ArticleBritish journal of clinical pharmacology2019
The relative lethal toxicity of pharmaceutical and illicit substances: A 16-year study of the Greater Newcastle Hunter Area, Australia.
Article in British journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The relative toxicity of medicines detected after poisoning suicide deaths in Australia, 2013-19: a data linkage case series study.The Medical journal of Australia · 2025Article
- Patterns of medicine use in the year prior to death by suicide: an Australian population-based case series study.EClinicalMedicine · 2024Article
- Analytically Confirmed Intentional Overdose of the Antidepressant Vortioxetine.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2024Article
- Patterns of suboptimal antipsychotic use and misuse in Australia: What can routinely collected data tell us?British journal of clinical pharmacology · 2023Article
- The Toxicity Potential of Antidepressants and Antipsychotics in Relation to Other Medication and Alcohol: A Naturalistic and Retrospective Study.Frontiers in psychiatry · 2022Article
- The impact of guidance on the supply of codeine-containing products on their use in intentional drug overdose.European journal of public health · 2021Article
- Add-On Selective Estrogen Receptor Modulators for Methadone Maintenance Treatment.Frontiers in endocrinology · 2021Article
- Attitudes and Knowledge of Australian Gastroenterologists Around the Use of Medicinal Cannabis for Inflammatory Bowel Disease.Crohn's & colitis 360 · 2020Article
- The relative lethal toxicity of pharmaceutical and illicit substances: A 16-year study of the Greater Newcastle Hunter Area, Australia.British journal of clinical pharmacology · 2019Article
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5 authors.
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Abstract
aimsWe aim to calculate 2 metrics of relative lethal toxicity; the fatal toxicity index (FTI; number of deaths per year of a daily dose) and the case fatality (CF; number of deaths per overdose) with a focus on opioids, antidepressants, antipsychotics, benzodiazepines and illicit drugs.
methodsThis descriptive cohort study used the Australian National Coronial Information System (NCIS) to identify a population of individuals with drug-associated deaths in the Greater Newcastle Hunter Area between January 2002 and December 2016. This was combined with Australian medicine dispensing data and corresponding data from the Hunter Area Toxicology Service to calculate FTI and CF.
resultsThere were 444 drug-related deaths and 21,296 overdoses during the study period. FTI and CF were well correlated (Spearman's rho 0.64, P < .001). Of the classes of interest, opioids had the highest FTI (40.3 95% confidence interval [CI] 35.2-45.4 deaths per 100 years of use at the defined daily dose or deaths/DDD/100 years) and CF (12.4% 95%CI 11.0-13.9). Fentanyl, methadone and morphine had the highest relative fatal toxicity within this class. Tricyclic antidepressants had the highest relative fatal toxicity of all antidepressants (FTI 14.5 95%CI 9.7-19.3 deaths/DDD/100 years and CF 7.1% [95%CI 4.8-9.3]) and benzodiazepines appeared to be more associated with multiple agent deaths than single. Of the illicit drugs, heroin had the highest CF (26.4%, 95%CI 19.1-33.7).
conclusionKnowledge of relative lethal toxicity is useful to prescribers and medicines and public health policy makers in restricting access to more toxic drugs and may also assist coroners in determining cause of death.
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