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Pharmacopsychiatry 2006; 39(5): 185-191
DOI: 10.1055/s-2006-949149
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Review of Deaths Related to Analgesic- and Cough Suppressant-opioids; England and Wales 1996-2002

F. Schifano 1 , G. Zamparutti 2 , F. Zambello 3 , A. Oyefeso 1 , P. Deluca 1 , M. Balestrieri 2 , D. Little 4 , A. H. Ghodse 1
  • 1National Programme on Substance Abuse Deaths, Division of Mental Health, Addictive Behaviour, St George's, University of London, London, UK
  • 2University of Udine School of Medicine, Department of Psychiatry, Udine, Italy
  • 3University of Verona School of Medicine, Department of Psychiatry, Verona, Italy
  • 4University of Udine School of Medicine, Institute of Hygiene and Epidemiology, Udine, Italy
Further Information

Publication History

Received 30.1.2006 Revised 18.5.2006

Accepted 6.6.2006

Publication Date:
30 August 2006 (online)

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Objective: The data on England and Wales voluntarily supplied by Coroners to the National Programme on Substance Abuse Deaths for the August 1996-December 2002 time frame were analyzed. Methods: All cases in which at least one analgesic- and cough suppressant-opioid other than heroin/morphine, methadone or buprenorphine was identified were extracted from the database. We hypothesized that: a) populations of addicts and non-addicts presented differences in patterns of drugs involved; and b) within the population of addicts and non-addicts, intentional and non-intentional deaths presented different patterns of substance consumption. Results: A total of 2024 deaths related to selected opioids, either alone or in combination, were included in the analysis. Typically, non-addicts were older than 45 and died as a result of intentional poisoning whilst majority of addicts were young, males and victims of accidental deaths. In about 93% of cases the selected opioids were reported in combination with another substance. Most frequently identified narcotics were propoxyphene, codeine and dihydrocodeine. Co-proxamol, Co-codamol and Co-dydramol were typically prescribed for non-addicts, whilst dihydrocodeine was mostly given to addicts. In non-addicts, alcohol was mostly represented in accidental deaths and antidepressants were typically represented in intentional deaths. Conversely, illicit drugs and hypnotics/sedatives were typically reported in addicts' accidental deaths. Conclusions: The present report constitutes the largest available collection of analgesic- and cough suppressant-opioid mortality data in the UK. Users should be educated about risks associated with polydrug misuse.

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1 Conflict of interest
None declared

2 Individual contributions
FS wrote the manuscript and coordinated the study. GZ and FZ collected the data. PD and DL carried out the statistical analysis. All Authors participated in interpreting the results. FS is guarantor. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication

Correspondence

Prof. Dr. Fabrizio Schifano

Academic Consultant Psychiatrist·Division of Mental Health·Addictive Behaviour·St George's·University of London

Cranmer Terrace·London, SW17 0RE·UK

Phone: +44/20/87 25 57 18

Fax: +44/20/87 25 29 14

Email: fschifan@sgul.ac.uk