Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method
Abstract
:1. Introduction
2. Materials and Methods
- The existence of a history of opioid use immediately before death
- Positive toxicological tests
- Autopsy findings compatible with death due to acute reaction following opioid use
- Forensic diagnosis of death due to opioid overdose
- Deaths without judicial intervention or forensic investigation
- Deaths of persons under ten years of age or over 64 years of age
- Deaths where the use of these substances may have been a contributing factor in the death but not the fundamental and direct cause of death
- Deaths due to unintentional exposure or ingestion
- Deaths due to adverse reactions to properly prescribed and administered psychoactive medications
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Full Inclusion and Exclusion Criteria for Recreational Opioid Overdose Deaths
Appendix A.1. Stage One
- (a)
- Deaths without judicial intervention or forensic study on their causes with a written record of the results.
- (b)
- Deaths of people under age 10 or over age 64 years.
- (c)
- Deaths NOT related to the use of psychoactive substances (cancer, diabetes mellitus, pneumonia, etc.) However, deaths due to pathologies that may have been aggravated or complicated by the recent use of psychoactive substances, such as sudden and unexpected deaths due to cardiovascular or neurological disease, ARE NOT EXCLUDED and move to stage two for further consideration.
- (d)
- Deaths indirectly related to the use of psychoactive substances, that is, those in which the use of these substances may have been a contributing factor to death, but not the fundamental and direct cause of death, such as deaths due to:
- -
- Infectious pathologies (AIDS, endocarditis, tuberculosis, hepatitis, etc.), even if related to the use of psychoactive substances.
- -
- Homicide.
- -
- Accidents of any type (occupational, domestic, traffic, etc.) in persons under the influence of psychoactive substances are excluded; however, deaths caused directly by poisoning, or acute intoxication with these substances are moved to stage two.
- -
- Suicide of any type (hanging, precipitation, immersion, injury by firearm, etc.) in persons under the influence of psychoactive substances, EXCEPT deaths caused directly by poisoning or acute intoxication with these substances.
- (e)
- Deaths (for which there is obvious evidence) that are due to involuntary or unintentional exposure to or ingestion of psychoactive substances. For example, deaths from a broken bag of drugs ingested for the purpose of trafficking or occupational exposure to a recordable volatile substance. Consumption resulting from the existence of dependence would be considered voluntary or intentional.
- (f)
- Deaths due to adverse reactions to properly prescribed and administered psychoactive drugs.
- (g)
- Deaths due to chronic diseases related to alcohol consumption and deaths due to acute alcohol intoxication exclusively (binge drinking), without evidence of acute reaction to other recordable psychoactive substances.
- (h)
- Deaths due to the use of volatile substances, household products or caustics, EXCEPT when inhaled or sniffed.
Appendix A.2. Second Two
- (a)
- History of recent psychoactive substance use.
- -
- Documented clinical evidence (hospital records or reports, etc.), of acute pathology due to psychoactive substance use immediately prior to death.
- -
- Physical signs of recent administration of psychoactive substances or presence of traces of psychoactive substances in the mouth, nostrils, stomach, etc.
- -
- Presence of psychoactive substances or utensils (syringes, foil, pill bottles, etc.) at the place of death.
- -
- History of recent consumption described by relatives or friends or collected by a coroner with forensic medical-legal expertise shortly before death.
- (b)
- Positive toxicological tests for any of the psychoactive substances that can be registered.
- (c)
- Autopsy signs compatible with death by acute reaction after consuming psychoactive substances.
- (d)
- Forensic diagnosis of death by the acute reaction after consumption of psychoactive substances (overdose, etc.).
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Number of Deaths | Estimation of PROU/1000 | Estimation of PROU/1000 without Suicides | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Year | Number in Register | Suicides | Ref. Population | % Spanish Population | Deaths/1000 | Point | 95% LCL | 95% UCL | Point | 95% LCL | 95% UCL |
2005 | 182 | 15 | 7,251,688 | 16.75 | 0.0251 | 5.21 | 3.45 | 8.62 | 4.78 | 3.16 | 7.91 |
2006 | 170 | 13 | 7,249,252 | 16.47 | 0.0235 | 4.89 | 3.24 | 8.10 | 4.52 | 2.99 | 7.48 |
2007 | 136 | 7 | 7,233,937 | 16.15 | 0.0188 | 3.92 | 2.60 | 6.50 | 3.72 | 2.46 | 6.16 |
2008 | 103 | 8 | 6,657,856 | 14.58 | 0.0155 | 3.23 | 2.14 | 5.35 | 2.98 | 1.97 | 4.93 |
2009 | 140 | 8 | 7,426,081 | 16.06 | 0.0189 | 3.94 | 2.61 | 6.53 | 3.72 | 2.46 | 6.15 |
2010 | 143 | 12 | 7,436,169 | 16.00 | 0.0192 | 4.04 | 2.68 | 6.69 | 3.71 | 2.45 | 6.13 |
2011 | 148 | 18 | 7,410,976 | 15.88 | 0.0200 | 4.22 | 2.79 | 6.99 | 3.71 | 2.45 | 6.14 |
2012 | 152 | 13 | 7,387,118 | 15.78 | 0.0206 | 4.37 | 2.89 | 7.23 | 4.00 | 2.64 | 6.61 |
2013 | 141 | 13 | 7,344,914 | 15.72 | 0.0192 | 4.09 | 2.71 | 6.78 | 3.72 | 2.46 | 6.15 |
2014 | 105 | 22 | 7,265,367 | 15.62 | 0.0145 | 3.10 | 2.05 | 5.13 | 2.45 | 1.62 | 4.06 |
2015 | 94 | 15 | 7,238,722 | 15.58 | 0.0130 | 2.80 | 1.85 | 4.63 | 2.35 | 1.55 | 3.89 |
2016 | 105 | 16 | 7,263,300 | 15.64 | 0.0145 | 3.11 | 2.06 | 5.15 | 2.64 | 1.75 | 4.37 |
2017 | 102 | 14 | 7,293,097 | 15.67 | 0.0140 | 3.01 | 1.99 | 4.98 | 2.60 | 1.72 | 4.30 |
2018 | 86 | 8 | 7,338,520 | 15.73 | 0.0117 | 2.52 | 1.67 | 4.17 | 2.29 | 1.51 | 3.78 |
2019 | 105 | 15 | 7,407,608 | 15.75 | 0.0142 | 3.04 | 2.01 | 5.02 | 2.60 | 1.72 | 4.31 |
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Pulido, J.; Sanchez-Niubo, A.; Llorens, N.; Hoyos, J.; Barrio, G.; Belza, M.J.; Cea-Soriano, L.; Angulo-Brunet, A.; Sordo, L. Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method. Int. J. Environ. Res. Public Health 2022, 19, 4815. https://doi.org/10.3390/ijerph19084815
Pulido J, Sanchez-Niubo A, Llorens N, Hoyos J, Barrio G, Belza MJ, Cea-Soriano L, Angulo-Brunet A, Sordo L. Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method. International Journal of Environmental Research and Public Health. 2022; 19(8):4815. https://doi.org/10.3390/ijerph19084815
Chicago/Turabian StylePulido, José, Albert Sanchez-Niubo, Noelia Llorens, Juan Hoyos, Gregorio Barrio, Maria Jose Belza, Lucía Cea-Soriano, Ariadna Angulo-Brunet, and Luis Sordo. 2022. "Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method" International Journal of Environmental Research and Public Health 19, no. 8: 4815. https://doi.org/10.3390/ijerph19084815