Drug-induced deaths in Southern Spain: profiles and associated characteristics (2017)

Background: This study aimed to (1) describe drug-induced deaths (DIDs) in Southern Spain (Andalusia) in terms of substances involved, sociodemographic characteristics, and circumstances of death, and (2) identify profiles by substances involved and their association with sociodemographic characteristics and circumstances of death.
Methods: Observational study of 398 deceased in 2010/2011 in Andalusia suspected of DIDs. Medical examiner diagnoses considered the scene of death, regulatory forensic autopsy, histopathological studies, and toxic-chemical analyses. Latent Class Analysis was applied.
Results: The final sample included 360 people diagnosed with DIDs. The mean age was 39.7 and 87.2% were male. The most frequent substances involved were methadone, benzodiazepines, cocaine, and opiates. Two or more substances were involved in 86.7% of deaths. Four profiles were identified: methadone-benzodiazepines, cocaine, benzodiazepines-cocaine-methadone-opiates, and benzodiazepines-alcohol. The methadone-benzodiazepines and benzodiazepines-cocainemethadone-opiates profiles included 62.5% of the deceased. A larger number of drugs were involved in the benzodiazepines-cocainemethadone-opiates profile and a larger percentage of cocaine deaths occurred in the weekend.
Conclusions: The results of this study are in agreement with the trend to increasing involvement of prescription drugs in DIDs detected in other European countries and the United States. The heterogeneity detected suggests that preventive measures must be adjusted to the various DID profiles.