Drug Related Deaths Summary 2011 and 2012 2011 (update) There had been 7 deaths, of which 4 male and 3 female. 20 years to 46 years of age, therefore average age 33 years. 3 individuals were in drug treatment at the time of death, 2 males and 1 female. All 3 were on methadone treatment. The deceased place of death- home 3, family/friends 3 and hospital 1 6 were pronounced dead at the scene and 1 hospital. Medical Causes of Death/Verdict:No. 1. Medical Cause of Death 1a Gastro-intestinal haemorrhage, b Oesophageal varices and cirrhosis, Hep C virus infection and chronic excess alcohol intake, 2. Intravenous drug use (contributing but not directly causing death) Coroner Verdict Misadventure* 2. 1(a) Drug (Morphine, tramadol, Methadone) toxicity 2 Hep C & fatty liver Misadventure* 3. 1a Cocaine, methadone and alcohol toxicity 2 Diazepam Open Verdict 4. I(a) Cocaine Toxicity Pending 5. 1a subarachnoid and cerebral haemorrhage, 2. Dilated cardiomyopathy intravenous drug usage and chronic excess alcohol intake. Narrative * Died from spontaneous cerebral bleeds which developed in a background of longstanding drug and alcohol abuse thus rendering him more susceptible of a fatal bleed. 6. The effects of a combination of ethanol and methadone Narrative Died at her home in the early hours of 12th June 2011 after drinking a substantial quantity of alcohol during the afternoon and evening of 11th June and ingesting methadone during the evening of the same day. There is insufficient evidence of the precise circumstances in which the methadone was ingested but it is more likely than not that consumption of the methadone was a voluntary act. The danger of consumption of methadone by a naïve user was known to those present at the time of consumption but no action was taken by them to seek help or advice at any time after consumption, and prior to the development of a terminal condition. 7. 1a Methadone toxicity and amphetamine misuse / 11 Ischaemic heart disease and bronchopneumonia Misadventure *The deceased were in drug treatment at time of death and had chronic health conditions including Hep C and all three were reported as having high levels of alcohol use. Other key points: One of the deceased (No. 7) was reported to have been heard snoring prior to death. Alcohol use appeared in all cases apart from No. 7. Poly substance use in all cases. Two deaths included consuming non- prescribed methadone. 2012 There had been 5 deaths, of which all were male. 21 years to 41 years of age, therefore average age 31 years. 2 individuals were in drug treatment at the time of death. Both on methadone. The deceased place of death- home 3, family/friends 1 and hospital 1 4 were pronounced dead at the scene and 1 hospital. Medical Causes of Death/Verdict:No. 1. Medical Cause of Death 1a Cardiac arrhythmia, b Paramethoxyamphetamine (PMA) toxicity Coroner Verdict Misadventure 2. 1a Mixed drug (ethanol. Methadone, diazepam, morphine) toxicity Accidental Death* 3. 1a Mixed drug toxicity 2 Alcoholic liver disease. Misadventure* 4. 5. 1a Bronchopneumonia, b Ischaemic brain injury c drug toxicity 2 Frontal lobe brain injury Narrative 1a Smoke inhalation 2 Alcohol intoxication and cannabis use Accidental death Deceased sustained an irreversible ischaemic brain injury due to an acute drug induced hypotensive episode. Brain injury sustained in a childhood road traffic accident contributed insofar as effecting his judgement and impulsivity. Died in Bsly Hosp on 8/6/2012. *The deceased were in drug treatment at time of death and had chronic health conditions including Hep C for No. 2, both were reported as having high levels of alcohol use. Other key points: One of the deceased (No. 4) was reported to have been heard snoring prior to death. One had history of multiple overdose (No. 4) and found after overdose then taken to hospital prior to death. One (No. 2) died as injecting heroin in groin. No. 1 had been ‘bombing’ previous night several times. (Bombing – crushing tablets and placing powder in cigarette paper and swallowing) Alcohol use appeared in all cases. Poly substance use in all cases. Debbie Stovin Adult Drug Treatment System Manager Rotherham Public Health June 2013