Fluctuations in heroin purity and the incidence of fatal heroin overdose

Drug Alcohol Depend. 1999 Apr 1;54(2):155-61. doi: 10.1016/s0376-8716(98)00159-8.


In order to determine the role played by heroin purity in fatal heroin overdoses, time series analyses were conducted on the purity of street heroin seizures in south western Sydney and overdose fatalities in that region. A total of 322 heroin samples were analysed in fortnightly periods between February 1993 to January 1995. A total of 61 overdose deaths occurred in the region in the study period. Cross correlation plots revealed a significant correlation of 0.57 at time lag zero between mean purity of heroin samples per fortnight and number of overdose fatalities. Similarly, there was a significant correlation of 0.50 at time lag zero between the highest heroin purity per fortnight and number of overdose fatalities. The correlation between range of heroin purity and number of deaths per fortnight was 0.40. A simultaneous multiple regression on scores adjusted for first order correlation indicated both the mean level of heroin purity and the range of heroin purity were independent predictors of the number of deaths per fortnight. The results indicate that the occurrence of overdose fatalities was moderately associated with both the average heroin purity and the range of heroin purity over the study period.

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death
  • Central Nervous System Depressants / blood
  • Central Nervous System Depressants / poisoning
  • Drug Interactions
  • Drug Overdose / blood
  • Drug Overdose / etiology
  • Drug Overdose / mortality
  • Female
  • Heroin / chemistry*
  • Heroin / poisoning
  • Heroin / standards
  • Heroin Dependence / blood
  • Heroin Dependence / mortality*
  • Humans
  • Illicit Drugs / chemistry*
  • Illicit Drugs / poisoning
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Narcotics / chemistry*
  • Narcotics / poisoning
  • Narcotics / standards
  • New South Wales / epidemiology
  • Regression Analysis
  • Time Factors


  • Central Nervous System Depressants
  • Illicit Drugs
  • Narcotics
  • Heroin