Heroin overdose

Darke, Shane

doi:10.1111/add.13516

Cited by 34 publications

(25 citation statements)

References 35 publications

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“…While polydrug use is common in drug overdose situations (e.g. [55]), and alcohol is one of the substances often present with other illicit substances, alcohol is rarely recorded as the cause of death, even when it has been specified and reported as the most toxic component by the medico-legal pathologist, and based on this should have been coded as the underlying cause of death [56].…”

Section: Alcohol Use Disordersmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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Background and aimsAlcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs).MethodsSystematic review of reviews and meta‐analyses on alcohol consumption and health outcomes attributable to alcohol use.For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others.ResultsIn total, 255 reviews and meta‐analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD‐10 three‐digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in‐depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently.ConclusionsResearch since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.

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Section: Alcohol Use Disordersmentioning

confidence: 99%

The relationship between different dimensions of alcohol use and the burden of disease—an update

et al. 2017

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“…Because drugs have acute and chronic effects on bodily functioning, the combined use of multiple drugs can magnify their pharmacological effects 23 , for example, the co-use of cocaine and heroin has a synergistic impact on reducing norepinephrine release and reuptake 24 . So the same dosage of poly-drugs can cause stronger stimulation than either heroin or SD alone, resulting in users having a higher possibility of engaging in high-risk behaviours, such as condomless sex and/or group sex 22 , 25 . Moreover, in China, poly-drug users are more likely to inject drugs and share injection equipment than SD-only users.…”

Section: Introductionmentioning

confidence: 99%

Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China

Mao

Zhao

et al. 2018

Sci Rep

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The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8–3.4]; 2.3, [1.6–3.1]) and syphilis infection (AOR = 4.1, [2.1–6.9]; 3.9, [1.8–5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.

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“…The senior editorial team will then decide whether or not to invite a full submission. The first paper in this series, presented in this issue, addresses classic works from the field of heroin overdose, examining works dating back to 1972 . It is our hope that this series will provoke reflection and conversation, and provide a solid grounding in the history of the addictions field for our readers.…”

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confidence: 97%

Addiction Classics

Darke

2016

Addiction

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Heroin overdose

Abstract: Landmark studies of heroin overdose from the 1970s, 1980s and 1990s laid the foundations for subsequent overdose research, mainly by identifying the major demographic characteristics of overdose cases, risk factors, survival times and behaviours at overdose events.

Cited by 34 publications

References 35 publications

The relationship between different dimensions of alcohol use and the burden of disease—an update

The relationship between different dimensions of alcohol use and the burden of disease—an update

Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China

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