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Journal Article

Citation

Fugelstad A, Bremberg S, Hjelmström P, Thiblin I. Addiction 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/add.15152

PMID

32533568

Abstract

AIMS: To identify methadone-related deaths and determine the prevalence among youth and young adults in Sweden 2006-2015.

DESIGN, SETTING AND PARTICIPANTS: National retrospective registry study comparing data from all forensic autopsy examinations and toxicology cases involving methadone during 2006-2015 in individuals aged 15-29 years with police records, previous pharmaceutical prescriptions and health care episodes.

MEASUREMENTS: Multinomial logistic regression. To assess the contributing factors to the deaths, we compared individuals with and without previous substance use treatment and opioid use related diagnose with regards to previous opioid agonist treatment (OAT), psychiatric care and previous pain medication. To assess the circumstances of deaths, we analyzed presence of other drugs and other factors at time of death.

FINDINGS: We identified 269 methadone-related deaths, and the rate increased during the study period. Seventy-two (27%) cases had not previously received substance use treatment, 112 (42%) had received treatment but had no opioid use related diagnosis and 85 (32%) had received treatment and had an opioid use related diagnosis. In total, only 10 individuals had been prescribed methadone during the year before death. Prescriptions of benzodiazepines (60%), antidepressants (62%) and opioids for pain (22%) the year before death were common. Most deaths occurred during sleep with a time lag from ingestion of methadone.

CONCLUSION: Prescription opioid and methadone related deaths increased in the age group 15-29 years in Sweden between 2006-2015. Exposure to non-prescribed methadone and prescribed benzodiazepines, antidepressants, and opioids for pain appears to be common in drug related deaths in youth and young adults in Sweden.


Language: en

Keywords

Epidemiology; Mortality; Methadone; Fatal poisoning; Opioid Agonist Treatment (OAT); Opioid dependence

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