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Journal of Public Health Advance Access published online on October 23, 2006
Journal of Public Health, doi:10.1093/pubmed/fdl059
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© The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Article

Changes to the daily pattern of methadone-related deaths in England and Wales, 1993-2003

O. W. Morgan 1 *, H. Johnson 2, C. Rooney 3, V. Seagroatt 4, and C. Griffiths 5

1 PhD Student and Public Health Specialist Trainee, Department of Primary Care and Social Medicine, Imperial College London, London W6 8RP, UK; Mortality Statistics Branch, Office for National Statistics, London SW1V 2QQ, UK
2 Research Officer, Mortality Statistics Branch, Office for National Statistics, London SW1V 2QQ, UK
3 Medical Epidemiologist, Mortality Statistics Branch, Office for National Statistics, London SW1V 2QQ, UK
4 Statistician, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford OX3 7LF, UK
5 Principal Research Officer, Mortality Statistics Branch, Office for National Statistics, London SW1V 2QQ, UK

* To whom correspondence should be addressed.
O. W. Morgan, E-mail: omorgan{at}bigfoot.com


  Abstract

Previous studies suggest that fatal poisoning deaths involving methadone occur more frequently on the weekends. We assessed changes in the daily pattern of mortality because of methadone poisoning following a review of drug misuse services in 1996 and publication of revised clinical guidelines in 1999. We also compared this to the daily pattern of deaths involving heroin/morphine. The Office for National Statistics provided data on all deaths in England and Wales between 1993 and 2003 for which methadone and heroin/morphine were mentioned on the coroner’s certificate of death registration after inquest, with or without alcohol or other drugs. There were 3098 deaths involving methadone. The death rate increased up to 1997 and then declined. Initially, there was a marked excess of deaths occurring on Saturdays. The rate of decline was greatest for deaths occurring on Saturdays. As a result, the Saturday peak disappeared (P = 0.006). There were 6328 deaths involving heroin/morphine. No change in the daily pattern of heroin/morphine deaths was observed during the study period. Although the marked change in the epidemiology of methadone deaths coincided with recommendations for service redevelopment and clinical management of methadone treatment, the contribution of improved prescribing practice or treatment services is unclear.

Keywords: drug misuse, epidemiology, public health.
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