Deaths by acute poisoning are mainly suicides or consequences of substance use disorders. The majority of deaths attributed to substance use disorder are considered accidental, i.e. death was not the intended outcome [1]. However, a post-mortem determination of the intention behind a fatal intake is uncertain. Some suicides might be classified

as accidental deaths, and vice versa [2]. Furthermore, Inhibitors,research,lifescience,medical self-destructiveness is a common feature among those with suicidal behaviour and among those repeatedly treated for accidental overdoses [3]. This may explain why the evaluated intention in repeated acute poisonings often changes from one admission to another [4]. Hence, the inclusion of all deaths by acute poisoning will give a more complete picture of mortality and Inhibitors,research,lifescience,medical toxic agents used among this group of people with unnatural deaths. The changing availability of drugs influences the pattern of toxic agents in fatal poisonings [5-7]. During recent decades there has been a shift in prescriptions from tricyclic anti-depressants (TCAs) to newer AP24534 mw selective serotonin reuptake inhibitors (SSRIs) and other anti-depressants, although

the recent controversy regarding suicide risk is still debated [8,9]. The implementation of methadone maintenance treatment has led to an increase in deaths Inhibitors,research,lifescience,medical related to methadone intake [7], but the magnitude of the increase varies between countries [1]. Regular updates on the pattern of toxic agents used are therefore of interest, as it is important in the discussion of prescription policy and treatment of drug addiction. Inhibitors,research,lifescience,medical Death certificates seldom include additional agents according to the Anatomical Therapeutic Chemical (ATC) classification system [10], and the coding of ethanol poisoning is problematic in the International Classification of Diseases (ICD) system. Important information Inhibitors,research,lifescience,medical regarding toxic patterns is therefore lost if studies are based solely on death certificates and mortality statistics [10,11]. Studies designed to examine the patterns of both main and additional agents in acute poisonings are therefore necessary. In order to describe the pattern of poisoning it would be

useful to compare the toxic agents used in fatal versus non-fatal poisonings, and hence the relative influence of each agent on mortality rates. Case fatality rates can be calculated as long as all fatal poisonings in a defined area are known, along with the number of diagnosed Oxymatrine non-fatal acute poisonings. The aim of the present study was to describe the pattern of drugs detected in fatal acute poisonings in Oslo during one year, including deaths both in and outside hospitals. Methods Acute poisonings in subjects aged 16 years or older occurring in Oslo were included consecutively in an observational multicentre study from 1st April 2003 to 31st March 2004. This was a prospective study using a standardized data collection form, and the cases were included consecutively.