ABSTRACT
The last complete report issued by the Drug Abuse Warning Network (DAWN) listed 8295 narcotic analgesic-related deaths as having occurred in 1999, amounting to a 49% increase from the 3403 narcotic-related deaths reported in 1990 (Kissin et al., 2000). In 2003 DAWN methodology was radically altered, so that the U.S. government no longer provides meaningful statistics on the consequences of drug abuse. Still, two trends seem to be emerging: heroin toxicity continues to account for thousands of narcotic-related deaths every year, and the illicit supply of high-quality heroin (and other synthetic narcotics) is increasing at an astonishing rate. Epidemiologic data compiled separately from DAWN demonstrate that between 1999 and 2002 the number of deaths due to poisoning from opioid analgesics, surpassed the number of deaths attributable to heroin and cocaine (Paulozzi et al., 2006). Nearly half of the opioid deaths and much of the morbidity were attributable to semisynthetic drugs such as oxycodone and hydrocodone, although mentions of heroin still remain 10 times more common than deaths from the synthetics, and these continue to rise(Anon., 2005). Approximately one third of the deaths reported in 2006 were due to methadone, and 13% from other synthetic opioids such as fentanyl (Compton and Volkow, 2006). In 1999, nearly 5000 deaths per year were being reported to the old version of DAWN. That number is unlikely to be lower now than it was in the past. Given the developments in Southwest Asia, the number is likely to rise drastically, if not in the U.S., then in Europe.
