Overdosing among young injection drug users in San Francisco

Ochoa, Kristen C.; Hahn, Judith A.; Seal, Karen H.; Moss, Andrew R.

doi:10.1016/s0306-4603(00)00115-5

Cited by 115 publications

(70 citation statements)

References 9 publications

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“…Overdoses with cocaine and heroin in combination, cocaine-only and cocaine, heroin and alcohol combinations are often experienced by drug users, yet their epidemiology is not well understood [29,31]. Areas that have historically reported high abuse of cocaine and other stimulants such as the US eastern seaboard [32], California [33] and Canada [34][35][36] may find muted effects of naloxone training programs on the prevalence of fatal drug overdose in their community. Curricula to recognize and respond to non-opioid overdose, especially cocaine intoxication, should be incorporated into naloxone trainings.…”

Section: Discussionmentioning

confidence: 99%

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

2008

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Aims-This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose-response in the United States.Design and participants-Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62).Setting-US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico.Measurements-Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics.Findings-Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t 60 = 3.76, P < 0.001) and instances where naloxone was indicated (t 59 = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0). Conclusions-Resultssuggest that naloxone training programs in the United States improve participants' ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.

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Section: Discussionmentioning

confidence: 99%

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

2008

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“…Little attention, however, has been paid to nonfatal overdose, which recent research has shown to be extremely common among heroin users. 11,[14][15][16][17][18][19] Typically, a half or more of cross-sectional samples of heroin users report a history of overdose, usually on multiple occasions. Such high rates are clinically significant as nonfatal overdose has been associated with pulmonary conditions, muscular complications such as rhabdomyolysis, renal failure, cardiovascular complications, and anoxia-induced cognitive impairment.…”

Section: Extent Of the Problemmentioning

confidence: 99%

“…Recently, however, there has been renewed research interest in fatal and nonfatal heroin overdose in the United States. [9][10][11][12] This article examines current research regarding heroin overdose and how these findings may inform evidence-based interventions.…”

Section: Introductionmentioning

confidence: 99%

Heroin Overdose: Research and Evidence-Based Intervention

Darke

2003

Journal of Urban Health: Bulletin of the New York Academy of Me

289

240

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“…12 Other risk factors include lifetime or recent incarceration experience, homelessness, syringe sharing, and homosexual or bisexual behavior. 8,9,11,13 Prior history of overdose has also been identified as a risk factor. 10,14,15 There are conflicting findings regarding the impact of age, with both younger and older age predicting nonfatal overdose in multivariate analyses.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

et al. 2011

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Opioid-involved overdose deaths are on the rise, both nationwide and in the state of Washington. In a survey of 443 participants at syringe exchanges in Seattle, Washington, 16% had overdosed in the last year. Several factors were significantly associated in bivariate analysis: lack of permanent housing; incarceration of five or more days in the past year; gender of sex partners; sharing of syringes and other injection paraphernalia; use of speedballs (cocaine and heroin together), goofballs (methamphetamine and heroin together), buprenorphine; injection use of crack cocaine and sedatives; and use of opioids with sedatives. Adjusting for other variables in multivariate logistic regression analyses, only recent incarceration and sharing of injection materials were still significantly associated with overdose. Correctional facilities, syringe exchange programs, and other agencies serving opioid injectors should include overdose prevention components in release planning and services.

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Overdosing among young injection drug users in San Francisco

Cited by 115 publications

References 9 publications

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

Heroin Overdose: Research and Evidence-Based Intervention

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

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