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Prescription opioid abuse based on representative postmortem toxicology
Margareeta Häkkinen1, Erkki Vuori1, Ilkka Ojanperä1
1Hjelt Institute, Department of Forensic Medicine, University of Helsinki, Helsinki, Finland.
Forensic Science International
|December 3, 2014
Summary
Prescription opioid abuse is a significant concern. Postmortem toxicology in Finland revealed buprenorphine and methadone were most frequently abused, with abuse concentrated in men aged 20-49.
Area of Science:
- Forensic Toxicology
- Public Health
- Pharmacology
Background:
- Opioid medications are crucial for pain management and treatment.
- Increasing prescription opioid misuse poses a global health challenge.
- Understanding the prevalence of prescription opioid abuse is vital.
Purpose of the Study:
- To determine the ratio of prescription opioid abuse to total use.
- To analyze opioid abuse patterns using postmortem toxicology data.
- To investigate associations between opioid abuse and demographic factors.
Main Methods:
- Analysis of medico-legally examined deaths in Finland (2010-2011).
- Included cases with positive findings for buprenorphine, codeine, fentanyl, methadone, oxycodone, or tramadol.
- Defined "abuse" as illicit use of licit opioids; identified abusers via history, injection, or illicit drug findings.
Main Results:
- Opioid findings in 2,499 cases; 545 (0.5% of deceased) involved drug abuse.
- Buprenorphine (85.5%) and methadone (82.4%) showed the highest abuse proportions.
- Tramadol, codeine, fentanyl, and oxycodone also showed significant abuse rates.
- Abuse and fatal poisonings were most common in men aged 20-49.
Conclusions:
- Buprenorphine and methadone are frequently linked to prescription opioid abuse.
- Significant abuse was observed across all studied opioids, particularly tramadol.
- Targeted interventions for opioid abuse should consider age and gender demographics.