Barbiturate-related hospitalisations, drug treatment episodes, and deaths in Australia, 2000‒2018

Abstract

Objectives: To determine the characteristics and population rates of barbiturate-related hospitalisations, treatment episodes, and deaths in Australia, 2000–2018. Design, setting: Analysis of national data on barbiturate-related hospitalisations (National Hospital Morbidity Database, 1999‒2000 to 2017‒18), drug treatment episodes (Alcohol and Other Drug Treatment Services National Minimum Data Set, 2002–03 to 2017–18), and deaths (National Coronial Information System, 2000–01 to 2016–17). Main outcome measures: Population rates directly age-standardised to the 2001 Australian standard population; average annual percentage change (AAPC) in rates estimated by Joinpoint regression. Results: We identified 1250 barbiturate-related hospitalisations (791 cases of deliberate self-harm [63%]), 993 drug treatment episodes (195 cases with barbiturates as the principal drug of concern [20%]), and 511 deaths during the respective analysis periods. The barbiturate-related hospitalisation rate declined from 0.56 in 1999‒2000 to 0.14 per 100 000 population in 2017‒18 (AAPC, ‒6.0%; 95% CI, ‒7.2% to ‒4.8%); the declines in hospitalisations related to accidental poisoning (AAPC, ‒5.8%; 95% CI, ‒9.1% to ‒2.4%) and intentional self-harm (AAPC, ‒5.6%; 95% CI, ‒6.9% to ‒4.2%) were each statistically significant. Despite a drop from 0.67 in 2002‒03 to 0.23 per 100 000 in 2003–04, the drug treatment episode rate did not decline significantly (AAPC, ‒6.7%; 95% CI, ‒16% to +4.0%). The population rate of barbiturate-related deaths increased from 0.07 in 2000–01 to 0.19 per 100 000 population in 2016–17 (AAPC, +9.3%; 95% CI, +6.2–12%); the rate of intentional self-harm deaths increased (AAPC, +11%; 95% CI, +7.4–15%), but not that of accidental deaths (AAPC, ‒0.3%; 95% CI, ‒4.1% to +3.8%). Conclusions: While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.