NDARC Technical Report No. 54 (1997)
EXECUTIVE SUMMARY
This report analysed data on opioid overdose mortality between 1988 and 1996 in order to: 1) examine differences between the States and Territories of Australia in the rate of fatal opioid overdose, the rate of increase in fatal overdose and the average age at death from opioid overdose and; 2) estimate the proportion of all deaths over that period which were attributed to opioid overdose.
Data were obtained from the Australian Bureau of Statistics (ABS) on the number of deaths attributed to opioid dependence (ICD 9 codes 304.0, 304.7) and accidental opioid poisoning (ICD 9 codes E850.0, E850.1) for the years 1988 to 1996. Further data was obtained from the ABS on the total number of deaths, the number attributed to suicide, and the age at death. To calculate age and sex-specific mortality rates, data were also obtained on the numbers of men and women of each age between birth and 85 who were resident in each state, and in the whole of Australia, at June 30 of each year between 1988 and 1996.
Between 1995 and 1996 there was a small decrease in the number of opioid overdose fatalities: this decrease could be largely attributed to a drop in the number and rate of female overdose from 110 in 1995 (27.9 per million population) to 86 (20.7 per million population) in 1996. By comparison the rate of male opioid overdose remained stable: In both years there was a total of 440 opioid overdose deaths among males.
The highest rate of fatal overdose occurred in New South Wales, Victoria had the second highest rate and the standardised mortality rate among the remaining States and Territories fluctuated quite markedly. Despite these differences in rates of mortality, all States showed an increase in the rate of overdose mortality between 1988 and 1996. Further analyses suggested that, while the rate of opioid overdose has increased throughout Australia, the rate of increase has been greater in some of the smaller States and Territories than it has in New South Wales or Victoria.
In 1996 approximately 6.5% of all deaths among people aged 15-24 years were due to opioid overdose and approximately 10% of all deaths among those aged 25-34 were attributed to this cause. During the interval from 1988 to 1996 the proportion of deaths attributed to opioid overdose increased. Among individuals aged 25-34 years, the proportion of deaths attributed to opioid overdose was approximately half that attributed to suicide. The rate of increase in the proportion of deaths attributed to opioid overdose was higher than the rate of increase in the proportion of deaths attributed to suicide.
Potential strategies for reducing mortality associated with opioid overdose include: 1) Increasing access to and utilisation of methadone maintenance and other treatment; 2) Educating injecting drug users about the dangers of polydrug use; 3) Encouraging injecting drug users not to inject alone; 4) Encouraging witnesses of opioid overdose to seek medical assistance and; 5) Trialing distribution of naloxone to high risk injectors.