Trends and characteristics of accidental and intentional codeine overdose deaths in Australia

Amanda Roxburgh, Wayne Dallas Hall, Lucinda Burns, Jennifer Lucinda Pilgrim, Eva Saar, Suzanne Nielsen, Louisa Degenhardt

Research output: Contribution to journalArticleResearchpeer-review

40 Citations (Scopus)

Abstract

OBJECTIVES: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths.

DESIGN AND SETTING: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013.

MAIN OUTCOME MEASURES: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator).

RESULTS: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity.

CONCLUSIONS: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.

Original languageEnglish
Pages (from-to)299.e1-299.e7
Number of pages7
JournalMedical Journal of Australia
Volume203
Issue number7
DOIs
Publication statusPublished - 5 Oct 2015

Cite this

Roxburgh, Amanda ; Hall, Wayne Dallas ; Burns, Lucinda ; Pilgrim, Jennifer Lucinda ; Saar, Eva ; Nielsen, Suzanne ; Degenhardt, Louisa. / Trends and characteristics of accidental and intentional codeine overdose deaths in Australia. In: Medical Journal of Australia. 2015 ; Vol. 203, No. 7. pp. 299.e1-299.e7.
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abstract = "OBJECTIVES: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths.DESIGN AND SETTING: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013.MAIN OUTCOME MEASURES: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator).RESULTS: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8{\%}) than intentional deaths (34.7{\%}), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6{\%}), substance use (36.1{\%}) and chronic pain (35.8{\%}) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7{\%}) were the result of multiple drug toxicity.CONCLUSIONS: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.",
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Trends and characteristics of accidental and intentional codeine overdose deaths in Australia. / Roxburgh, Amanda; Hall, Wayne Dallas; Burns, Lucinda; Pilgrim, Jennifer Lucinda; Saar, Eva; Nielsen, Suzanne; Degenhardt, Louisa.

In: Medical Journal of Australia, Vol. 203, No. 7, 05.10.2015, p. 299.e1-299.e7.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - OBJECTIVES: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths.DESIGN AND SETTING: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013.MAIN OUTCOME MEASURES: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator).RESULTS: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity.CONCLUSIONS: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.

AB - OBJECTIVES: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths.DESIGN AND SETTING: Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013.MAIN OUTCOME MEASURES: Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional); and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator).RESULTS: The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity.CONCLUSIONS: Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.

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