Overdose deaths following previous non‐fatal heroin overdose: Record linkage of ambulance attendance and death registry data
- 6 July 2009
- journal article
- Published by Wiley in Drug and Alcohol Review
- Vol. 28 (4), 347-352
- https://doi.org/10.1111/j.1465-3362.2009.00057.x
Abstract
Introduction and Aims. Experiencing previous non-fatal overdoses have been identified as a predictor of subsequent non-fatal overdoses; however, few studies have investigated the association between previous non-fatal overdose experiences and overdose mortality. We examined overdose mortality among injecting drug users who had previously been attended by an ambulance for a non-fatal heroin overdose. Design and Methods. Using a retrospective cohort design, we linked data on non-fatal heroin overdose cases obtained from ambulance attendance records in Melbourne, Australia over a 5-year period (2000–2005) with a national death register. Results. 4884 people who were attended by ambulance for a non-fatal heroin overdose were identified. One hundred and sixty-four overdose deaths occurred among this cohort, with an average overdose mortality rate of 1.20 per 100 person-years (95% CI, 1.03–1.40). Mortality rate decreased 10-fold after 2000 coinciding with widely reported declines in heroin availability. Being male, of older age (>35 years) and having been attended multiple times for previous non-fatal overdoses were associated with increased mortality risk. Discussion and Conclusions. As the first to show a direct association between non-fatal overdose and subsequent overdose mortality, this study has important implications for the prevention of overdose mortality. This study also shows the profound effect of macro-level heroin market dynamics on overdose mortality.[Stoové MA, Dietze PM, Jolley D. Overdose deaths following previous non-fatal heroin overdose: Record linkage of ambulance attendance and death registry data. Drug Alcohol Rev 2009;28:347–352]This publication has 39 references indexed in Scilit:
- Patterns of Nonfatal Heroin Overdose Over a 3-Year Period: Findings From the Australian Treatment Outcome StudyJournal of Urban Health, 2007
- Effects of a sustained heroin shortage in three Australian StatesAddiction, 2005
- Determinants of overdose incidents among illicit opioid users in 5 Canadian citiesCMAJ : Canadian Medical Association Journal, 2004
- Mortality risk among new onset injection drug usersAddiction, 2004
- Interpreting changes in heroin supply in Melbourne: droughts, gluts or cycles?Drug and Alcohol Review, 2002
- Deaths by unintentional illicit drug overdose in Italy, 1984–2000Drug and Alcohol Dependence, 2002
- Factors associated with non‐fatal heroin overdose: assessing the effect of frequency and route of heroin administrationAddiction, 2002
- Ambulance calls to suspected overdoses: New South Wales patterns July 1997 to June 1999Australian and New Zealand Journal of Public Health, 2001
- Ambulance attendance at heroin overdose in Melbourne: the establishment of a database of Ambulance Service recordsDrug and Alcohol Review, 2000
- Deaths in the first two weeks of maintenance treatment in NSW in 1994: identifying cases of iatrogenic methadone toxicityDrug and Alcohol Review, 1998