No abstract

The frequency of accidental or deliberate overdose was investigated among 200 opiate addicts in methadone substitution treatment in clinics in Edinburgh and south London. One hundred and three of the participants reported a mean of 3.4 overdoses, with 71 (69%) reporting that their most recent overdose was accidental, 27 (26%) deliberate—the remainder were uncertain. Those whose last overdose was deliberate were more likely to have been prescribed diazepam at that time and were more depressed at the time of interview. Differentiation by self‐reported reason for overdose suggests that treatment providers should distinguish between accidental and deliberate overdose in developing overdose prevention strategies.

One hundred and thirty-five drug users in contact with treatment services in Scotland and England were interviewed about their experiences of witnessing overdoses - both overdoses resolved successfully and those leading to death - and actions taken to effect resuscitation. One hundred and four (77%) had witnessed a mean of 11.5 overdoses, of whom 41 (30.4% of the study sample) had witnessed an average of 4.2 fatal overdoses. A wide range of actions was reported at the most recent witnessed overdose, the most common being slapping or shaking the victim (an average of 2.5 minutes after overdose was first recognised) or walking the person around the room (3.2 minutes after recognizing overdose). There was no consistent relationship between the time taken to acting and the number of actions taken. Successful resolution of last witnessed overdose was associated more strongly with immediate onset of overdose, while those that led to death were more often those that involved slow onset of overdose. There is clear evidence of the opportunity and willingness of witnesses to intervene, particularly when overdose onset is immediate, with a wide range of strategies adopted to encourage recovery, although these may often be inappropriate and wrongly prioritized.

No abstract

The study investigated overdose attitudes and experiences among 155 attenders at an out-patient drug clinic in south London. Almost half the sample (46.8%) had ever overdosed while 82.6% had witnessed overdoses, of whom 43 had witnessed overdose fatalities. However, this does not appear to have been a consequence of inaction, with most users reporting that they had attempted to resuscitate or assist the victim in a number of ways. Most participants also reported a reasonable awareness of the appropriate actions to take, were not deterred by fear of police sanction and managing reported that they would be willing to intervene in the future. Over a third were keen to receive training on managing overdose and that the majority would be willing to keep naloxone at home. This evidence supports previous research suggesting that addicts may be a valuable resource in strategies for reducing overdose fatalities through training and the dissemination of new drug technologies such as naloxone.