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Epidemiologic Investigation of the Elderly Deaths Caused by Narcotic and Psychedelic Drug Abuse Complications Referred to the Legal Medicine Organization of Tehran, Iran During 2013 and 2014

Introduction: The survey of drug and psychedelic abuse-related deaths in elderly people provides information on the most severe social and psychological consequences of drug abuse and its impact on community health. In contrast, with regard to the ageing population of Iran, along with all age groups who might misuse drugs, elderly people cannot be ignored. Therefore, the present study aims to investigate the number of deceased elders whose deaths were caused by complications related to narcotic or psychedelic drug abuse as described by the legal medicine organization of Tehran, Iran, 2013 to 2014. Methods: In this descriptive study, the forensic files of all elderly people (age, 60 y or older) who died because of narcotic or psychedelic drug abuse and were referred to the legal medicine center of Tehran in 2013 and 2014 were investigated. Elders who died because of reasons other than narcotic or psychedelic drug abuse or because of underlying illness were excluded from the study. Data were recorded in a questionnaire containing questions related to demographic status, family status, social status, examinations, autopsy, and laboratory data, of elders. The data were analyzed using SPSS 16 software. Findings: According to inclusion and exclusion criteria, 227 (n=203, 89.4% male) deaths of elderly people because of narcotic or psychedelic drug abuse were investigated. The incidence of drug-related deaths among elderly people was 2.2012 and 1.912 per 100,000 people, during 2013 and 2014, respectively. The incidence of drug-related deaths among elderly women during the years 2013 and 2014 was .3598 and .5179 1.22, respectively. In addition, the incidence of drug-related deaths among elderly men during the years 2013 and 2014 was 4.5096 and 3.3517, respectively. The most common drug used by the elders (126, 55.5%) was opium. The mean age of the elders was 66.9±7.3 years (60 to 90 y old) and the mean age of onset (first intake) was 40.3±12.9 years (14 to 85 y old). Most of the deceased elders were from the Tehran (38%), Khorasan Razavi (11%), and Hamedan (9%) provinces of Iran. Half of the deceased elders had their own home (52.9%), and most were married (55%). Few (n=15, 6.6%) of the deceased elders had a history of hospitalization because of mental illness. The highest rate of death was observed in free-occupation (26.9%), retired (14.5%), and unemployed (11%) elders, respectively. Many deceased elders had an education level below the diploma (78, 34.4%) or were illiterate (63, 27.7%). Few (5, 2.2%) of the deceased elders had a history of suicide attempts. More than half (61.7%) of the elderly deceased were autopsied. In 113 (49.8%), poison sampling and in 54 (23.8%), pathology test was performed. Conclusions: It can be argued that factors such as low level of education, male gender, habitation in a big city, free occupation, retirement or unemployment can contribute to an individual’s inclination to become addicted to narcotic or psychedelic drug abuse in aging (in the elderly), and these factors may be used to identify the elderly people at risk of drug addiction. Low prices and the fast availability of opium in Iran and some misconceptions about opium among Iranian people, may lead to its prevalent consumption among the elders. Increasing awareness in the elderly about the adverse effects of narcotic or psychedelic drug abuse can reduce their willingness to consuming drugs. Family support and psychological services, as well as medical and rehabilitation services for the elderly, can also be helpful in this regard.