Rate of drug-induced deaths on the rise, new report finds

There were almost 1800 drug-induced deaths among Australians in 2017, according to a new report by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney.

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There were almost 1800 drug-induced deaths among Australians in 2017, according to preliminary estimates released in a new report by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney.

There were 1,795 drug-induced deaths among Australians in 2017, according to preliminary estimates released in a new report by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney.

Analyses showed that most of these deaths were accidental. Opioids were the main drug cited in drug-induced deaths occurring in Australians in 2017 (1,171 deaths), with most of these deaths attributed to pharmaceutical opioids. The rate of deaths involving opioids has increased over the past decade. There have also been increasing rates of drug-induced deaths involving other medicines.

In 2017, there were 824 drug-induced deaths among Australians that involved benzodiazepines (e.g., diazepam), which are often prescribed for anxiety and sleep disorders, and 340 deaths that involved antipsychotics (e.g., quetiapine), which are typically prescribed for schizophrenia and bipolar disorder.

There were also increases in deaths involving pregabalin, a medicine with analgesic and anticonvulsant effects prescribed for certain pain conditions. Prior to 2015, less than 20 drug-induced deaths involving pregabalin were reported among Australians. This increased to 72 deaths in 2016 and 100 deaths in 2017. Most of these deaths were attributed to opioids, with pregabalin considered contributory to death.

Dr Amy Peacock, Program Lead for Drug Trends at NDARC, said that many of the deaths caused by opioids also involved other sedative medicines, such as benzodiazepines, antipsychotics and pregabalin. In 2017, pregabalin was the sixth most prescribed subsidised medicine in Australia.

“Increased prescribing of these medicines, as well as improved routine testing for substances such as pregabalin in drug-induced deaths, must be considered when studying trends involving these substances,” Dr Peacock said. “Drug-induced deaths are preventable. We know about the risks of mixing opioids with other drugs, including other sedative medicines such as pregabalin, benzodiazepines, and antipsychotics. We also have good evidence to support a range of strategies that can reduce risk of loss of life from drugs. Key amongst these is ensuring affordable, accessible treatment for all Australians who are experiencing problems as a consequence of drug use.

“We also need to ensure that people who are at risk of overdose – and their friends and families – have access to naloxone, a drug available over-the-counter in pharmacies that can be used to reverse opioid overdose.”

Melanie Walker, CEO of the Australian Injecting and Illicit Drug Users League (AIVL), echoed this call, stating that “It is very concerning to see a continuing trend of drug-related deaths involving opioids and other sedatives in Australia. We need to be proactive in implementing practical strategies to save lives and help people to protect themselves. This includes focusing on strategies that we know work, including expanding access to treatment and to naloxone.”

The report, Trends in Drug-Induced Deaths in Australia, 1997-2017, includes estimates of drug-induced deaths in Australia from 1997 to 2017; estimates for 2016 and 2017 are not final.

Key findings include:

• Preliminary estimates indicate that there were 1,795 drug-induced deaths among Australians in 2017 (1,591 drug-induced deaths among Australians aged 15-64 years). The number of drug-induced deaths in 2017 is similar to the peak in deaths observed in the late 1990s.

• The rate of drug-induced deaths has been increasing but has not reached the rate observed in 1999 (13.2 versus 9.8 deaths per 100,000 people aged 15-64 in 1999 versus 2017, respectively).

• Consistent with previous years, most drug-induced deaths (72%) in 2017 among Australians aged 15-64 years were considered accidental; one in five (20%) were intentional (68% and 25% for Australians all ages, respectively).

• Higher rates of drug-induced deaths were observed among males than females in 2017 (13.0 versus 6.7 deaths per 100,000 people aged 15-64; 9.4 versus 5.2 deaths per 100,000 all ages), consistent with previous years.

• There has been a shift over time to higher rates of drug-induced deaths in older age groups among both males and females. In 2017, the highest rate of drug-induced deaths among females occurred among the 45-54 age group (10.5 deaths per 100,000 people) and among males in the 35-44 age group (20.9 deaths per 100,000 people).

• Opioids are the main drug cited in drug-induced deaths occurring in Australians aged 15-64 (1,084 deaths, 6.7 deaths per 100,000 people; 1,171 deaths all-ages).

• There are increasing rates of deaths involving other drugs in recent years. In particular, increasing drug-induced deaths involving psychotropic medicines (e.g., benzodiazepines, antipsychotics) and non-opioid medicines used for treatment of certain pain conditions (e.g., pregabalin) are of concern.

• Natural and semi-synthetic opioids (e.g., morphine, oxycodone) have been the most commonly cited opioids in drug-induced deaths throughout monitoring. There have been particular increases in deaths involving heroin and synthetic opioids (e.g., fentanyl) over the past decade.

• Deaths attributed to amphetamine (e.g., methamphetamine, MDMA) have increased since 2010 (93 deaths, 0.6 deaths per 100,000 people aged 15-64 in 2017; 94 deaths all-ages).

This work was supported by funding from the Australian Government under the Drug and Alcohol Program.