Shane Darke1, Sharlene Kaye1,2, Johan Duflou1,3. 1. National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia. 2. Justice Health and Forensic Mental Health Network, NSW Health, NSW, Australia. 3. Sydney Medical School, University of Sydney, NSW, Australia.
Abstract
AIMS: To (1) assess trends in the number and mortality rates of methamphetamine-related death in Australia, 2009-15; (2) assess the characteristics and the cause, manner and circumstances of death; and (3) assess the blood methamphetamine concentrations and the presence of other drugs in methamphetamine-related death. DESIGN: Analysis of cases of methamphetamine-related death retrieved from the National Coronial Information System (NCIS). SETTING: Australia. CASES: All cases in which methamphetamine was coded in the NCIS database as a mechanism contributing to death (n = 1649). MEASUREMENTS: Information was collected on cause and manner of death, demographics, location, circumstances of death and toxicology. FINDINGS: The mean age of cases was 36.9 years, and 78.4% were male. The crude mortality rate was 1.03 per 100 000. The rate increased significantly over time (P < 0.001), and at 2015 the mortality rate was 1.8 [confidence interval (CI) = 1.2-2.4] times that of 2009. Deaths were due to accidental drug toxicity (43.2%), natural disease (22.3%), suicide (18.2%), other accident (14.9%) and homicide (1.5%). In 40.8% of cases, death occurred outside the major capital cities. The median blood methamphetamine concentration was 0.17 mg/l, and cases in which only methamphetamine was detected had higher concentrations than other cases (0.30 versus 0.15 mg/l, P < 0.001). The median blood methamphetamine concentration varied within a narrow range (0.15-0.20 mg/l) across manner of death. In the majority (82.8%) of cases, substances other than methamphetamine were detected, most frequently opioids (43.1%) and hypnosedatives (38.0%). CONCLUSIONS: Methamphetamine death rates doubled in Australia from 2009 to 2015. While toxicity was the most frequent cause, natural disease, suicide and accident comprised more than half of deaths.
AIMS: To (1) assess trends in the number and mortality rates of methamphetamine-related death in Australia, 2009-15; (2) assess the characteristics and the cause, manner and circumstances of death; and (3) assess the blood methamphetamine concentrations and the presence of other drugs in methamphetamine-related death. DESIGN: Analysis of cases of methamphetamine-related death retrieved from the National Coronial Information System (NCIS). SETTING: Australia. CASES: All cases in which methamphetamine was coded in the NCIS database as a mechanism contributing to death (n = 1649). MEASUREMENTS: Information was collected on cause and manner of death, demographics, location, circumstances of death and toxicology. FINDINGS: The mean age of cases was 36.9 years, and 78.4% were male. The crude mortality rate was 1.03 per 100 000. The rate increased significantly over time (P < 0.001), and at 2015 the mortality rate was 1.8 [confidence interval (CI) = 1.2-2.4] times that of 2009. Deaths were due to accidental drug toxicity (43.2%), natural disease (22.3%), suicide (18.2%), other accident (14.9%) and homicide (1.5%). In 40.8% of cases, death occurred outside the major capital cities. The median blood methamphetamine concentration was 0.17 mg/l, and cases in which only methamphetamine was detected had higher concentrations than other cases (0.30 versus 0.15 mg/l, P < 0.001). The median blood methamphetamine concentration varied within a narrow range (0.15-0.20 mg/l) across manner of death. In the majority (82.8%) of cases, substances other than methamphetamine were detected, most frequently opioids (43.1%) and hypnosedatives (38.0%). CONCLUSIONS:Methamphetaminedeath rates doubled in Australia from 2009 to 2015. While toxicity was the most frequent cause, natural disease, suicide and accident comprised more than half of deaths.
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