Trends and characteristics in barbiturate deaths Australia 2000–2019: a national retrospective study

Abstract

Introduction

There have been increasing reports documenting barbiturate-related deaths, despite routine prescribing for only relatively rare indications. The aims of the current study were to examine trends in barbiturate-related deaths in Australia from 2000 to 2019 and determine the case characteristics and circumstances of barbiturate-related deaths.

Methods

All barbiturate-related deaths identified in the Australian National Coronial Information System were examined. Information was collected on cause, manner, demographics, location, psychosocial factors, circumstances of deaths and toxicology. We examined these based on the age categories 18–44 years, 45–64 years and ≥65 years.

Results

We identified 511 cases. Mean age was 57.9 years (SD 20.2, range 18–100) and 56% were male. Intentional poisoning was the most common cause of death (87.5%) and was slightly higher in the oldest age group (92.1%) and lowest in the youngest age group (81.1%). Pentobarbitone was the most common barbiturate (75.7%) and pentobarbitone-related deaths increased from 0% in 2000 to 93.6% in 2017. There were notable differences between age categories, with the youngest age group recording more severe psychiatric histories. In contrast, the oldest age group were more likely to have severe physical health problems, such as cancer, chronic non-cancer pain, neurological conditions and significant cardiopulmonary morbidity. Euthanasia resources were commonly documented (33.9%), most frequently in the oldest age group (52.3%).

Conclusion

Barbiturate-related deaths in Australia are increasing, particularly pentobarbitone-related deaths. Most deaths were intentional and involved adults across the lifespan. Younger people were more likely to have significant mental health problems, whilst the oldest age group were more likely to have severe physical health conditions.

Keywords:

• Toxicity
• barbiturates
• drug overdose
• self-poisoning

Acknowledgements

The authors would like to thank the Ethics Committees of the Department of Justice and Community Safety on behalf of the State of Victoria, the University of New South Wales, University Human Research Ethics Committee, and the staff of the National Coronial Information System. The authors acknowledge the National Coronial Information System as the data source and the Department of Justice and Community Safety as the source organisation of that data.

Disclosure statement

GC has received an investigator-initiated untied educational grants from Reckitt Benckiser for a study of opioid substitution therapy uptake among chronic non-cancer pain patients. This is not related to the current study. All other authors have no conflicts to declare.

Additional information

Funding

GC is supported by NHMRC Earle Career Research Fellowship (#1119992). The National Drug and Alcohol Research Centre, UNSW Sydney, is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. Funding bodies had no role in study design, data analysis, data interpretation, data collection or writing of the article. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication.