INTRODUCTION: Knowledge of trends of illegal drug use is vital for planning initiatives to reduce accidents and deaths among
drug users. The aim of this study was to describe the cause of death, abuse pattern and geographic differences in fatal
poisonings among drug users in Denmark in 2017.
METHODS: All fatal poisonings among drug users examined at the three institutes of forensic medicine in Denmark in 2017
were included in the study.
RESULTS: Overall, fatal poisonings declined from a maximum of 226 in 2007 to 162 in 2017. Methadone (52%) was the most
common cause of death, followed by heroin/morphine (25%). A marked increase in deaths was due to stimulants (13%),
especially cocaine. The abuse pattern has changed since 2012. Methadone remained the most frequently detected drug, but
clonazepam and cocaine surpassed heroin/morphine, diazepam and tetrahydrocannabinol as the second-most frequently
detected drugs. Ketobemidone had disappeared, whereas buprenorphine, oxycodone, fentanyl, pregabalin and gabapentin had
increased. Antidepressants/antipsychotics were detected in half (47%) of the cases. Cocaine was more frequent in the areas
covered by Copenhagen and Aarhus, whereas heroin/morphine was most frequently detected in the area covered by Odense.
Amphetamine was more frequent in the Aarhus area.
CONCLUSIONS: Methadone and heroin/morphine still account for most fatal poisonings. However, deaths due to stimulants,
especially cocaine, have increased. The abuse pattern has changed and geographical differences have emerged.