Changing trends in heroin-related deaths in Sydney, Australia-1995 to 1999.

This 1997-1999 study replicates an earlier one (1995-1997) in which coronial cases were reviewed at the Department of Forensic Medicine in Australia. Ten percent of the 2945 cases were considered accidental illicit drug deaths, compared to 4% in the previous study. Heroin was associated with 90% of the deaths, but in only 17% of these cases as a single drug. Concomitant drug use, in particular alcohol, benzodiazepines, and antidepressants, has increased considerably. The combined effects of these substances might play a role in the disturbingly large increase in heroin (morphine) related deaths during this period.