A quantitative exploration of risk factors associated with drug-related deaths involving heroin, alcohol or methadone in the West of Scotland

Abstract

A number of risk factors have been identified that increase the potential for overdose events to occur, however in-depth studies exploring multiple Drug-Related Death (DRD) risk factors simultaneously are less prevalent and mainly conducted among non-fatal OD populations. Using retrospective data from two Scottish NHS Board areas, this study looked at three main types of DRD in more depth, namely those involving heroin, alcohol or methadone, exploring the associations between personal and population DRD risk factors and attempting to predict their impact. Of a total of 291 DRDs across the two areas between 2006 and 2007; almost two-thirds (65%; n = 190) involved heroin, one-third (34%; n = 100) involved methadone and over a quarter (28%; n = 80) involved alcohol. The direct involvement of benzodiazepines was much less prominent (4%; n = 11). Age and geographical area were both significant predictors of DRDs involving both heroin and alcohol. Heroin-related DRDs were significantly more likely to affect males than females and prison release within the last 14 days a significant predictor. Gender and heroin involvement were both significant predictors of Methadone-related DRDs with females more likely to be affected than males and heroin less likely to be co-involved. These findings support previous research into DRD and overdose risk factors by revealing co-presences and predictors of DRD-subtypes. They suggest new areas where overdose prevention messages should be targeted; such as an increasing risk of alcohol involvement in DRD with age and an increased risk of Methadone-related DRD for females.

• Drug-related death
• fatal overdose
• heroin
• methadone
• alcohol
• risk factors

Notes

Notes

1. See GROS (2009) for a fuller breakdown of the differences between definitions.

2. 1.7% of standardised residuals >2; 99% Cooks <1. Difference in −2LL is significant, so we can reject null hypothesis that geographical area and age have no involvement with HA DRDs.

3. 0% of standardised residuals >2; 100% Cooks <1. Difference in −2LL is significant, so we can reject null hypothesis that ‘liberated within 14 days’ has no involvement with heroin without alcohol (no methadone) involved DRDs.

4. 8% of standardised residuals >2; 100% Cooks <1. Difference in −2LL is significant, so we can reject null hypothesis that gender and heroin have no involvement with methadone DRDs.