Witnessing heroin‐related overdoses: the experiences of young injectors in San Francisco

Davidson, Peter J.; Ochoa, Kristen C.; Hahn, Judith A.; Evans, Jennifer L.; Moss, Andrew R.

doi:10.1046/j.1360-0443.2002.00210.x

Cited by 100 publications

(101 citation statements)

References 9 publications

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“…Although young drug users have a lower probability compared to older IDUs of experiencing opiate overdoses, a large study of IDUs under 30 years old in San Francisco reported 45% of the sample had ever overdosed and 22% had overdosed in the past year (Davidson et al, 2002). Seventy-three percent of the participants in that study had witnessed at least one opiate overdose.…”

Section: Introductionmentioning

confidence: 99%

“…Studies conducted in both the U.S. and Australia have shown that over 70% of IDUs have witnessed an opiate overdose (Davidson et al, 2002;Seal et al, 2001;McGregor et al, 1998;Darke and Ross, 1996). In studies exploring responses to opiate overdoses, witnesses reported that ambulances were reportedly called in 10% to 56% of events (Warner-Smith et al, 2001;.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city

Sherman

Cheng

Kral

2007

Drug and Alcohol Dependence

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city

Sherman

Cheng

Kral

2007

Drug and Alcohol Dependence

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“…Rates of emergency medical response to overdose and witnesses' attempts to revive the victim have been described elsewhere (Bennett and Higgins, 1999;Darke et al, 1996b;Davidson et al, 2002;McGregor et al, 1998;Sergeev et al, 2003;Tobin et al 2005;Tracy et al, 2005). Less is known about whether the overdose event serves as an impetus for entering drug treatment or other changes in drug use behaviors.…”

Section: Introductionmentioning

confidence: 99%

Non-fatal overdose and subsequent drug treatment among injection drug users

Pollini

McCall

Mehta

et al. 2006

Drug and Alcohol Dependence

111

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Overdose is a leading cause of death among illicit drug users. 924 injection drug users (IDUs) in Baltimore, Maryland, were interviewed to characterize overdose events and determine the circumstances under which they lead to drug treatment. Overall, 366 (39.7%) reported at least one non-fatal drug overdose. Most (96.2%) used heroin on the day of their last overdose and almost half (42.6%) used heroin and alcohol but few (4.1%) used tranquilizers or benzodiazepines. Five percent were in drug treatment when the overdose occurred and 7.1% had been incarcerated two weeks prior. One in four IDUs (26.2%) sought drug treatment within 30 days after their last overdose of whom 75% enrolled. Speaking with someone about drug treatment after the overdose was associated with treatment seeking (AOR 5.22; 95% CI: 3.12, 8.71). Family members were the most commonly cited source of treatment information (53.7%) but only those who spoke with spouses, crisis counselors and hospital staff were more likely to seek treatment. Not being ready for treatment (69.6%) and not viewing drug use as a problem (30.7%) were the most common reasons for not seeking treatment and being placed on a waiting list was the most common reason for not subsequently enrolling in treatment (66.7%). Of the IDUs treated by emergency medical technicians, emergency room staff, or hospital staff, only 17.3%, 26.2% and 43.2% reported getting drug treatment information from those sources, respectively. Interventions that provide drug treatment information and enhance motivation for treatment in the medical setting and policies that reduce barriers to treatment entry among motivated drug users are recommended.

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“…Fatal overdose is usually not instantaneous; it occurs over a period of 1-3 hours [8]. Given the relatively long window of opportunity in which to intervene and the fact that the vast majority of overdoses occur in the presence of others [1,[9][10][11][12], efforts to mobilize immediate medical intervention are optimal, i.e. rescue breathing and/or administration of naloxone hydrochloride (hereafter naloxone), a shortacting opioid antagonist.…”

mentioning

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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Witnessing heroin‐related overdoses: the experiences of young injectors in San Francisco

Abstract: Respondents were willing to act at overdoses at which they were present, but frequently did not do so in the most efficacious manner. Fear of police was identified as the most significant barrier to the ideal first response of calling emergency services.

Cited by 100 publications

References 9 publications

Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city

Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city

Non-fatal overdose and subsequent drug treatment among injection drug users

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

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