{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:11:25Z","timestamp":1790626285389,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T00:00:00Z","timestamp":1506556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aims of this study were to estimate the prevalence and predictors of non\u2010medical substance use, and to assess the association between non\u2010medical substance use and fatal poisoning or history of drug abuse in Finland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Retrospective cohort study of all medico\u2010legally investigated death cases in Finland. The postmortem toxicology database was linked together with the register on reimbursed prescription medicines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants and cases<\/jats:title><jats:p>All postmortem cases between 2011 and 2013 positive for one or more of the following drugs: oxycodone, fentanyl, tramadol, clonazepam, gabapentin, pregabalin, tizanidine, olanzapine, quetiapine, risperidone, alprazolam, zolpidem, mirtazapine and bupropion, <jats:italic>n<\/jats:italic>\u00a0=\u00a02974.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Non\u2010medical use of substance was the outcome variable. Predictors were the following: gender, residence at the time of death, place of death, blood alcohol concentration, age, drug abuse, number of prescriptions of any psychoactive drugs in last year and proportion of prescriptions issued by psychiatrist in last year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In 50.4% of the studied cases, at least one drug was detected without a prescription. Clonazepam, alprazolam and tramadol were the most prevalent non\u2010medical findings in these cases (6.6, 6.1 and 5.6%, respectively). The risk of non\u2010medical use of prescription drugs was especially high in cases with history of drug abuse (88.5%) and in fatal poisonings (71.0%). The proportion of non\u2010medical use of the studied substances varied between 5.9% [95% confidence interval (CI)\u00a0=\u00a03.1\u201310.1%)] for risperidone and 55.7% for fentanyl (95% CI\u00a0=\u00a044.1\u201366.9%).<\/jats:p><jats:p>Valid prescription for one or more of any psychoactive drug was associated with lower odds for non\u2010medical use of the studied substances. Additionally, the higher the proportion of psychoactive drugs prescribed by a psychiatrist, the lower the probability of non\u2010medical use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010prescribed psychoactive drugs are found commonly at postmortem in drug poisoning deaths in Finland, with history of drug abuse being a major contributing factor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14014","type":"journal-article","created":{"date-parts":[[2017,8,25]],"date-time":"2017-08-25T22:42:41Z","timestamp":1503700961000},"page":"464-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Non\u2010medical use of psychoactive prescription drugs is associated with fatal poisoning"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-6208","authenticated-orcid":false,"given":"Jari","family":"Haukka","sequence":"first","affiliation":[{"name":"Department of Public Health University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5721-2827","authenticated-orcid":false,"given":"Pirkko","family":"Kriikku","sequence":"additional","affiliation":[{"name":"Forensic Toxicology Unit National Institute for Health and Welfare  Helsinki Finland"},{"name":"Department of Forensic Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mariottini","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Partonen","sequence":"additional","affiliation":[{"name":"Department of Health National Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-1473","authenticated-orcid":false,"given":"Ilkka","family":"Ojanper\u00e4","sequence":"additional","affiliation":[{"name":"Forensic Toxicology Unit National Institute for Health and Welfare  Helsinki Finland"},{"name":"Department of Forensic Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2015.01.003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2010.06.015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2012.07.004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.802"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1626"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200730060-00007"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02650.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2006.012583"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2006.08.002"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2012.752036"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.04.005"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12347"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/10673229709030550"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb10625.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2013-040762"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302843"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2015.12.023"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-013-7272-8"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038-008-7068-3"},{"key":"e_1_2_6_22_1","unstructured":"R Development Core Team.R: A language and environment for statistical computing [internet]. Vienna Austria:2011. Available at:https:\/\/www.r\u2010project.org\/(access 20 March 2012) (Archived athttp:\/\/www.webcitation.org\/6tdqC1wXT)."},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2512"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2014.04.028"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2012.09.005"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2011-040202"}],"updated-by":[{"DOI":"10.1111\/add.14241","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T00:00:00Z","timestamp":1524528000000}}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.14014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.14014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T05:16:13Z","timestamp":1695791773000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.14014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,28]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/add.14014"],"URL":"https:\/\/doi.org\/10.1111\/add.14014","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1111\/add.14241","asserted-by":"object"}]},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,28]]},"assertion":[{"value":"2017-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-09-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}