoidable mortality among European adults. In Europe, drug overdose continues to be the main cause of death among drug users, and over three-quarters of overdose victims are male (78 %). Most EU countries reported an increasing trend in overdose deaths from 2003 until around 2008/09, when overall levels first began to decline. For 2014, it is estimated that at least 6 800 overdose deaths occurred in the European Union. This represents an increase from the revised 2013 figure and, as in previous years, the United Kingdom (36 %) and Germany (15 %) together account for a large part of the total.
Reflecting the ageing nature of Europe’s opioid-using population, who are at greatest risk of drug overdose death, the reported number of overdose deaths increased among older age groups between 2006 and 2014, while those among younger age groups decreased. However, there has recently been a slight increase in the number of overdose deaths reported among those aged under 25 in some countries.
How do we estimate drug related death?
The number is drug related deaths is estimated on the basis of two registers in most countries. One is the General Mortality Register, run by the national statistical offices. The other one is the Special Register that is a forensic or police register in most cases.
In 2009 there was a significance change in the data collection relating to drug-related death. Instead of the earlier OSAP data collection containing exclusively aggregate data, the information relating to death cases occurring in 2009 derive from the mortality module of the reporting system of the National Centre for Addictions (OAC) relating to illicit drug use. The module’s datasheet contains detailed information for example on the deceased persons’ circumstances of death, known history and toxicology results.
In the interest of the comprehensive analysis of the deceased persons the National Institute of Forensic Medicine discussed with ISZKI National Institute for Forensic Toxicology drug-positive toxicology results. The National Institute of Forensic Medicine requested information relating to positive cases from the responsible institutes, taking into consideration the rules of data protection, i.e. anonymously, using generated codes. The institutes in charge could not always enter drug-positive cases in the system (in the lack of human or material resources), these cases were entered by the National Institute of Forensic Medicine.
Due to the new data collection system a case-based database is available on drug-related death cases, which database, with the help of a generated code, can be connected with treatment data. This year, for the first time we also have detailed information on indirect cases of death as well, which we can be analysed broken down into further categories (death by nature or by violence).