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Occasional Paper

Annex A

Additional notes on the new baseline definition

1. Compound analgesics: Where a drug listed under the Misuse of Drugs Act was present because it was part of a compound analgesic or cold remedy it has been ignored. Specific examples are:

Co-proxamol:     paracetamol, dextropropoxyphene

Co-dydramol:     paracetamol, dihydrocodeine

Co-codamol:      paracetamol, codeine sulphate

All three of these compound analgesics, but particularly Co-proxamol, are commonly used in suicidal overdoses.

As it is believed that dextropropoxyphene is rarely if ever available other than as a constituent of a paracetamol compound, it has been ignored on all occasions (even if there is no mention of a compound analgesic or paracetamol). However deaths involving codeine or dihydrocodeine without mention of paracetamol have been included in the baseline as these drugs are routinely available on their own and known to be abused in this form.

2. Contaminated heroin: Deaths resulting from the injection of contaminated heroin have been excluded. It had originally been intended to include such deaths in the baseline but there are possible problems of coverage. In Scotland GROS tried to identify all the cases associated with the outbreak in 2000 caused by clostridium novyi infection; 22 cases had been identified when the 2000 deaths file was closed in May 2001, but it is not clear whether additional deaths have subsequently been identified as part of this outbreak which is now the subject of a public inquiry. Moreover it is not clear whether sporadic cases, either in the past or in the future, could be readily identified. The geographical distribution of the 22 cases identified on the GROS database was as follows: Greater Glasgow, 18; Grampian, 2; Fife, 1; Lanarkshire, 1.