Poisoning by pharmaceuticals
This section provides:
- a summary of all poisoning deaths involving pharmaceuticals in 2016–17 that are identifiable in the deaths data
- a summary of unintentional poisoning deaths involving pharmaceuticals in 2016–17
- a description of trends in unintentional poisoning deaths involving pharmaceuticals from 1999–00 to 2016–17.
This section includes unintentional deaths due to poisoning by medications intended to treat various health conditions. This includes medications prescribed for a particular individual by a medical practitioner, as well as medications obtained through other means, such as medications prescribed for another person or the illegal purchase of pharmaceutical medications from a website that does not require a prescription. Also included are unintentional deaths due to poisoning by illicit drugs, such as heroin and cocaine.
What methods were used?
The criteria given in Section 1.3 were applied, and records that included the following ICD-10 codes were included in this section:
- the UCoD was Unintentional poisoning by pharmaceuticals (X40–X44)
- the MCoDs included codes for Unintentional poisoning by pharmaceuticals (X40–X44) and for Injury (S00–T75 or T79)
- the MCoDs included codes for Toxic effects of pharmaceuticals (T36–T50) and for Unintended external cause of injury (V01–X59).
Suicide and homicide deaths (UCoD X60–Y09) were excluded. The concepts underlying the abbreviations used in this section are defined in the Glossary.
Relevant terms and information about the data used in this section are summarised in boxes 1.1, 1.2, 1.3 and 5.1. Further information on methods is provided in Appendix A.
Box 5.1: External causes of poisoning by pharmaceuticals
Accidental poisoning by and exposure to noxious substances (X40–X49) is the subject of a section of Chapter XX External causes of morbidity and mortality of ICD-10. The first 5 categories in this section refer to poisoning by, and exposure to, drugs, medicaments, and biological substances (X40–X44):
- Accidental poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics (X40)
- Accidental poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified (X41)
- Accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified (X42)
- Accidental poisoning by and exposure to other drugs acting on the autonomic nervous system (X43)
- Accidental poisoning by and exposure to other and unspecified drugs, medicaments and biological substances (X44).
Overview of poisoning by pharmaceuticals deaths
In 2016–17, unintentional poisoning deaths involving pharmaceuticals accounted for 69% of all poisoning by drugs deaths (Table 5.1). Those reported as Intentional self-harm by drug poisoning, Assault by drug poisoning, and Drug poisoning, undetermined intent are not included in this section.
Counts of deaths involving poisoning by pharmaceuticals included in this report will differ from those published by the ABS. This is because the ABS selects cases only on the basis of UCoD codes, and includes codes for mental and behavioural disorders (F11–F16, F19) and for Abuse of non-dependence-producing substances (F55).
Table 5.1: All identifiable poisoning deaths involving pharmaceuticals, 2016–17
|
Terminology in this report |
Coverage in this report | ICD-10 codes | Number | % |
|---|---|---|---|---|
|
Unintentional poisoning by drugs |
Poisoning by pharmaceuticals |
UCoD X40–X44; or MCoD X40–X44 and S00–T75, T79; or MCoD V01–X59 and T36–T50 |
1,391 |
69.2 |
| Intentional self-harm by drug poisoning | Suicide | UCoD X60–X64; or MCoD X60–X64 and S00–T75, T79 | 535 | 26.6 |
| Assault by drug poisoning | Homicide | UCoD X85; or MCoD X85 and S00–T75, T79 | 4 | 0.2 |
| Drug poisoning, undetermined intent | Undetermined intent | UCoD Y10–Y14; or MCoD Y10–Y14 and S00–T75, T79 | 81 | 4.0 |
| Total deaths involving poisoning by drugs | 2,011 | 100.0 | ||
Source: AIHW NMD.
How many deaths in 2016–17 were due to unintentional poisoning involving pharmaceuticals?
Unintentional poisoning involving pharmaceuticals accounted for 1,391 injury deaths, 10.6% of all injury deaths for this period (Table 5.2). About twice as many males as females died as a result of unintentional poisoning involving pharmaceuticals.
Table 5.2: Key indicators for unintentional poisoning deaths involving pharmaceuticals, by sex, 2016–17
|
Indicator |
Males |
Females | Persons |
|---|---|---|---|
|
Number |
965 |
426 |
1,391 |
| Percentage of all injury deaths | 12.2 | 8.2 | 10.6 |
| Crude rate (deaths per 100,000 population) | 8.0 | 3.5 | 5.7 |
| Age-standardised rate (deaths per 100,000 population) | 8.3 | 3.4 | 5.9 |
Source: AIHW NMD.
People aged 25–44 (50%) and 45–64 (39%) were the most likely to die from unintentional poisoning involving pharmaceuticals (Table 5.3). In comparison, 20% and 19% of all injury deaths occurred at these ages.
The proportion of deaths within each age group was higher for males than for females in those aged 15–24 and 25–44 but were higher for females than males among those aged 45–64 and 65 and over.
Table 5.3: Unintentional poisoning deaths involving pharmaceuticals, by age and sex, 2016–17
|
Age group |
Males | Females | Persons | |||
|---|---|---|---|---|---|---|
| Number | % | Number | % | Number | % | |
|
0–4 |
1 | 0.1 | 1 | 0.2 | 2 | 0.1 |
|
5–14 |
2 | 0.2 | 0 | 0.0 | 2 | 0.1 |
|
15–24 |
47 | 4.9 | 9 | 2.1 | 56 | 4.0 |
|
25–44 |
520 | 53.9 | 169 | 39.7 | 689 | 49.5 |
|
45–64 |
345 | 35.8 | 194 | 45.5 | 539 | 38.7 |
|
65+ |
50 | 5.2 | 53 | 12.4 | 103 | 7.4 |
|
Total |
965 | 100.0 | 426 | 100.0 | 1,391 | 100.0 |
Source: AIHW NMD.
State or territory of usual residence
The age-standardised rate for unintentional poisoning deaths involving pharmaceuticals was highest for residents of Western Australia (7.7 deaths per 100,000 population) and New South Wales (6.3 per 100,000) (Table 5.4). Residents of the Northern Territory recorded the lowest rate of all jurisdictions, with 3.1 deaths per 100,000 population.
Table 5.4: Unintentional poisoning deaths involving pharmaceuticals, by state/territory of usual residence, 2016–17
|
Indicator |
State/territory of usual residence | |||||||
|---|---|---|---|---|---|---|---|---|
| NSW | VIC | QLD | WA | SA | TAS | ACT | NT | |
|
Number |
483 |
349 | 235 | 192 | 78 | 26 | 20 | 8 |
|
% |
34.7 |
25.1 | 16.9 | 13.8 | 5.6 | 1.9 | 1.4 | 0.6 |
|
Age-standardised rate |
6.3 |
5.7 | 5.0 | 7.7 | 4.8 | 5.1 | 4.8 | 3.1 |
Source: AIHW NMD.
Remoteness of usual residence
The number and age-standardised rate of unintentional poisoning deaths involving pharmaceuticals declined with increasing remoteness of usual place of residence (Table 5.5).
Rates for residents of Inner regional areas (6.6 deaths per 100,000 population) were above the national rate of 5.9 deaths per 100,000 population, while residents of the Remote and very remote areas recorded a combined rate of 2.5 deaths per 100,000 population, which was less than half the rate of the other remoteness areas.
Numbers in Remote and very remote areas have generally been small in the previous reports in this series, with the rate for residents of Remote areas being about 1.5–2 times as high as for residents of Very remote areas.
Table 5.5: Unintentional poisoning deaths involving pharmaceuticals, by remoteness of usual residence, 2016–17
| Indicators | Remoteness of usual residence(b) | |||
|---|---|---|---|---|
| Major cities | Inner regional | Outer regional | Remote/ Very remote |
|
|
Number(a) |
998 |
259 | 106 | 12 |
|
% |
72.5 |
18.8 | 7.7 | 0.9 |
|
Age-standardised rate |
5.8 |
6.6 | 5.3 | 2.5 |
Notes:
- Excludes 16 deaths where remoteness was not reported.
- Derived using the Australian Statistical Geography Standard (ASGS) classification.
Source: AIHW NMD.
Socioeconomic area
The age-standardised rate for unintentional poisoning deaths involving pharmaceuticals generally rose with increasing disadvantage (Table 5.6). The highest rate was among people living in the lowest socioeconomic areas (7.6 deaths per 100,000 population), which was twice as high as the rate for people living in the highest socioeconomic areas (3.8 per 100,000).
Table 5.6: Unintentional poisoning deaths involving pharmaceuticals, by socioeconomic area, 2016–17
|
Indicator |
Socioeconomic area | ||||
|---|---|---|---|---|---|
| 1—lowest | 2 | 3 | 4 | 5—highest | |
|
Number |
342 |
295 | 257 | 297 | 184 |
|
% |
24.6 |
21.2 | 18.5 | 21.4 | 13.2 |
|
Age-standardised rate |
7.6 |
6.3 | 5.4 | 6.1 | 3.8 |
Note: Excludes 16 deaths where socioeconomic area was not reported.
Source: AIHW NMD.
Aboriginal and Torres Strait Islander people
The age-standardised rate of unintentional poisoning deaths involving pharmaceuticals for Aboriginal and Torres Strait Islander people was 2.6 times the rate for non-Indigenous Australians (Table 5.7).
Table 5.7: Key indicators for unintentional poisoning deaths involving pharmaceuticals, by Indigenous status and sex, 2016–17
|
Indicator |
Indigenous |
Non-Indigenous | ||||
|---|---|---|---|---|---|---|
| Males | Females | Persons | Males | Females | Persons | |
| Number |
49 |
27 | 7.6 | 608 | 283 | 891 |
| Age-standardised rate (deaths per 100,000 population) |
18.9 |
10.2 | 14.4 | 7.7 | 3.3 | 5.5 |
|
Rate ratio(a) |
2.5 |
3.1 | 2.6 | . . | . . | . . |
| Rate difference(b) |
11.2 |
6.9 | 8.9 | . . | . . | . . |
Notes:
- Rate ratios are standardised rates for Indigenous males, females, and persons, divided by standardised rates for non-Indigenous males, females, and persons.
- Rate differences are standardised rates for Indigenous males, females, and persons, minus standardised rates for non-Indigenous males, females, and persons.
Includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory (see Box 1.2).
Source: AIHW NMD.