NDARC Technical Report No. 40 (1997)

EXECUTIVE SUMMARY

The coronial files of all 1995 heroin-related deaths in the South Western Sydney (SWS) region were inspected for toxicological results, demographic characteristics and circumstances of death. These data were compared with SWS heroin-related deaths from 1992. There were 44 deaths attributed to heroin overdose in the region during 1995, an increase of 120% compared with the 20 cases that occurred in 1992. The mean age of cases was 31.7 years, and 96% were male. Cases were significantly older than in 1992, and more likely to be male. The route of heroin administration was by injection in all cases in both years.

Over a half (59%) of fatalities occurred in the suburb of Cabramatta, compared to 15% of cases in 1992. Seventy one percent of fatalities occurred in a public place, including 92% of cases who died in Cabramatta. The proportion of fatalities that occurred in public settings has increased markedly since 1992, when 35% of fatalities occurred in public places. The proportion of cases in which no interventions occurred prior to rose from 60% in 1992 to 80% in 1995.

The median blood morphine concentration among fatalities in 1995 was 0.35 mg/L (range 0.08-3.20 mg/L), more than twice the corresponding figure of 0.16 mg/L in 1992. The majority of deaths (69%) involved drugs in addition to heroin, a similar pattern to 1992 fatalities (79%). Alcohol was the most frequently detected drug other than morphine, present in 52% of cases at a median concentration of 0.10 g/100ml (range 0.01-0.33 g/100ml). The median blood morphine concentration in cases positive for alcohol was significantly lower than in cases without alcohol (0.26 v 0.55mg/L). There was also a significant negative correlation between blood alcohol and blood morphine concentrations (rs= - 0.41).

A large increase has occurred since 1992 in the number of heroin-related deaths in SWS, and higher concentrations of morphine are being detected. Cabramatta has clearly emerged as a focal point of these fatalities. The patterns of these fatalities also appears to be changing, with more deaths occurring in public settings, and fewer interventions occurring prior to death. Heroin-related fatalities in SWS represent a growing, and changing problem. Interventions designed to prevent heroin-related fatalities in SWS must take into account of the changing patterns of heroin related fatalities in SWS.

Resources

Author(s)

Shane Darke, Deborah Zador, Sandra Sunjic
Date Commenced
15 Nov 1996
Resource Type
Technical Reports