Historique
Article de Périodique
Trends in drug overdose deaths in England and Wales 1993-98: methadone does not kill more people than heroin (2003)
(Les tendances en matière de décès liés aux overdoses en Angleterre et aux Pays de Galles, de 1993 à 1998 : la méthadone ne tue pas plus de personnes que l'héroïne.)
Auteur(s) :
HICKMAN, M. ;
MADDEN, P. ;
HENRY, J. ;
BAKER, A. ;
WALLACE, C. ;
WAKEFIELD, J. ;
STIMSON, G. ;
ELLIOTT, P.
Année
2003
Page(s) :
419-425
Langue(s) :
Anglais
Refs biblio. :
35
Domaine :
Drogues illicites / Illicit drugs
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus mots-clés
METHADONE
;
HEROINE
;
SURDOSE
;
MORTALITE
;
COMPARAISON
;
PREVALENCE
Thésaurus géographique
ANGLETERRE
;
PAYS DE GALLES
Résumé :
FRANÇAIS :
Une analyse multivariée de 3961 certificats de décès mentionnant la morphine, l'héroïne ou la méthadone, entre 1993 et 1998, en Angleterre et aux Pays de Galles, montrent une augmentation des décès (378 à 909) : soit, 24,7% par an pour l'héroïne et 9, 4% pour la méthadone. La plupart des décès surviennent le samedi (673) et on observe une prépondérance des décès liés à la méthadone le week-end.
ENGLISH :
Aims: To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends. Design and setting: Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug-related poisoning mortality database from 1993 to 1998 in England and Wales. Measurements: Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone-related overdose compared to dying from heroin/morphine overdose. Findings: From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22-28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6-13%) for methadone only This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (9 5% CI 1.29-1.71) for methadone-only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% GI 0.95-1.25) if the weekend was defined as Friday and Saturday Conclusions: There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue. (Review' s abstract)
Une analyse multivariée de 3961 certificats de décès mentionnant la morphine, l'héroïne ou la méthadone, entre 1993 et 1998, en Angleterre et aux Pays de Galles, montrent une augmentation des décès (378 à 909) : soit, 24,7% par an pour l'héroïne et 9, 4% pour la méthadone. La plupart des décès surviennent le samedi (673) et on observe une prépondérance des décès liés à la méthadone le week-end.
ENGLISH :
Aims: To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends. Design and setting: Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug-related poisoning mortality database from 1993 to 1998 in England and Wales. Measurements: Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone-related overdose compared to dying from heroin/morphine overdose. Findings: From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22-28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6-13%) for methadone only This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (9 5% CI 1.29-1.71) for methadone-only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% GI 0.95-1.25) if the weekend was defined as Friday and Saturday Conclusions: There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue. (Review' s abstract)
Affiliation :
Ctre Res. Drugs and Hlth Behaviour, Soc. Sci. Med., Imperial Coll., Reynolds Bldg, Charing Cross Campus, St Dunstan's Rd, London W6 8RP
Royaume-Uni. United Kingdom.
Royaume-Uni. United Kingdom.