Poisoning deaths are decreasing in Finland – drug poisonings are still common

Background  Forensic toxicology in connection with the medico-legal cause-of-death investigations forms the basis for statistics on fatal poisonings caused by alcohols, drugs, medicines, and other poisons. In Finland, the rate of medico-legal investigations and forensic toxicology is high allowing for accurate epidemiology.

Methods  The aim of this study was to investigate all fatal poisonings between 2018 and 2022 in Finland and to compare the results to those from previous years. The study material consisted of the results of the postmortem toxicological analyses and death certificates from cases determined by the forensic pathologist to be fatal poisonings.

Results The total number of poisoning deaths decreased over the study period. The decrease was especially pronounced with fatal alcohol poisonings, and especially among individuals aged 45 years and older, which is also the largest age group in fatal alcohol poisonings. The number of fatal drug poisonings has increased since the early years of 2000 but has levelled off in the recent years. The number of fatal poisonings related to prescription medicines has decreased markedly, in particular due to a decrease in suicides. There were no changes in the number of deaths related to carbon monoxide. Similar to previous studies, most of the victims of carbon monoxide poisoning death had been under the influence of alcohol at the time of death.

Conclusions   For decades, the Finnish poisoning death scene was dominated by alcohol poisonings and suicides by prescription drugs or carbon monoxide. Today, fatal poisonings are more often caused by abused drugs and especially opioids, like in most European countries. However, instead of heroin, that is considered the main drug of abuse in much of the world, the primary drug causing dependence and deaths in Finland is buprenorphine.

Pirkko Kriikku, Ilkka Ojanperä