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Opioid overdose mortality in Australia, 1964-1997: birth-cohort trends
W D Hall1, L J Degenhardt, M T Lynskey
1National Drug and Alcohol Research Centre, University of New South Wales, Sydney. w.hall@unsw,edu.com.au
Objective:
To examine trends in rates of opioid overdose deaths from 1964 to 1997 in different birth cohorts.
Design:
Age-period-cohort analysis of national data from the Australian Bureau of Statistics.
Main Outcome Measures:
Annual population rates of death attributed to opioid dependence or accidental opioid poisoning in people aged 15-44 years, by sex and birth cohort (in five-year intervals, 1940-1944 to 1975-1979).
Results:
The rate of opioid overdose deaths increased 55-fold between 1964 and 1997, from 1.3 to 71.5 per million population aged 15-44 years. The rate of opioid overdose deaths also increased substantially over the eight birth cohorts, with an incidence rate ratio of 20.70 (95% confidence interval, 13.60-31.46) in the 1975-1979 cohort compared with the 1940-1944 cohort. The age at which the cumulative rate of opioid overdose deaths reached 300 per million fell in successive cohorts (for men, from 28 years among those born 1955-1959 to 22 years among those born 1965-1974; for women, from 33 years among those born 1955-1959 to 27 years among those born 1965-1969).
Conclusions:
Heroin use in Australia largely began in the early 1970s and rates of heroin use have markedly increased in birth cohorts born since 1950.