Toxicology of Scotland's drugs-related deaths in 2000–2007: Presence of heroin, methadone, diazepam and alcohol by sex, age-group and era

Scotland has a new database on drugs-related deaths (DRDs). We review the prior toxicology and demography of Scotland's DRDs in 2000–2007. Each DRD was cross-classified by the presence/absence of heroin (H); methadone (M); diazepam (D); and alcohol (A). Comparisons were made by era (2000–2002, 2003–2005 and 2006–2007), sex and age-group (under 35 years and 35+ years). Data were for 1007 DRDs in 2000–2002 (180 female); 1011 in 2003–2005 (206 female); and 875 in 2006 and 2007 (149 female). DRDs citing diazepam decreased from around half in 2000–2002 to only 18% by 2006 and 2007 (95% CI: 15–21%). The presence of alcohol decreased also, for males, down from 43% of 827 DRDs in 2000–2002 (95% CI: 40–46%) to 35% of 726 DRDs in 2006 and 2007 (95% CI: 31–38%). The presence of heroin and alcohol were positively associated; of heroin and methadone strongly negatively. Alcohol's co-presence was age related: present in 53% of 598 male heroin-DRDs at 35+ years of age but in only 36% of 974 male heroin-DRDs under 35 years of age. Neither methadone nor heroin was present in a third of all female DRDs (183/535) and a fifth of male DRDs (460/2358). In 101 female and 276 male DRDs, none of H, M, D or A was mentioned. Periodically, the toxicology and demography of a country's DRDs should be analysed together, as here for Scotland, to highlight idiosyncrasies or insights. That alcohol's co-presence at heroin-DRDs was age related adds to several reasons for (ageing) heroin injectors to moderate their alcohol intake.