Introduction

In this chapter we examine the epidemiology of illicit drug-related death. Specifically, this chapter presents rates of mortality amongst illicit drug users from all causes, the demography of cases, and the associated risk factors. As any discussion of illicit drug-related mortality must necessarily discuss the issues surrounding the estimation of drug-related mortality, they are examined first. Rates of death due to specific causes will be examined in subsequent chapters, as will the specific factors associated with these causes.

Problems in estimating mortality

A number of problems arise when attempting to estimate global mortality attributable to illicit drug use (cf. Degenhardt et al., 2004a). Part of the problem arises from the very fact that the drugs in question are illicit, and that these deaths thus occur amongst “hidden” populations. Whilst a death may be attributable to illicit drug use, the use of these drugs may well have been concealed by the individual. As such, the link to illicit drug use may not be formally recognised as the cause of death, or as a factor associated with the death. A good example is the completed suicide of an illicit drug user, an issue addressed in detail in a later chapter. If the suicide method is by means of an illicit drug overdose, then the death will be clearly attributable to illicit drug use.