[Psychosocial stress preceding drug-related deaths]

This article analyses drug-related deaths in the German Federal States of Bavaria (Munich, Nuremberg and Augsburg counties) during 1999 and Baden-Wurttemberg (Stuttgart and Mannheim counties) during 1999 and in the first half of 2000. The persons who had been in contact with drug care services were studied for psychosocial stress preceding drug-related deaths. Epidemiological data from different sources (police, relatives, counselling centres, detoxification clinics, therapy and substitution treatment) were collated to estimate factors of psychosocial stress preceding drug deaths. The results in both Laender indicate high prevalence rates of a history of at least one non-fatal overdose (approx. 50%) or a suicide attempt (approx. 35%). More than 40% of the deceased had been suffering from at least one additional mental disorder, in most cases from depression. At least one critical life event (in most cases, a relapse) or a period of abstinence (i.e., due to imprisonment, therapy or detoxification) during the past three months before death was reported for more than half of the addicts. The results were discussed in the light of data on opiate users and the general population. Improved specialist training of therapeutic and medical workers as well as of any other co-operating professionals is considered a necessary prerequisite for an early detection of risk factors.