Reduction in use of temazepam is factor in deaths related to overdose

BMJ 1997;315:1463-1464 (29 November)

Letters

Reduction in use of temazepam is factor in deaths related to overdose

Editor–The reported increase in drug related deaths inLothian¹ has not been mirrored in Strathclyde. Despite a largeincrease in the amounts of methadone prescribed in Glasgow²the rate of death due to drug overdose has fallen from eighta month in 1995 to four a month in the first half of 1997 (StrathclydePolice drugs squad, personal communication). The system of prescribing as describedby Gruer et al² has shown that methadone can be associated withimprovements in mortality, in contrast to the experience elsewhere.

The dramatic drop in deaths related to overdose in Strathclydeis not, however, principally due to the methadone programme.The other main change in drug use in the area has been the reductionin use of temazepam since this drug was rescheduled as a controlleddrug in January 1996. This is shown in the drug histories ofthose attending the Glasgow Drug Crisis Centre over the past twoyears. Overall use of the drug and, particularly, its injectionhave fallen to a quarter of the previous levels (1).

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Number of deaths due to drug overdose and percentages of drug misusers using and injecting temazepam

Careful use of methadone is of central importance in the treatmentof injecting drug users. Although it often reduces all causemortality,³ because of methadone's toxicity it rarely reducesmortality due to overdose.⁴ The success of the reschedulingof temazepam shows that such public health measures can alsohave positive effects in mortality due to overdose.

T C Gilhooly, Visiting medical officer ^a

^a Glasgow Drug Crisis Centre, 123 West Street, Glasgow G5 8BA