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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2003 Sep 1;94(5):346–350. doi: 10.1007/BF03403558

Temporal Correlation Between Opiate Seizures in East/Southeast Asia and B.C. Heroin Deaths

A Transoceanic Model of Heroin Death Risk

Mark E McLean 17,27,37,✉
PMCID: PMC6979632  PMID: 14577741

Abstract

Background

Because heroin supply changes cannot be measured directly, their impact on populations is poorly understood. British Columbia has experienced an injection drug use epidemic since the 1980s that resulted in 2,590 illicit drug deaths from 1990–1999. Since previous work indicates heroin seizures can correlate with supply and B.C. receives heroin only from Southeast Asia, this study examined B.C. heroin deaths against opiate seizures in East/Southeast Asia.

Methods

Opiate seizures in East/Southeast Asia and data from two B.C. mortality datasets containing heroin deaths were examined. The Pearson correlation coefficient for seizures against each mortality dataset was determined.

Results

Opiate seizures, all illicit drug deaths and all opiate deaths concurrently increased twice and decreased twice from 1989–1999, and all reached new peak values in 1993. Three B.C. sub-regions exhibited illicit drug deaths rate trends concurrent with the three principal datasets studied. The Pearson correlation coefficient for opiate-induced deaths against opiate seizures from 1980–1999 was R=0.915 (p<0.0001), and for illicit drug deaths against opiate seizures from 1987–1999 was R=0.896 (p<0.0001).

Conclusions

From 1980–1999, opiate seizures in East/Southeast Asia were very strongly correlated with B.C. opiate and illicit drug deaths. The number of B.C. heroin-related deaths may be strongly linked to heroin supply. Enforcement services are not effective in preventing harm caused by heroin in B.C.; therefore, Canada should examine other methods to prevent harm. The case for harm reduction is strengthened by the ineffectiveness of enforcement and the unlikelihood of imminent eradication of heroin production in Southeast Asia.

Footnotes

Acknowledgements: A draft of this paper was reviewed by Dr. Perry Kendall, B.C. Provincial Health Officer, and Dr. John Blatherwick, Medical Health Officer for the Vancouver Coastal Health Authority. Dr. McLean developed ideas for this study while employed as Associate Medical Health Officer at the Vancouver Coastal Health Authority. Data provided by organizations mentioned in the paper are gratefully acknowledged.

References

  • 1.Darke S, Zador D. Fatal heroin ‘overdose’: A review. Addiction. 1996;91:1765–72. doi: 10.1111/j.1360-0443.1996.tb03800.x. [DOI] [PubMed] [Google Scholar]
  • 2.Powis B, Strang J, Griffiths P, Taylor C, Williamson S, Fountain J, Gosop M. Self-reported overdose among injecting drug users in London: Extent and nature of the problem. Addiction. 1999;94:471–78. doi: 10.1046/j.1360-0443.1999.9444712.x. [DOI] [PubMed] [Google Scholar]
  • 3.Perucci CA, Davoli M, Rapiti E, Abeni DD, Forastieri F. Mortality of intravenous drug users in Rome: A cohort study. Am J Public Health. 1991;81:1307–10. doi: 10.2105/AJPH.81.10.1307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.McLean ME. Vancouver Drug Use Epidemiology — 2001. Vancouver, BC: Canadian Community Epidemiology Network on Drug Use; 2001. [Google Scholar]
  • 5.Single E, Rehm J, Robson L, Truong MV. The relative risks and etiologic fractions of different causes of death and disease attributable to alcohol, tobacco and illicit drug use in Canada. CMAJ. 2000;162(12):1669–75. [PMC free article] [PubMed] [Google Scholar]
  • 6.Darke S, Hall W, Weatherburn D, Lind B. Fluctuations in heroin purity and the incidence of fatal heroin overdose. Drug Alcohol Dependence. 1999;54:155–61. doi: 10.1016/S0376-8716(98)00159-8. [DOI] [PubMed] [Google Scholar]
  • 7.Ruttenber AJ, Kalter HD, Santinga P. The role of ethanol abuse in the etiology of heroin-related death. J Forensic Sci. 1990;35:891–900. [PubMed] [Google Scholar]
  • 8.Gutiérrez-Cebollada J, de la Torre R, Ortuño J, Garcés JM, Camí J. Psychotropic drug consumption and other factors associated with heroin overdose. Drug Alcohol Dependence. 1994;35:169–74. doi: 10.1016/0376-8716(94)90124-4. [DOI] [PubMed] [Google Scholar]
  • 9.Poulin C, Stein J, Butt J. Surveillance of drug overdose deaths using medical examiner data. Chron Dis Can. 1998;19:177–82. [PubMed] [Google Scholar]
  • 10.Püschel K, Teschke F, Castrup U. Etiology of accidental/unexpected overdose in drug-induced deaths. Forensic Sci Int. 1993;62:129–34. doi: 10.1016/0379-0738(93)90057-H. [DOI] [PubMed] [Google Scholar]
  • 11.Tagliaro F, De Battisti Z, Smith FP, Marigo M. Death from heroin overdose: Findings from hair analysis. Lancet. 1998;351:1923–25. doi: 10.1016/S0140-6736(97)10101-5. [DOI] [PubMed] [Google Scholar]
  • 12.United Nations Office for Drug ControlCrime Prevention. World Drug Report 2000. New York: Oxford University Press; 2000. [Google Scholar]
  • 13.Royal Canadian Mounted Police, Criminal Intelligence Directorate. Drug Situation in Canada 2001. 2002. [Google Scholar]
  • 14.Royal Canadian Mounted Police, Criminal Intelligence Directorate. Drug Situation in Canada 2000. 2001. [Google Scholar]
  • 15.Royal Canadian Mounted Police, Criminal Intelligence Directorate. Drug Situation in Canada 1999. 2000. [Google Scholar]
  • 16.Office of the Chief Coroner of British Columbia. Annual Report 1998.
  • 17.United Nations Office for Drug ControlCrime Prevention. Global Illicit Drug Trends 2001. New York: United Nations; 2001. [Google Scholar]
  • 18.Bertini G, Russo L, Cricelli F, Daraio A, Giglioli C, Pini C, et al. Role of a prehospital medical system in reducing heroin-related deaths. Crit Care Med. 1992;20:493–98. doi: 10.1097/00003246-199204000-00011. [DOI] [PubMed] [Google Scholar]
  • 19.Hall W. Reducing the toll of opioid overdose deaths in Australia. Drug Alcohol Rev. 1999;18:213–20. doi: 10.1080/09595239996662. [DOI] [Google Scholar]
  • 20.Hall WD, Degenhardt LJ, Lynskey MT. Opioid overdose mortality in Australia, 1964–1997: Birth-cohort trends. MJA. 1999;171:34–37. doi: 10.5694/j.1326-5377.1999.tb123495.x. [DOI] [PubMed] [Google Scholar]
  • 21.Strathdee SA, Patrick DM, Currie SL, Cornelisse PG, Rekart ML, Montaner JS, et al. Needle exchange is not enough: Lessons from the Vancouver injecting drug use study. AIDS. 1997;8:F59–65. doi: 10.1097/00002030-199708000-00001. [DOI] [PubMed] [Google Scholar]
  • 22.Department of Foreign AffairsInternational Trade . Canada. 2003. [Google Scholar]

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