Narcotics at street level in Denmark. A prospective investigation from 1995 to 2000.

This article describes an investigation of illicit drugs at street level in six selected police districts in different regions of Denmark. The investigation was carried out during a 6-year period from 1995 to 2000. During the period, a total of 1244 samples were examined, as about 200 samples were seized each year. A total of 94% of the seized samples were familiar drugs: heroin base, heroin hydrochloride, cocaine hydrochloride and amphetamine sulphate. Only 2% of the samples contained designer drugs. From having constituted 53% of the samples in 1995, the frequency of heroin base fell during the period to 27% of the samples in 2000. The frequency of heroin hydrochloride was unchanged. In the same period, the frequency of cocaine hydrochloride increased from 10% of the samples in 1995 to about 25% of the samples in 2000. Apart from a few exceptions, cocaine had the same extension in all regions of Denmark after 1996. Amphetamine was more frequent in the west of Denmark, while heroin hydrochloride was more frequent in central Denmark. The purity of heroin base was lower in the period 1997-1999 than in the other years. During the entire period, the purity of cocaine hydrochloride and amphetamine sulphate fell, while the purity of heroin hydrochloride was unchanged. No significant differences between the various regions of Denmark were detected during the period in the purity of heroin hydrochloride, heroin base, cocaine hydrochloride or amphetamine sulphate. MDMA was the most frequent designer drug, but other types of designer drugs such as MDA and MDE and the less common PMA, PMMA and MBDB were also found.

Fatal poisoning in drug addicts in the Nordic countries.

The study includes medicolegally examined fatal poisonings among drug addicts in 1997 in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden, and the results are compared to a similar investigation from 1991. A common definition of "drug addict" was applied by the participating countries. The highest death rate by poisoning in drug addicts was observed in Denmark, where it was 6.54 per 10(5)inhabitants, followed by Norway with 6.35, Sweden with 2.21, Finland with 1.63 and Iceland with 1.20 per 10(5)inhabitants. All countries showed a higher death rate in 1997 than in 1991. For all countries the distribution of deaths according to geographical regions showed a decreasing number of drug deaths in the metropolitan area and an increasing number in other cities. Heroin/morphine dominated as the cause of death and was responsible for about 90% of the cases in Norway. In Sweden and Denmark, however, heroin/morphine caused only about 70% of the fatal poisonings. About 30% of the fatal poisonings in Denmark and Sweden were caused by other group I drugs, in Denmark mainly methadone and in Sweden mainly propoxyphene. Apart from two cases in Sweden methadone deaths were not seen in the other Nordic countries. In Finland heroin/morphine deaths have increased from about 10% in 1991 to about 40% in 1997. Forty-four percent of the fatal poisonings in Finland were caused by other group I drugs, mainly codeine and propoxyphene. The two fatal poisonings in Iceland were caused by carbon monoxide. Only few deaths in this investigation were caused by amphetamine and cocaine. A widespread use of alcohol, cannabis and benzodiazepines, especially diazepam, was seen in all the countries.

[Designer drugs in Jutland]. / Designerdrugs i Jylland.

INTRODUCTION: The aim of this investigation was to examine illegal tablets and capsules seized in Jutland, the western part of Denmark, during the period 1995-1999. The drugs are described according to technical appearance (colour, logo, score, diameter) and content of synthetic drugs. MATERIAL AND METHODS: All illegal tablets and capsules received during the period 1995-1999 (109 cases containing 192 different samples) were examined. RESULTS: MDMA was the most common drug and was seen during the entire period. Amphetamine was the second most common drug and has been frequently detected during the the last two years. Drugs like MDE, MBDB, BDB, and 2-CB were rarely seen and they disappeared quickly from the illegal market. MDA appeared on the market at the end of 1999. Only 53% of the tablets contained MDMA as the sole drug. Eighty-one percent of the tablets/capsules contained only one synthetic drug, whereas 13% contained a mixture of two or more synthetic drugs. Six per cent of the samples did not contain a euphoric drug/designer drug. The content of MDMA, MDE, and amphetamine in the tablets varied greatly. DISCUSSION: MDMA is apparently the drug preferred by the users, but still only half of the tablets contained MDMA as the only drug. The rest of the tablets contained either another synthetic drug or a mixture of drugs. In conclusion, the increasing supply of various drugs with different and unpredictable effects and of miscellaneous quality brings about the risk of serious and complicated intoxications.

[Fatal intoxications among drug addicts in Denmark in 1997]. / Forgiftningsdødsfald blandt narkomaner i Danmark i 1997.

INTRODUCTION: The purpose of this study was to investigate fatal poisonings among drug addicts in 1997 and to compare the results to similar investigations from 1985 and 1991. MATERIAL AND METHODS: All fatal intoxications among drug addicts in Denmark in 1997, investigated at the three Institutes of Forensic Medicine in Denmark. RESULTS: The number of fatal intoxications increased by 32% from 1991 to 1997, mainly outside the metropolitan area, The average age increased from 32 to 36 years. The proportion of heroin/morphine intoxications increased from 57% to 71%. The most commonly used drugs were as in 1991 heroin/morphine, diazepam and methadone. The frequency of cocaine increased from one positive case in 1991 to 14% positive cases in 1997. DISCUSSION: This study showed an increasing number of fatal intoxications and changes in drug abuse pattern and place of death since 1991.

[The illicit drug market in Aarhus. I. Supply]. / Det illegale stofmarked i Arhus. I. Udbud.

Drugs (n = 2240) seized on the illicit drug market in the Aarhus Police District during the period 1.1.1992-31.12.1993 are described with regard to weight, identity, purity and distribution. This article dealing with drugs together with the article dealing with the "actors" are reviews of results published in book form (English summary) (1). Two thirds of the samples were cannabis, mainly hash. Medical prescription drugs, mainly benzodiazepines, constituted 11% of the samples. Amphetamine was found in 9% of the samples and heroin in 8%. Cocaine and other euphoriants were each found in less than 1% of the samples. The purity of all types of drugs varied greatly during the study period, good and poor quality drugs being available on the market at the same time. No difference was found between the purity of drugs in user packages and that of drugs in large packages. Most batches were on the market only for a brief period of time. It is concluded that it is difficult for users to obtain the same quality of a substance each time.

[The illicit drug market in Aarhus. II. Actors]. / Det illegale stofmarked i Arhus. II. Aktører.

People (n = 823) from whom drugs were confiscated by the police during the period 01.01.1992-31.12.1993 are characterized with regard to sex, age, nationality, other criminal offences etc. The data were obtained from the Central Criminal Register, the database of the National Drugs Intelligence Unit and the Danish Board of Health methadone list. Seven hundred and fifty men and 73 women were charged with drug offences in Aarhus during the two-year period. Fifty of these were foreign nationals. Almost all of the suspects were drug abusers. Ten percent of the people in the study were on methadone treatment at the time of confiscation. Sixty percent were categorized as users of cannabis only, 16% used heroin, 16% stimulants, and 7% medical drugs. Almost all of the suspects in the study were registered for offences other than drug offences (mainly theft and burglary). It is concluded that a substantial number of drug addicts in methadone treatment were found in possession of illicit drugs, and that most of the people charged with drug offences had previously been charged with other criminal offences.

Fatal poisonings in young drug addicts in the Nordic countries: a comparison between 1984-1985 and 1991.

Fatal poisonings among young drug addicts (15-34 years) in the five Nordic countries, Denmark, Finland, Iceland, Norway and Sweden in 1991 were investigated and compared to a similar investigation for 1984-1985 (Sweden for 1984 only). A common definition of 'drug addict' has been applied by the participating countries. In both investigations, the greatest number of drug addict deaths was seen in Denmark calculated per 10(5) inhabitants, followed in descending order by Norway, Sweden, Finland and Iceland. An increased number of deaths was observed from 1984-1985 to 1991 in all five countries. The increase in Denmark and Sweden was small while the number of deaths was more than doubled in Norway and Finland. The increased number of cases in Norway and Sweden in 1991 is mainly due to a greater number of deaths in the age group 25-34 years. In Finland, the increased number was seen mainly in the age group 15-24 years. In the two investigations heroin/morphine caused most of the fatal poisonings in Norway and Sweden. In Denmark, heroin/morphine caused about half of the fatal poisonings only, and strong analgesics other than heroin/morphine caused about one third of the deaths. In 1984-1985 it was methadone, propoxyphene and ketobemidone and in 1991 mostly methadone. The number of heroin/morphine related deaths in Finland increased from 1984-1985 to 1991, but other drugs and poisons caused a much higher proportion of the deaths. Pentobarbital caused the only fatal poisoning in Iceland in 1991.

Drug addict deaths in the Nordic countries: a study based on medicolegally examined cases in the five Nordic countries in 1991.

The study includes medicolegally examined deaths among drug addicts in 1991 in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. A common definition of 'drug addict' was applied by the participating countries. The greatest number of drug addict deaths per 10(5) inhabitants was observed in Denmark followed, in descending order by Norway, Sweden, Finland and finally Iceland with only four deaths. The main difference between the countries was found in the number of fatal poisonings. The distribution according to geographical regions showed that about half of all drug addict deaths occurred in the metropolitan areas. Of the capitals, the greatest number of fatal poisonings per 10(5) inhabitants was seen in Oslo, followed by Copenhagen with a similar number, Stockholm with only the half, and Helsinki with a quarter. Heroin/morphine dominated as cause of death in fatal poisonings in Norway and Sweden. In Denmark, heroin/morphine caused about half of the fatal poisonings only, and nearly one third of the fatal poisonings was caused by methadone. Except for two cases in Sweden, methadone deaths were not seen in the other Nordic countries. Amphetamine caused one tenth of the fatal poisonings in Sweden. In Finland only one tenth of the deaths were caused by heroin/morphine and more by codeine, ethylmorphine and different drugs and poisons not classified in Single Convention on Narcotic Drugs 1961 or the International Convention on Psychotropic Substances 1971. A widespread use of alcohol, cannabis and benzodiazepines, diazepam especially, was seen in all the countries.

[Deaths among drug addicts in Denmark. A forensic medical study of deaths among drug addicts during the period 1991-1992 related to the period 1984-1985]. / Narkomandødsfald i Danmark. En retsmedicinsk undersøgelse af narkomandødsfald 1991-1992 relateret til 1984-1985.

This study includes all deaths among drug addicts in the years 1991 (n = 219) and 1992 (n = 214) investigated at the three institutes of forensic medicine in Denmark. The results are compared with deaths among drug addicts in 1984-1985. The number of deaths among drug addicts increased by approximately 50% in 1991-1992 compared with 1984-1985. The increase was most significant among drug addicts over 35 years of age. The cause of death was intoxication in three-quarters of the cases in 1991-1992. In half of these cases heroin/morphine had caused death, while intoxications caused by methadone accounted for approximately 30% of the cases. In the metropolitan area the frequency of methadone intoxications increased significantly compared with 1984-1985, whereas the number of heroin/morphine intoxications did not change. Outside the metropolitan area, however, a significant increase in heroin/morphine intoxications was noticed. In all parts of the country the number of propoxyphene intoxications decreased to a few annual cases. The most commonly used drugs of abuse were heroin/morphine, diazepam and methadone, often in combination with alcohol.

Deaths among drug addicts in Denmark in 1987-1991.

In the period 1987-1991 a total of 739 fatalities among drug addicts was investigated at the three University Institutes of Forensic Medicine in Denmark. The annual number rose from 130-140 in the first 4 years to 192 in 1991, and 80% were males. The mean and median age for both males and females increased by 1 year in the period. The main drug of abuse was heroin, in most cases supplemented by various other drugs, and in almost all cases taken intravenously. In about one-third of the cases each year there was information of abuse of alcohol in addition. In the poisoning cases, the main drug of poisoning was morphine/heroin, constituting 35-55% of the cases each year. As regards methadone-poisoning cases, the number increased significantly in 1991 compared to the first 4 years. Furthermore, the number and proportion of addicts dying while in methadone treatment increased during the 5-year period. In about half of the methadone poisoning cases, there was information of methadone treatment at the time of death. The other half obviously obtained the methadone completely illegally. Ketobemidone was the third most frequent drug of poisoning, while propoxyphene and barbituric acid only were found in a very few cases each. The results are compared to those from an earlier investigation concerning drug deaths in Denmark in 1968-1986. The importance of registering drug deaths is emphasized.

[Mortality among drug addicts 1980-1989. A comparative study of fatal poisonings among drug addicts examined at the institutes of forensic medicine in Arhus and Oslo]. / Narkomandødsfald 1980-1989. En sammenlignende undersøgelse af forgiftningsdødsfald blandt narkomaner undersøgt ved de retsmedicinske institutter i Arhus og Oslo.

Cases of fatal poisonings among drug addicts examined at the Institutes of Forensic Medicine in Aarhus (n = 238) and Oslo (n = 263) are compared and discussed on the basis of the availability of illicit and medical drugs during the 1980s. The annual number of deaths in age groups over 30 years increased in both countries. Heroin and/or morphine-related deaths comprised one-third of the Danish material compared with three-quarters of the Norwegian material. The registered medical drugs propoxyphene, methadone and ketobemidone accounted for half of the Danish cases. Alcohol and benzodiazepines were present in more than one-third of the cases in both countries.

Impurities, adulterants and diluents of illicit heroin. Changes during a 12-year period.

Changes in the content of impurities, adulterants and diluents are described for 383 samples of illicit heroin seized in the western part of Denmark during the 12-year period 1981 through 1992. A wide range in purity was found within each year, whereas the average purity did not vary much from one year to another. The average purity of wholesale samples (45%) was only slightly higher than the purity of retail samples (36%). The SW Asian type of heroin, containing high concentrations of noscapine, predominated from the mid-eighties. Heroin base and heroin hydrochloride each accounted for approximately half of the samples during the eighties. However, in recent years the base form has become predominant. During the early eighties caffeine and procaine were the most frequent additives next to sugars. During the middle and late eighties an increasing number of heroin samples were cut with phenobarbital and methaqualone. During the early nineties the occurrence of phenobarbital and methaqualone has decreased, whereas paracetamol in combination with caffeine has become predominant. Re-analyses of samples which had been kept in storage for several years showed that most samples had not changed after being stored in the dark for a couple of years at room temperature. However, storage for more than 5 years often resulted in decomposition, particularly in samples consisting of the SW Asian type of heroin.

[Detection of morphine after ingestion of poppy seeds]. / Påvisning af morfika efter indtagelse af birkes.

The aim of this study was to investigate whether morphine can be detected in urine after the ingestion of poppy seeds bought in Denmark. Morphine and codeine were determined in 10 different poppy seed specimens bought in Denmark. Ten and 25 g of the specimens containing the highest amount of morphine and codeine were consumed by respectively six and seven volunteers. Urine samples were collected for analysis at intervals up to 24 h. All samples were found positive by radioimmunoassay up to 24 h after ingestion. Using the less sensitive thin layer chromatography method, one of six and two of seven were positive, two to four hours after intake of respectively 10 and 25 g of the specimens. We conclude that the detection of morphine in urine does not necessarily indicate an illegal drug use.

[Fatal poisonings in Jutland 1980-1989]. / Forgiftningsdødsfald i Jylland 1980-1989.

A description is given of trends in the pattern of fatal poisonings examined at the Department of Forensic Medicine, Aarhus University during the period 1980 through 1989 (638 men and 391 women). These cases comprised 36% of all fatal poisonings in the area during the decade. In more than half of the medicolegally examined cases, death was categorized as accident. In two thirds of the examined cases death was caused by drugs, whereas non-medical substances (alcohol, carbon monoxide etc.) accounted for one third of the deaths. During the ten-year period, a decline was seen in the number of barbiturate-related deaths, whereas the number of deaths caused by analgesics increased. Propoxyphene was the drug found to have caused most deaths during the period, and developments concerning fatal poisonings involving this drug must still be watched closely.

Drug-related deaths during the 1980s. A comparative study of drug addict deaths examined at the institutes of forensic medicine in Aarhus, Denmark and Oslo, Norway.

Cases of fatal poisoning among drug addicts examined at the institutes of forensic medicine in Aarhus, Denmark (n = 238) and Oslo, Norway (n = 263) are compared and discussed on the basis of the availability of illicit and medical drugs during the 1980s. The annual number of deaths among drug addicts in age groups over 30 years increased, but there was no increase in the number of deaths among younger drug addicts in either country. More than 80% of the drug addicts in both samples were men. Heroin-/morphine-related deaths comprised three-quarters of the Norwegian material compared with one-third of the Danish material. The registered medical drugs propoxyphene, methadone and ketobemidone accounted for half of the Danish cases but only a small number of the Norwegian cases. Amphetamine caused few deaths in either country. Alcohol and benzodiazepines were present in more than one-third of the cases in both countries, indicating frequent use of these substances.

Drug abuse in western Denmark during the eighties. I. Drugs of abuse.

A description is given of the availability and quality of drugs seized in the Danish illicit drug market during the eighties. Cannabis was the most prevalent illegal drug throughout the decade. Seizures of heroin predominated among the 'hard' illegal drugs until 1987 but during the late eighties a significant increase in amphetamine seizures was observed. Most of the cocaine was seized in transit, apparently not meant for the Danish market. Medical drugs, particularly benzodiazepines and the synthetic opiates methadone and ketobemidone, comprised an increasing part of the illegal drug market during the period. No seizures of designer drugs were seen. The street level purities of both heroin and amphetamine were, on average, 30-40%.

Drug abuse in western Denmark during the eighties. II. Fatal poisonings among drug abusers.

Cases of fatal poisoning among drug addicts (n = 246) and abusers of medical drugs (n = 138) are discussed on the basis of the availability of illicit and medical drugs during the eighties. Propoxyphene was frequently the cause of death among both drug addicts and abusers of medical drugs. Deaths caused by analgesics and psychoactive drugs, mainly barbiturates and antidepressants, predominated among abusers of medical drugs. During the late eighties the number of deaths caused by barbiturates and propoxyphene declined as a result of changes in the distribution regulations for both drugs. Heroin/morphine accounted for only one-third of the poisonings in drug addicts. No trends concerning the prevalence of deaths caused by these drugs were observed throughout the decade. The number of deaths caused by the synthetic opiates methadone and ketobemidone, however, increased during the late eighties, probably due to an increased availability of these drugs in the illicit drug market. Alcohol was detected in half of all the poisoning cases and benzodiazepines in one-third.

Fatal poisonings in Jutland (Denmark) during the 1980s.

During the period 1980 through 1989 a total of 1029 cases of fatal poisoning (638 men and 391 women) were examined at the Department of Forensic Medicine, Aarhus University, Denmark. In 68% of the cases death had been caused by drugs, whereas acute alcohol poisoning and carbon monoxide accounted for 15% and 14% of the cases, respectively. Alcohol was detected in more than half of the 1029 fatal poisoning cases, and in 42% of all cases the blood alcohol concentration was above 0.8 g/kg. In 57% of the cases death was categorized as accidental, only in 31% of the cases as suicide. Accidental deaths were especially predominant amongst drug and/or alcohol abusers. Propoxyphene was the drug found to have caused most fatal poisonings during the decade (30% of the drug-related deaths). Most of the propoxyphene-related deaths occurred during the early and mid-eighties. Barbiturate poisonings were quite frequent during the first half of the eighties. However, the number of deaths caused by barbiturates decreased significantly after 1986, when most barbiturates were withdrawn from the market. The number of deaths caused by narcotics and analgesics increased during the survey period, while no specific tendency was observed concerning antidepressants.

[Narcotics. Classification of drugs according to legislation]. / Narkotika. Inddeling af stofferne i henhold til juridiske bestemmelser.

Based on a historical outline, the survey describes the classifications of narcotic drugs according to present international conventions and Danish legislation. The classification of drugs according to the Danish act concerning euphoriant substances is compared to the classifications in Danish medical and pharmaceutical legislation.