Transient changes in behaviour lead to heroin overdose: results from a case‐crossover study of non‐fatal overdose

Dietze, Paul; Jolley, Damien; Fry, Craig Lindsay; Bammer, Gabriele

doi:10.1111/j.1360-0443.2005.01051.x

Cited by 83 publications

(62 citation statements)

References 20 publications

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“…Many studies have reported that any level of alcohol consumption is a significant predictor of non-fatal and fatal drug overdose (eg Kaye & Darke 2004;Coffin et al 2007). However, people who use drugs illicitly are typically unaware of the potentiating effects of alcohol and illicit drugs (Dietze et al 2005;Neira-León et al 2006). There are no recommended safe levels of illicit drug use when combined with alcohol as dosage levels for illicit drugs are unpredictable.…”

Section: People Who Use Drugs Illicitlymentioning

confidence: 99%

Survey of alcohol-related presentations to Australasian emergency departments

et al. 2014

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Objective: To determine the proportion of alcohol‐related presentations to emergency departments (EDs) in Australia and New Zealand, at a single time point on a weekend night shift. Design, setting and participants: A point prevalence survey of ED patients either waiting to be seen or currently being seen conducted at 02:00 local time on 14 December 2013 in 106 EDs in Australia and New Zealand. Main outcome measures: The number of ED presentations that were alcohol‐related, defined using World Health Organization ICD‐10 codes. Results: At the 106 hospitals (92 Australia, 14 New Zealand) that provided data, 395 (14.3%; 95% CI, 13.0%–15.6%) of 2766 patients in EDs at the study time were presenting for alcohol‐related reasons; 13.8% (95% CI, 12.5%–15.2%) in Australia and 17.9% (95% CI, 13.9%–22.8%) in New Zealand. The distribution was skewed left, with proportions ranging from 0 to 50% and a median of 12.5%. Nine Australian hospitals and one New Zealand hospital reported that more than a third of their ED patients had alcohol‐related presentations; the Northern Territory (38.1%) and Western Australia (21.1%) reported the highest proportions of alcohol‐related presentations. Conclusions: One in seven ED presentations in Australian and New Zealand at this 02:00 snapshot were alcohol‐related, with some EDs seeing more than one in three alcohol‐related presentations. This confirms that alcohol‐related presentations to EDs are currently underreported and makes a strong case for public health initiatives.

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Section: People Who Use Drugs Illicitlymentioning

confidence: 99%

Survey of alcohol-related presentations to Australasian emergency departments

et al. 2014

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“…14 Another widely accepted risk factor for overdose is the use of heroin together with other central nervous system depressors such as tranquilizers (mainly benzodiazepines) and alcohol. 1,4,[11][12][13][14][15][33][34][35] The participants in this study identified the use of tranquilizers together with heroin as an important reason for overdose more frequently than using heroin by the injected route or after a period of abstinence; however, a large proportion (38%) of them did not recognize this reason. An interesting issue for discussion is whether the order in which tranquilizers and heroin are taken affects the risk of overdose.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, 85.1% identified it in the OEQ or PCQ referring to overdose in general. Previous studies have found that use of a larger than usual amount of heroin greatly increases the risk of overdose, 15,33 although there is also evidence that the blood concentration of morphine is relatively low in most overdose fatalities, 12 especially when other respiratory depressants are present. Furthermore, there is only moderate evidence of a relation between fluctuations in heroin purity and overdose.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors that have been cited less frequently are the use of very pure or a large amount of heroin, the presence of some health problems, the use of heroin together with cocaine, the use of methadone alone or together with benzodiazepines or alcohol, and attempted suicide. 4,[10][11][12][13][14][15][16][17][18][19][20][21] A comparison of these objective risk factors with the reasons for overdose self-perceived by users, a subject addressed by few studies to date, 2,[22][23][24] could provide some guidance on the need for specific programs to prevent overdoses or for a change in our approach to these programs.…”

Section: Introductionmentioning

confidence: 99%

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Do Young Heroin Users in Madrid, Barcelona and Seville have Sufficient Knowledge of the Risk Factors for Unintentional Opioid Overdose?

Neira-León

Barrio²,

Brugal³

et al. 2006

J Urban Health

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To identify the self-perceived reasons for unintentional opioid overdose of young heroin users in three Spanish cities and their agreement with objective risk factors for overdose. Computer-Assisted Personal Interviews (CAPI) were held with 991 streetrecruited current heroin users aged 18-30. The general reasons for overdose and the reasons for the last overdose suffered were explored with open-ended (OEQs) and precoded questions (PCQs). Limited knowledge of overdose risk factors was defined as mention of fewer than two objective risk factors for unintentional overdose in the OEQ. Univariate, bivariate, and logistic regression methods were used. 77.8% (Seville), 64.9% (Madrid) and 57.2% (Barcelona) of participants have limited knowledge of overdose risk factors. Residence in Seville and not having attended courses or meetings on overdoses were significantly associated with limited knowledge, after adjusting for other factors. The most frequently identified general reasons in OEQ or PCQ were using heroin in large amounts (66.8%), together with tranquilizers (62.0%), adulterated (60.7%), or purer than usual (57.6%). Most reasons were selected more frequently in PCQ than in OEQ, especially rapid injection of the entire dose and using heroin shortly after using tranquilizers or alcohol, by injection, or after a period of abstinence. The results were similar for overdoses suffered by participants. Most young heroin users do not have sufficient knowledge of overdose risk factors, especially the use of heroin by injection, after a period of abstinence, or together with alcohol or methadone. Specific informational or educational programs adapted to the local context are critically needed.

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“…Overdoser mens man går i denne type behandling har nesten uten unntak bakgrunn i samtidig bruk av benzodiazepiner eller alkohol. Overdosefaren ved heroinbruk er også naert knyttet til samtidig benzodiazepinbruk (4).…”

Section: Se Også Kunnskapsprøve På Wwwtidsskriftetno/quizunclassified

Benzodiazepiner til personer med rusmiddelproblemer?

Waal¹,

Bramness²

2010

Tidsskriftet

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Transient changes in behaviour lead to heroin overdose: results from a case‐crossover study of non‐fatal overdose

Cited by 83 publications

References 20 publications

Survey of alcohol-related presentations to Australasian emergency departments

Survey of alcohol-related presentations to Australasian emergency departments

Do Young Heroin Users in Madrid, Barcelona and Seville have Sufficient Knowledge of the Risk Factors for Unintentional Opioid Overdose?

Benzodiazepiner til personer med rusmiddelproblemer?

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