Department of Forensic Medicine: Opioids are the most dangerous drug

The Department of Forensic Medicine now categorizes opioids as the most dangerous drug in Denmark. As a result, the government is announcing a series of measures.

Close up of person taking pill
The forensic medicine departments have evaluated some of the medications containing opioids, which until recently have not been considered particularly problematic - such as tramadol and oxycodone. Photo: Shutterstock

Facts: Why Are Opioids Dangerous?

All opioids can cause euphoria, but different doses of the various substances are needed, as some are stronger than others.

Besides addiction, the most serious risk—from the perspective of the forensic medicine departments—is that opioids can result in acute serious or fatal poisoning, in part because an overdose can lead to severe consciousness impairment or unconsciousness, as well as suppressing breathing, ultimately leading to death.

Facts: Department of Forensic Medicine

 The Department of Forensic Medicine at Aarhus University provides independent, research-based advisory services for the police districts in East Jutland, Southeast Jutland, North Jutland, and Central and West Jutland. In addition, the institute collaborates with many other Danish and foreign authorities and private companies. Among other things, the institute performs:

  • Legal autopsies
  • Crime scene investigations - with accompanying forensic examinations
  • Forensic chemical examinations
  • Clinical forensic examinations (examinations of live persons).

Perhaps you received these pills on prescription after experiencing pain, but medications containing opioids are far from harmless — especially if used incorrectly.

This is the conclusion of the country's three forensic medicine departments in a new 'risk assessment,' where they compared opioids such as morphine and tramadol to other substances like cocaine and MDMA.

The government has tasked the Department of Forensic Medicine at Aarhus University and the country's two other forensic medicine departments with conducting the risk assessment of medications containing opioids — and it is the first of its kind in a Danish context.

"We assess the danger of the prescribed opioids as very high, on par with heroin and methadone, and above cocaine, amphetamine, and MDMA," says Christian Lindholst, department head at the Department of Forensic Medicine at Aarhus University.

"Perscribed opioids have been considered relatively harmless by many, but in contexts of misuse, these opioids are like heroin and fentanyl. They have the same mechanism of action, the same potential for abuse, and they belong to the same group of drugs. It is the most dangerous group of psychoactive drugs we have," he says.

Improved advice and stricter penalties

Following the risk assessment, the Minister of Justice has announced that the government will soon present a catalogue of measures to prevent opioids from truly gaining a foothold in Denmark. This includes higher penalties for the illegal manufacturing, import, and sale of these substances, more information, and initiatives in the healthcare system to help people with an opioid abuse problem.

The worst case scenario is the opioid crisis in North America, which kills tens of thousands of Americans every year.

There is particular concern about strong and addictive drugs like oxycontin and tramadol gaining ground in Denmark.

"The well-known opioids methadone and heroin have long been the most common causes of fatal drug poisonings in Denmark, but we know little about the spread and consumption of tramadol, oxycodone, and fentanyl. We need to find out how big the problem is, and we must monitor the development," says Christian Lindholst.

Upcoming Study

Charlotte Uggerhøj Andersen, clinical associate professor at the Department of Forensic Medicine and senior consultant at Aarhus University Hospital, has explained in several media outlets why the danger of opioids is assessed so high.

"There is a particular risk of poisoning when using opioids, because the range between the doses that produce euphoria and the doses that can lead to serious or fatal poisoning is relatively narrow," says Charlotte Uggerhøj Andersen.

The opioid issue is also being focused on elsewhere at Aarhus University. The Centre for Drug Research began a qualitative study of young people's use of opioids in September 2023.

Associate professors Maj Nygaard-Christensen, Birgitte Thylstrup, and Esben Houborg are leading the study, which is based on interviews with professionals within drug treatment and prevention efforts as well as young people in drug treatment for using opioids such as tramadol and oxycodone. Follow the project on the Centre for Drug Research's LinkedIn page.

Contact

Department head Christian Lindholst
Aarhus University, Department of Forensic Medicine
Email: cl@forens.au.dk  
Phone: 20 93 92 23

Clinical associate professor and Senior Consultant Charlotte Uggerhøj Andersen
Aarhus University, Department of Forensic Medicine and Aarhus University Hospital, Clinical Pharmacology
Phone: +45 60 12 84 30
Email: cua@forens.au.dk