Self‐reported and observed heroin overdoses in Malmoe

Brådvik, Louise; Hulenvik, Per; Frank, Arne; Medvedeo, Alvaro; Berglund, Mats

doi:10.1080/14659890601178667

Cited by 12 publications

(12 citation statements)

References 27 publications

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“…We found that nearly half of this sample of PWIDs had experienced at least one non-fatal overdose in their lifetime, consistent with other research (Bradvik et al, 2007; Latkin et al, 2004; Philbin et al, 2008; Pollini et al, 2006; Seal et al, 2001; Sergeev et al, 2003; Sherman et al, 2007). Further, we found that 8% of the sample had experienced a non-fatal overdose in the previous six months.…”

Section: Discussionsupporting

confidence: 90%

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Wagner

Liu

Davidson

et al. 2015

Drug and Alcohol Dependence

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Background Accidental overdose, driven largely by opioids, is a leading cause of death among people who inject drugs (PWIDs). We conducted secondary analysis of data from a cohort of PWIDs to identify venues where high-risk PWID could be targeted by overdose education/naloxone distribution (OEND) programs. Methods 573 PWIDs completed a quantitative survey between June, 2012 and January, 2014, which was analyzed using multivariable logistic regression. The dependent variable was a dichotomous indicator of experiencing a heroin/opioid-related overdose in the past six months. Independent variables included: demographics, drug use behavior, and encounters with two venues – the health care and criminal justice systems – that could serve as potential venues for OEND programs. Results Almost half (41.5%) reported ever experiencing a heroin/opioid overdose, and 45 (7.9%) reported experiencing at least one heroin/opioid overdose in the past six months. In the final multivariable model, receiving care in a hospital in the past six months (Adjusted Odds Ratio [AdjOR] 4.08, 95% Confidence Interval [C.I.] 2.07 -- 8.04, p<0.001) and being arrested for drug possession in the past six months (AdjOR 5.17, 95% C.I. 2.37 – 11.24, p<0.001) were associated with experiencing an opioid overdose in the past six months. Conclusions Identifying venues outside of those that traditionally target services to PWIDs (i.e., syringe exchange programs) will be critical to implementing OEND interventions at a scale sufficient to address the growing epidemic of heroin/opioid related deaths. Clinical settings, such as hospitals, and drug-related encounters with law enforcement officers are promising venues for the expansion of OEND programs.

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Section: Discussionsupporting

confidence: 90%

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Wagner

Liu

Davidson

et al. 2015

Drug and Alcohol Dependence

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“…Även dödsfall i nära relationer har visat sig innebära en ökad risk för överdoser (Neale & Robertson 2005). Den kontext i vilket drogen injiceras påverkar risken för överdos Enligt en studie av 149 personer vid Sprutbytesmottagningen och Avgiftningsenheten i Malmö (Brådvik et al 2007a) ligger överdosfrekvensen i staden högt i jämförelse med resultatet från internationella studier. Hela 74 procent av respondenterna hade upplevt minst en egen överdos och nästan samtliga, 95 procent, hade bevittnat minst en överdos de senaste fem åren.…”

Section: Resultsunclassified

“…Interventions targeted at reducing harm from drug use are controversial in Sweden (Svensson, 2012) and overdose prevention measures such as, drug consumption rooms, peer naloxone distribution, and overdose response training programs are lacking (EMCDDA, 2013b (Brådvik et al, 2007a;Davidson, Ochoa, Hahn, Evans, & Moss, 2002;. Most overdoses do not have a fatal outcome (Brådvik et al, 2007a;, and overdose fatalities are rarely immediate -rather they often entail a successive process, in which the victim sometimes dies more than an hour after using heroin (Zador, Sunjic, & Darke, 1996;Sporer, 2003). Therefore, there is often time to act and good prospects to save the person's life if someone else is present (Darke, Ross, & Hall, 1996a).…”

Section: Introductionmentioning

confidence: 99%

Wasted, overdosed, or beyond saving – To act or not to act? Heroin users’ views, assessments, and responses to witnessed overdoses in Malmö, Sweden

Richert

2015

International Journal of Drug Policy

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“…Among people who inject drugs (PWID), overdose (usually related to heroin) is the leading cause of death (Sporer, 1999; Tyndall et al, 2001), even surpassing HIV-related morbidity (Tyndall et al, 2001). Community studies in the US and elsewhere estimate that between one quarter to over half of PWIDs have ever experienced a drug overdose (Bradvik, Hulenvik, Frank, Medvedeo, & Berglund, 2007; Latkin, Hua, & Tobin, 2004; Philbin et al, 2008; Pollini, McCall, Mehta, Vlahov, & Strathdee, 2006; Seal et al, 2001; Sergeev, Karpets, Sarang, & Tikhonov, 2003; Sherman, Cheng, & Kral, 2007). …”

mentioning

confidence: 99%

“I felt like a superhero”: The experience of responding to drug overdose among individuals trained in overdose prevention

Wagner¹,

Davidson²,

Iverson³

et al. 2014

International Journal of Drug Policy

101

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Background Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an “overdose responder” for the participants. Methods We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010–2011 who had responded to at least one overdose since being trained in overdose prevention and response. Results Being trained by an OPP and responding to overdoses had both positive and negative effects for trained “responders”. Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one’s expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects. Conclusion Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits.

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Self‐reported and observed heroin overdoses in Malmoe

Cited by 12 publications

References 27 publications

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

Wasted, overdosed, or beyond saving – To act or not to act? Heroin users’ views, assessments, and responses to witnessed overdoses in Malmö, Sweden

“I felt like a superhero”: The experience of responding to drug overdose among individuals trained in overdose prevention

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