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Factors associated with fatal overdoses in Oslo 2006-2008. Linn Gjersing, Thomas Clausen, Jørgen Bramness, Helge Waal, Stian Biong & Edle Ravndal. Definitions. Drug-induced deaths
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Factorsassociatedwith fatal overdoses in Oslo2006-2008 Linn Gjersing, Thomas Clausen, Jørgen Bramness, Helge Waal, Stian Biong & Edle Ravndal
Definitions • Drug-induced deaths • Deaths directly due to use of illegal substances, although these often occur in combination with other substances such as alcohol or psychoactive medicines. These deaths occur generally shortly after the consumption of the substance • Overdoses or poisonings (EMCDDA 2009) Universitetet i Oslo
Background Universitetet i Oslo EMCDDA 2009 s 84
Background • City council of Oslo • March 2009 • Investigate all overdoses in Oslo and identify possible causes • Norwegian Centre for Addiction Research (Seraf) • November 2009 • To identify all drug-induced deaths in Norway 2006-2008 • To assess the drug-induced deaths in Oslo • Assess toxicology • Place of death (street, low threshold housing facilities, hospitals) • Possible causes • Role of primary and secondary health care services Universitetet i Oslo
Methods • Epidemiologicalstudy • Cross-linked • Qualitative research study Universitetet i Oslo
Cases • Overdoses • European Monitoring Centre for Drugs and Drug Addiction’s (EMCDDA) definition • T42.4 benzodiazepines • Alcohol • F100 Acuteintoxication • X45 Accidentalpoisoning • X65 Intentionalpoisoning • < 70 år Universitetet i Oslo
*T43.6 Psychostimulantswithabusepotential ** T40.0-.9 Narcotics and psychodysleptics Universitetet i Oslo
Identification of cases • General Mortality Registry • Cause of death • Contributing cause of death • Age • Date of death • Residency according to Directory of Residents • Region of death • Place (hospital, home, street etc) Universitetet i Oslo
Registries • The Incarceration Registry • 2/3 time, end of time, date of release • Registry for Drug-related Deaths • Toxicology reports • The Drug Prescription Registry • The Norwegian institute of Public Health • Prescribed medications previous 12 months before death Universitetet i Oslo
Patientrecords • Hospitals • Community health care services • Outpatient emergency clinics • Low threshold facilities • Housing, street clinics • Outreach services • Social welfare offices • Treatment centres • Detoxification units • Salvation army, Bymisjonen, P22, Fredheim, Tyrilistiftelsen Universitetet i Oslo
Preliminary resultsDeaths in Oslo Universitetet i Oslo
Age of death Universitetet i Oslo
Place of death Universitetet i Oslo
Type of deaths Universitetet i Oslo
Release from prison Universitetet i Oslo
Age and death after prison release Universitetet i Oslo
Preliminary conclusions • 70% Oslo residents • 20% women • Women older than men • Most deaths accidental • First month after prison release critical • Majority of those that die after prison release were between 26 and 36 yrs Universitetet i Oslo