The Netherlands Drug Situation 2010 - Trimbos-instituut

12 Mortality related to drug use: a comprehensiveapproach and public health implications12.1 Overall mortality among problem drug usersThe total overall mortality among drug users consists of three parts: mortality that is notrelated to drugs (base-rate mortality), mortality that is directly related to drugs, andmortality that is indirectly related to drugs. For the Netherlands, information about thetotal mortality among problem opiates users comes available from a mortality cohortstudy in Amsterdam. This information can be combined with information from the GeneralMortality Register (Causes of Death Statistics) to estimate the total opiates-relatedmortality in the Netherlands. Since 2003, the mortality figures from the cohort study inAmsterdam show a stabilizing downward trend. For the Netherlands as a whole, it is estimatedthat, in 2008, there were about 200 deaths that directly or indirectly were relatedto opiates.Overall mortality among drug users in AmsterdamEach year the Municipal Health Service Amsterdam (GGD Amsterdam) traces drugrelateddeaths by combining data from the Central Methadone Register, the municipalregistrar’s office, the municipal coroners, hospital records, and the police. Data on fatalpoisonings ('overdoses') from the Amsterdam coroners also include tourists and drugusers that stay illegally in the Netherlands and are therefore not included in the PopulationRegistry. The regular General Mortality Register (GMR), on the contrary, only includesresidents of the Netherlands who are recorded in the Population Registry. Moreover,in addition to direct deaths (or ‘overdoses’), the Amsterdam registration also includesmortality cases that are indirectly related to drugs. Figure 12.1.1 gives the numberof deaths that were found according to this procedure among the drug users in Amsterdam(ST18_2010_NL_01).179