Trends in drug intoxication deaths in Connecticut, 1997 - 2007

Background: The incidence of accidental/unintentional drug intoxication deaths (AUODs) has increased in the U.S. since the 1990s. AUODs are the principal cause of mortality among drug injectors (IDUs), far exceeding deaths attributable to AIDS, hepatitis, or other morbidities. This study examines trends in AUOD incidence in Connecticut, the types of drugs involved, and potential associated risk factors.

Methods: From the database of Connecticut's Office of the Chief Medical Examiner, we extracted all cases of AUODs occurring between 1997 and 2007. AUODS with a cause of death of vehicular accident, drowning, asphyxia, or smoke inhalation were excluded as were those attributed to carbon monoxide, caffeine, cyanide, water, or ethylene glycol. We calculated trends in AUODs involving heroin, various prescription opioids (including methadone), tramadol, ethanol, and cocaine; sociodemographic trends are also reported.

Results: Of the 2900 AUODs, 77.2% involved opioids, which occurred more often among younger age groups, whites, and males when compared to AUODs not involving opioids. Trends over time suggest a reduction in heroin-, cocaine-, and alcohol-involved AUODs and an increase in prescription opioid- and methadone-involved deaths. Methadone, oxycodone, and fentanyl were the three most frequently cited opioids, and their mention increased over time. The proportion of opioid-involved AUODs also increased for Whites and females. The proportion of AUODs occurring in a public place decreased over time.

Conclusions: Trends in AUODs in Connecticut suggest an increase in the proportion of prescription opioid-involved deaths relative those involving heroin. Potential strategies to decrease the incidence of AUODs will be discussed.