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Information extracted on toxicology, pathology and circumstances were used to identify drug(s) implicated in the death.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> Poly\u2010 or multiple drug use was detected in the majority of deaths with at least 69 different combinations, including 66% for heroin and 42% for cocaine. Six categories of death were identified involving an opiate (100, 68%); cocaine (14, 9%); other controlled drug (five, 3%); mixed drug overdose (18, 12%); other prescribed drug (five, 3%); and other causes (seven, 5%). A witness was present and the death was not instantaneous in 92 (61%) cases, although evidence in the coronial file suggested that in the majority of cases the overdose went unnoticed until too late to intervene. In all, 15 (one in 10) of the deceased were released from prison within 3\u2003months of death; and 37 (one in four) were reported as in receipt of a methadone prescription.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> Perhaps for the first time in the United Kingdom cocaine was detected in more drug overdose deaths than methadone. However, reducing heroin use is central to the prevention of drug\u2010related deaths. We recommend that overdose prevention encompasses strategies to encourage a \u2018mutual duty of care\u2019 among problem drug users, and in the United Kingdom further investigation of the relationship of methadone treatment failures on overall trends in drug\u2010related deaths is merited.<\/jats:p>","DOI":"10.1111\/j.1360-0443.2006.01688.x","type":"journal-article","created":{"date-parts":[[2006,12,20]],"date-time":"2006-12-20T10:53:58Z","timestamp":1166612038000},"page":"317-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["London audit of drug\u2010related overdose deaths: characteristics and typology, and implications for prevention and monitoring"],"prefix":"10.1111","volume":"102","author":[{"given":"Matthew","family":"Hickman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Carrivick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Paterson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Zador","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Cusick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Henry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,12,18]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"Reducing Drug Related Deaths","author":"Advisory Council on Misuse of Drugs.","year":"2000"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jtg022"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cki168"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/jtg030"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1996.911217652.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2005.019273"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh306"},{"key":"e_1_2_6_9_2","first-page":"22","article-title":"Trends in the mortality of young adults aged 15\u201344, England and Wales 1961\u20132001","volume":"19","author":"Brock A.","year":"2003","journal-title":"Health Stat Q"},{"key":"e_1_2_6_10_2","unstructured":"MorganO. 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