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The Difference is Research
Methamphetamine-related death in Australia:
A national 7 year study
Shane Darke1, Sharlene Kaye1,2 & Johan Duflou1,3
1 National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia 2Justice Health and Forensic Mental Health Network, NSW Health, Australia 3Sydney Medical School, University of Sydney, NSW, Australia
The Difference is Research The Difference is Research
• All NCIS cases where methamphetamine was coded as a mechanism contributing to death, 1/1/2009-31/12/2015:
o Toxicity, disease, suicide, traumatic accident, homicide
• Contain police reports of circumstances, blood toxicology, autopsy, coroners conclusions
• Cases restricted to where person’s own methamphetamine use was contributory to their death
2
Methods
The Difference is Research The Difference is Research
Number of methamphetamine-related deaths
2009-2015
3
0
50
100
150
200
250
300
350
2009 2010 2011 2012 2013 2014 2015
Nu
mb
er
of
cases
YEAR
Male Female All
The Difference is Research The Difference is Research
4
Demographics & circumstances
N=1649
Age
Years Potential Life Lost
36.9 yrs
43.9 yrs
Male 78%
Employed 34%
In Rx 8%
History IDU 56%
Location
Metropolitan
Rural & regional
59%
41%
The Difference is Research The Difference is Research
Toxicology: Methamphetamine concentrations,
2009-2015
5
0
0.05
0.1
0.15
0.2
0.25
2009 2010 2011 2012 2013 2014 2015
Med
ian
co
ncen
trati
on
m
g/L
YEAR
The Difference is Research The Difference is Research
6
Toxicology: polydrug use
43 38
26 25 20
12 6 05
101520253035404550
Perc
en
tag
e o
f cases
Disease
The Difference is Research The Difference is Research
7
Manner of Death
712
367 300
245
25 0
100
200
300
400
500
600
700
800
Toxicity Disease Suicide Accident Homicide
Nu
mb
er
of
cases
Manner of death
The Difference is Research The Difference is Research
o Attributed
Solely to methamphetamine: 91 cases
Attributed to multiple drugs: 621cases
• Characteristics of methamphetamine toxicity
o Sudden collapse
o Hyperthermia
o Laboured breathing
o Delirium
o Convulsions
8
Accidental toxicity (n=712)
The Difference is Research The Difference is Research
• Cause of death
o Coronary disease: 275 cases
Ischaemic heart disease
Cardiomegaly
Cardiomyopathy
o Stroke: 38 cases
All but one haemorrhagic
9
Disease & methamphetamine (n=367)
The Difference is Research The Difference is Research
10
Cardiovascular disease
27
19 14
9 3 05
1015202530
Perc
en
tag
e o
f cases
Disease
The Difference is Research The Difference is Research
• Methods
o Violent: 256 cases (70% of both sexes)
o Poisoning: 44 cases
• Circumstances o High activation
o Agitated
o Argumentative
o Aggressive immediately prior to the incident
11
Suicide (n=300)
The Difference is Research The Difference is Research
• MVA: 166 cases o Single vehicle: 90 cases
o Multiple vehicle: 66 cases
o Pedestrian: 10 cases
• Drown: 27 cases
• Falls: 16 cases
• Pattern of high activation and risk-taking
12
Accident (n=245)
The Difference is Research The Difference is Research
• Public health problem to be taken seriously
o Effects will be felt for decades to come
o Rural and regional
• Need to look beyond toxicity
o Heart disease & stroke
o Suicide
o Accidents
• Treatment
13
Clinical and public health implications
The Difference is Research The Difference is Research
• Darke, S., Kaye, S. & Duflou, J. (2017) Rates, characteristics and circumstances of methamphetamine-related death in Australia: a national 7 year study. Addiction.
• Darke, S., Duflou & Kaye, S. (2017) Prevalence and nature of cardiovascular disease in methamphetamine-related death: a national study. Drug and Alcohol Dependence, 179, 174-179.
• Darke, S., Kaye, S., Duflou, J. & Lappin, J. (2017) Completed suicide amongst methamphetamine users: a national study. Suicide & Life-threatening Behavior.
• Darke, S., Lappin, J., Kaye, S. & Duflou, J. (2017) Clinical characteristics of fatal methamphetamine-related stroke: a national study. Journal of Forensic Sciences.
14
References
