Mortality Related to Drug Use in Germany, 2011

"The reliability of information on drug-induced deaths strongly depends on the question as to whether autopsies and toxicological examinations have been used to validate the initial classification as drug-induced death or not (cf. chapter 6.1). The autopsy rate of all drug-induced deaths in the reporting year 2011 was on average at 65% (2010: 66%; 2009: 66%), whereby individual Laender considerably diverged from this value either upwards or downwards (minimum: 35%; maximum 100%).
"In the year 2011, a total of 986 people died because of the use of illicit drugs which corresponds to a decline of 20 percent in comparison with the previous year (1,237) and the lowest level for the number of drug-related deaths since 1988. Overdose of heroin (including use of heroin in connection with other drugs) remains with 569 cases the most common cause of death (58%; 2010: 69%; 2009: 70%). The portion of drug-related deaths in which substitution substances alone or in combination with other drugs were detected, was at 22% (2010: 14%; 2009: 13%) and thus slightly up in comparison with recent years, however it is still lower than 2002, as this proportion was at 40%. Since 2006, the statistics of the federal criminal police office discriminate in the detected substitution substances between methadone/polamidone and Subutex® (buprenorphine). According to the BKA data, the majority of death cases that were attributable to one substitution substance alone happened in connection with methadone/polamidone (N=51; 96%). Among the 160 cases of death, in which substitution drugs in combination with other drugs were found, there were also two cases in which buprenorphine was detected¹⁰⁸ (see also Table 6.2) (BKA [Bundeskriminalamt (Federal Criminal Police Office)] 2012b).
"Generally, it is however to be assumed that in the presentation of the involvement of substances in the recorded deaths, the number of mixed intoxications (combination categories) but also the involvement of substitution substances is underestimated due to frequently missing exact toxicological data on a death case."