Unintentional and intentional drug poisoning deaths, Australia, 2012–2016: Drug pattern profile and demographic characteristics

Abstract Background Identifying differences in unintentional versus intentional drug poisoning deaths can inform targeted prevention. This study aimed to: compare unintentional versus intentional drug poisoning deaths by drug involvement, age and sex; describe patterns of drug involvement by intent; and describe common drug patterns by age and sex. Methods Cases comprised deaths among Australians aged ≥15 where drug poisoning was the underlying cause (Cause of Death Unit Record File 2012–2016). Sex, age, and drug involvement were analysed by intent using logistic regression. Results Of 7994 deaths, 71% were unintentional and 24% intentional. Compared with unintentional deaths, intentional deaths were more likely among females (OR 1.31 [95% CI 1.16–1.48]) and those aged 55+ (1.50 [1.25–1.81] for 55–64 years; 3.79 [3.07–4.66] for 65+ years, compared to 35–44 years), and were more likely to involve hypnosedatives (2.11 [1.87–2.39]), other psychotropic medicines (1.58 [1.39–1.78]), non-opioid analgesics and anaesthetics (1.48 [1.25–1.73]). Common unintentional profiles comprised: opioids (excluding heroin); heroin; alcohol; opioids with hypnosedatives; opioids with hypnosedatives and other psychotropic medicines; stimulants; other psychotropic medicines; and opioids with other psychotropic medicines. Unintentional deaths involving heroin or stimulants only had a greater proportion of males (79.0% and 83.4%, respectively) and younger individuals aged 15–34 (30.3% and 39.5%, respectively). Common intentional profiles comprised: hypnosedatives; other psychotropic medicines; opioids (excluding heroin); hypnosedatives with other psychotropic medicines; opioids with hypnosedatives; and opioids with hypnosedatives and other psychotropic medicines. Conclusion The demographic and drug involvement profile of intentional and unintentional deaths were distinct, suggesting different approaches to prevention are necessary.