3321.0.55.001 - Drug Induced Deaths, Australia, 1991-2001  
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  • Explanatory Notes

1. The source of data in this paper is the ABS Causes of Death data set, compiled from data provided by the Registrar of Births, Deaths and Marriages in each state and territory.

2. Drug-induced deaths refer to deaths where the underlying cause of death is directly attributed to drug use. This definition, more fully discussed in Drug-induced deaths - A Guide to ABS Causes of Death Data explicitly excludes the following causes:

  • "Any death where drugs played only a contributory role. Deaths considered to be indirectly related to drug use include cases such as motor vehicle accidents or drownings where drugs were reported as having played a contributory role.
  • Deaths of newborn babies associated with the mother's drug use.
  • Any death where the underlying cause of death is a medical condition caused by long-term drug use e.g. where the underlying cause of death is cardiomyopathy due to drugs. In these instances, there is no drug toxicity reported on the Medical Certificate of Cause of Death.
  • Any death where the underlying cause of death is related to the use of alcohol, tobacco or volatile solvents (e.g. petrol). These deaths are excluded as the substances involved are classified as non-medicinal substances under ICD-10 rules."

3. In this paper, deaths from 1991-1996 are classified according to the International Classification of Disease Ninth Edition (ICD-9), while deaths from 1997-2001 are classified according to the Tenth Edition (ICD-10). The ABS provides concordance and comparability factors to assist users with changes in coding between these two editions of the ICD (based on a sample of data that was coded to both ICD-9 and ICD10). These are published in ABS Causes of Death 2001 (cat.no 3303.0) and additional tables are available on request. In relation to drug-induced deaths, codes from ICD-9 and ICD-10 have been matched to facilitate comparisons over time, and a time series based on underlying cause of death due to drug use is possible from 1979. The following table lists the comparable ICD-9 and ICD-10 codes for drug-induced deaths.


ICD-10 CodesICD-9 CodesCode Descriptors

F11-F16, F19304Mental and behavioural disorders due to psychoactive substance use (excluding alcohol, tobacco and volatile solvents, e.g. petrol)
F55305.2-305.9Abuse of non-dependence-producing substances
X40-X44E850-E858Accidental poisoning by drugs, medicaments and biologicals
X60-X64E950.0-E950.5Intentional self-harm by drugs, medicaments and biologicals
X85E962.0Assault by drugs, medicaments and biological substances
Y10-Y14E980.0-E980.5Deaths of undetermined intent by drugs, medicaments and biologicals


4. The term 'drug-induced deaths involving opioids' (drug-induced deaths cross-classified with ICD-10 poison codes T40.0-T40.4, T40.6) has been used in this paper rather than heroin-induced deaths. Heroin is rapidly converted by the body into monocetyl morphine and then morphine. The presence of these drugs at the time of post-mortem may therefore indicate heroin use. However it is not possible to accurately distinguish the number of heroin deaths from those due to morphine or codeine.

5. Death rates are the number of deaths in a year expressed per 100,000 of the estimated resident population.

6. Standardised death rates enable the comparison of death rates between populations with differing age structures by relating them to a standard population. As explained in the ABS publication Deaths, Australia 2001 (cat. no. 3302.0) , "there are two methods of calculating standardised death rates:
  • The direct method - this is used when the populations under study are large and the age-specific death rates are reliable. It is the overall death rate that would have prevailed in the standard population if it had experienced at each age the death rates of the population under study;
  • The indirect method - this is used when the populations under study are small and the age-specific death rates are unreliable, less stable, or not known. It is an adjustment to the crude death rate of the standard population to account for the variation between the actual number of deaths in the population under study and the number of deaths which would have occurred if the population under study had experienced the age-specific death rates of the standard population."7
    In this paper, graphs and tables indicate which method of standardisation has been used. The direct method has been used whenever standardised rates are cited in the text. For direct standardisation the 2001 Australian population has been used as the standard population. Similarly, for the indirect method of standardisation, standard rates from the 2001 Australian population have been used.

7. Year of occurrence deaths are those registered within the occurrence year and the year immediately following. While some deaths are registered many years after they occur, analysis in Australia has shown that the number of deaths registered after the second year are of little significance (less than 0.1%) and do not affect any analysis.



REFERENCES

1. Australian Bureau of Statistics (2002), Australian Social Trends, 2001, cat. no. 4102.0.

2. Australian Bureau of Statistics (2002), Drug-induced Deaths - A Guide to ABS Causes of Death Data, cat. no. 4809.0.55.001.

3. Australian Institute of Health and Welfare (2002), 2001 National Drug Strategy Household Survey: Detailed Findings (Drug Statistics Series), cat. no. PHE 14, AIHW, Canberra.

4. Topp, L et al. (2002), Australian Drug Trends 2001: Findings of the Illicit Drug Reporting System (IDRS), National Drug and Alcohol Research Centre. Executive Summary available online at URL http://ndarc.med.unsw.edu.au/ndarc.nsf/website/Publications.monographs. Accessed on 11.04. 2003.

5. Weatherburn, D et. al. (2001), 'The Australian Heroin Drought and its Implications for Drug Policy', in Crime and Justice Bulletin, Number 59, October.

6. Australian Institute of Health and Welfare (2003), Statistics on Drug Use in Australia, 2002, Cat. No. PHE 43, AIHW.

7. Australian Bureau of Statistics (2002), Deaths, Australia 2001, cat. no. 3302.0.

8. Australian Bureau of Statistics (2001), Causes of Death, Australia 2001, cat. no. 3303.0.