The role of dihydrocodeine in causing death among drug users in the west of Scotland

There has been a wealth of information relating to the role of methadone in fatalities over the past decade. However, a dearth exists in the literatur e of deaths involving dihydrocodeine, a substitute that is being increasing ly prescribed by general practitioners for drug harm reduction purposes. Ov er the past five years in the Strathclyde region of Scotland there has been an increase in the number of drug related deaths involving dihydrocodeine with the largest increase occurring in the latter two years. This in combin ation with a general acceptance for this drug as a substitute for methadone amongst general practitioners highlights its potential abuse factor which is addressed in this paper As the number of methadone deaths in relation to the total number of accidental drug related deaths per annum decrease, tho se related to dihydrocodeine are shown to be increasing.