The key indicator 'Drug-Related Deaths (DRD) and mortality among drug users' has twocomponents. One is the overall and cause-specific mortality among drug users monitored through mortality cohort studies following drug users overtime. A second component is thestatistics on deaths directly caused by drugs, also called 'overdoses', 'poisonings' and more recently 'drug-induced deaths'. The preferred method of estimating the number of deaths is to extract cases from existing General Mortality Registries (GMR) where a selection of ICD 10 codes are defined as drug-related. An alternative method is to estimate the number of deaths by extracting cases from existing Special Registries (typically forensic or police registries). The method based on the Special Registry will be applied in countries where the preferred method cannot be implemented, but will also be used whenever possible as a backup estimate for the GMR.
The aim of this project was to better understand risk factors and substances involved in drug- induced deaths in Europe. It aims to improve the monitoring of drug-induced deaths and to help to assess the feasibility of future work on this domain in Europe. Specific objectives were:
to conduct a targeted inventory of national Special Mortality Registries
to describe their overall working procedures and information flows within the Special Mortality Registries to describe the core data or information recorded regularly for each case of drug- induced deaths.
Potential areas of interest were discussed in a working group. In the follow-up of the working group a draft questionnaire was prepared in close cooperation with the EMCDDA. The questionnaire was send to an advisory group before disseminating to all members of the European Union and Croatia, Norway and Turkey.
16 countries returned the questionnaire on Special Registries (Austria, Czech Republic Croatia, Cyprus, Denmark, Finland, France, Germany, Hungary, Ireland, Latvia, Lithuania, Malta, Spain, Sweden, United Kingdom) on DRD, and 2 countries reported having no Special Registry (Estonia, Poland). This leads to a return rate of 60 percent.
The information flow of data for Special Registry varies across Europe. Most Special Mortality Registries combine various information sources and therefore have different persons in charge. Unlike the information in the GMR the information flow is very complex. Most Special Mortality Registries include a lot of additional (contextual) information which is not found in the GMR and which can be used to describe risk factors for Drug-Related Deaths. This valuable additional information should be focused on by small-scale studies.
This report is the final output of EMCDDA contract CT.08.EPI.083.1.0