Drug related deaths in France. A critical view

Background. - Available data suggest a reduction in the number of overdoses due to psychoactive substances (tobacco and alcohol excluded) in France. Nevertheless, official levels remain considerably low compared to other European countries, and strong differences between the different sources providing information support the hypothesis of under-reporting. Methods. - Two cross-tabulations of the main sources of information (police data and national mortality registry on one hand; police data and on another hand) allow the use of easy-to-compute, capture-recapture based indicators to estimate the invisible population (i.e. hidden overdoses). Results. - Results support a significant under-reporting of overdoses, reaching a minimum level of 30%. Conclusion. - Unlike official claims, there has been a rise in overdoses in France during the last decade. Besides the applied corrections, levels of overdoses still remain low. Attention should be paid to death certification. Other issues of interest are the lack of a common definition and the need for greater institutional coordination. (C) 2009 Elsevier Masson SAS. All rights reserved.