Heroin-related deaths in New South Wales, Australia, 1992-1996

The coronial files of all heroin-related fatalities that occurred in New So uth Wales (NSW) over the period 1992-1996 were inspected. There were 953 he roin-related fatalities in NSW over the study period. There was a substanti al, statistically significant increase in heroin-related fatalities over th e study period, from 152 deaths in 1992 to 226 during 1996. The mean age of cases was 31.0 years, 85% were male, and 85% were classified as dependent on heroin at the time of death. There was a significant increase in the age of cases over the study period and the proportion of cases that were emplo yed. Fatalities predominantly occurred in home settings (61%). No intervent ion occurred in 79% of cases. Fifty deaths (5%) occurred in the month follo wing release from prison, 16 of which occurred the first 24 hours after rel ease. Morphine concentrations rose from 0.24 mg/l in 1992 to 0.38 mg/l in 1 996. Seventy six percent of cases involved heroin in combination with other drugs: alcohol (46%), benzodiazepines (27%), antidepressants (7%) and coca ine (7%). In only 24% of cases was morphine the sole drug detected. Males w ere significantly more likely to have alcohol detected at autopsy (49 vs. 2 4%), while females were more likely to have benzodiazepines detected (41 vs . 17%). The median blood morphine concentration among cases in which alcoho l was detected was significantly lower than other cases (0.27 vs. 0.39 mg/l ). It is concluded that heroin-related deaths continued to rise throughout the study period, and that deaths were predominantly among older, untreated males. Despite the rise in blood morphine concentrations, polydrug use rem ained the predominant toxicological pattern. (C) 2000 Elsevier Science Irel and Ltd. All rights reserved.