Problematic use of alcohol and psychoactive drugs is an important risk factor for decreased disability-adjusted life years, and early death. In Norway, 324 overdose deaths occurred in 2020. The annual number of overdoses has not reached 300 in Norway since 2004, with 304 deaths that year. It was 411 overdose deaths in Norway in 2001, and 312 in 2002. The death rate was 8.6/100 000 in 2001 and 6.1/100 000 in 2020. In the period from 2010 to 2020, the mean annual number has been approximately 271 with a death rate of 5.2/100 000. Morphine-like painkillers, opioids, are involved in approximately 80-90% of overdose deaths and roughly 50 000 people died from opioid overdoses in the United States of America in 2019, which was more than double the situation in 2010. Fentanyl and fentanyl analogues are involved in most of these deaths.
Our research data regarding overdose deaths is to a large extent, based on coupling of data between the Norwegian Cause of Death Registry (NoCDR) and the forensic toxicology database of Oslo University Hospital from autopsy cases, and provides information about the cause of death and drug findings in biological samples taken at autopsy. Combining these registries, we can identify which substances that contributed to the poisoning and the death. This is important to reveal the specific drug responsible/contributing to death, since poly-drug use often are seen in such cases. NoCDR does not contain cause of death codes for all individual substances, but so-called aggregated codes in the vast majority of cases, therefore, detailed information are provided with the forensic toxicology data. In order to investigate the trends of individual substances over time, forensic toxicological findings in addition to the cause of death are essential. Knowledge of which substances that contribute to fatal overdoses is important from a prevention perspective.
The overall aims in overdose research are to identify risk factors for death, and more specified aims are:
- To identify which drugs that contributed to drug related deaths in Norway, with focus on changes in prevalence with age, sex and death year (time trends)
- To identify associations between contact with the health care service, the ambulance service, disease and drug-related deaths
- To identify associations between medically or illegal acquired drug use, disease and death, and if certain drugs cause a higher number of deaths related to prescription use than other medical drugs
- To identify differences regarding drug findings and concentrations between non-fatal opioid overdoses and fatal opioid overdoses
Overdose research at Department of Forensic Sciences, OUH, is a permanent assignment based on funding from the Ministry of Health and Care Services. In addition, the Norwegian Directorate of Health has provided funding on targeted overdose research projects.
Drug related deaths in a large registry based study
The basic overdose research utilises data from NoCDR and the forensic toxicology database of Oslo University Hospital which identifies which drugs and drug concentrations that are present in deceased with different underlying cause of death. In order to provide more information about overdose deaths, this project will collect data from several health registries to provide data on diagnosis and contact with the health care services prior to death. Furthermore, coupling of data with the Norwegian Prescription Database (NorPD) provides data on whether the detected drugs were obtained through a valid prescription, or illegal use.
This project will also include a control group based on extraction from the National Population Register in order to identify which factors that actually increases the risk of overdose death.
- Overdoses in the Nordic Countries 1984/85, 2007, 2012, 2017
- Opioid related deaths in Norway 2000-2017
- Overdoses in patients receiving opioid maintenance treatment
- GHB-, fentanyl- and oxycodone related deaths
- Opioid related deaths 2000-2019
- MDMA related deaths
- Non-fatal overdoses
- Hilde Marie Erøy Edvardsen (Scientist, PhD)
- Vigdis Vindenes (Section Manager, PhD)
- Stig Tore Bogstrand (Professor, Head of Research, PhD)
- Torill Tverborgvik (PhD)
- Per Trygve Normann (PhD)
- Svetlana Konstantinova-Larsen (PhD)
- Asbjørg S. Christophersen (Prof. em.)
- Thomas Clausen (Professor), Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway
- Svetlana Skurtveit (Professor), Norwegian Institute of Public Health, Oslo, Norway; University of Oslo, Oslo, Norway
- Eline Borger Rognli (Senior Scientist), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Kirsten Wiese Simonsen (Forensic Chemist, PhD), Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Pirkko Kriikku (Forensic Toxicologist, PhD), Forensic Toxicology Unit, Finnish Institute for Health and Welfare; Department of Forensic Medicine, University of Helsinki, Helsinki, Finland.
- Gunilla Thelander (Chemist), Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Svava Thordardottir (Senior Researcher), Department of Pharmacology and Toxicology, University of Iceland, Reykjavik, Iceland.
- Charlotte Uggerhøj Andersen (MD, PhD), Department of Forensic Medicine, University of Aarhus, Aarhus, Denmark.
- Anna Jönsson (Forensic Toxicologist), Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
- Joachim Frost (Associate Professor), Department of Clinical Pharmacology, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway.
- Dorte Christoffersen (Head of Section, PhD), Section of Forensic Toxicology, Departmen of Forensic Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
- Gerd Jorunn Møller Delaveris (Head of Section, PhD), Department of Forensic Sciences, Oslo University Hospital, Oslo Norway; Institute of Forensic Medicine, University of Oslo, Oslo, Norway.
- Ilkka Ojanperä (Professor), Department of Forensic Medicine, University of Helsinki, Helsinki, Finland; Forensic Toxicology Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Press and Media Reports
- Heroinoverdoser – hva skjuler seg bak tallene? Er det rene heroinoverdoser som tar liv i Norge?
- Obduksjon avslører trender i rus- og legemiddelinntaket vårt
- Kommer opioidepidemien til Norge?
- FENTANYLDERIVATER – EN NY OG FARLIG RUSGIFTTREND
- Flere i Norge dør med MDMA i blodet (forskning.no)
If you have questions about the project or suggestions for research collaboration, please contact: Hilde Erøy Edvardsen (email@example.com) at the Department of Forensic Sciences, Section of Drug Abuse Research, Oslo University Hospital, Oslo, Norway.
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Concentrations of psychoactive substances in blood samples from non-fatal and fatal opioid overdoses
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Deaths associated with MDMA in the period 2000-2019
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Opioid related deaths in Norway in 2000-2019
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