DEATHS : DUE TO DRUGS

Drug dependence is characterized as a chronic disease with many relapses. Substitution maintenance therapy with methadone or buprenorphine improves the health and social performance of opioid-dependent people and decreases the use of illicit drugs and the crime rate. Statistics show that investment in prevention pays off well: every dollar invested in drug treatment saves seven dollars in health and social costs.

Dextropropoxyphene is a synthetic weak opioid used as analgesic both as standalone as well as in combination with acetaminophen for more than 50 years. Ministry of Health and Family Welfare, Government of India has issued a gazette notification (dated May 23, 2013) suspending the manufacture, sale, and distribution of dextropropoxyphene and formulations containing dextropropoxyphene in the country.

Overdose related deaths including suicide

Concerns have been expressed regarding the extent of fatal self-poisoning with dextropropoxyphene/acetaminophen combination in some countries including England and USA. A combination of dextropropoxyphene/acetaminophen was reported to be single drug used most frequently for suicide in England and Wales for the period 1997-1999. It was responsible for 766 deaths over the 3-year period. Additionally, it was implicated in a fifth of all drug poisoning suicides. Reports of concern about dextropropoxyphene poisoning have been cited as a matter of concern from other nations including Australia, New Zealand, Sweden, and the USA.

Death following overdose due to this combination has been attributed to the toxic effects of high levels of dextropropoxyphene on respiration and cardiac conduction .It has been stated that there is a relatively narrow margin between therapeutic and potentially lethal concentrations for this drug. Also, concerns have been raised about possible underestimation of accidental deaths due to dextropropoxyphene.

The United Nation's latest report on drug use revealed a 30 per cent increase on 2009 with regards to the consumption of narcotics with some 35 million people worldwide suffering from drug disorders, thanks to in-depth surveys conducted in India and Nigeria.

The UN has raised the alarm on the need for further international cooperation to deal with the health and criminal impact of substance misuse, the Efe news reported."

"The findings of this'year's World Drug Report fill in and further complicate the global picture of drug challenges, underscoring the need for broader international cooperation to advance balanced and integrated health and criminal justice responses to supply and de"and," Yury Fedotov, Executive Director of the UN's Office on Drugs and Crime (UNODC), said.

The surveys in India in 2018 and Nigeria in 2017 have offered great insights into drug consumption due to being such vast demographics for their region. India accounts for 30 per cent of the population in Asia alone.

The Indian survey was based on interviews with 5,00,000 people across the nation.

The studies have contributed to more accurate figures of drug use globally.

The report estimated that of the 271 million people that used any drug, 35 million (nearly 13 per cent) suffer from a drug use disorder.

Previous records fell 4.5 million people short in their estimates and it was the surveys conducted in both India and Nigeria that triggered the adjustment.

The death toll also increased, with 5,85,000 people dying in 2017 from drug use.

Cannabis consumption, the most widely used drug globally with approximately 188 million users in 2016, has increased in Asia and North and South America, whilst a spike in use of opioids was registered.

Opioids are the drugs that present the largest cause for concern due to the severe impact on the health of users.