Rowan P Ogeil1, Jeremy Dwyer2, Lyndal Bugeja3, Cherie Heilbronn4, Dan I Lubman4, Belinda Lloyd4. 1. Eastern Health Clinical School, Monash University, Box Hill 3128, Victoria, Australia; Turning Point, Eastern Health, Richmond 3121, Victoria, Australia. Electronic address: rowan.ogeil@monash.edu. 2. Coroners Court of Victoria, Southbank 3006, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3010, Victoria, Australia. 3. Coroners Court of Victoria, Southbank 3006, Victoria, Australia; School of Nursing and Midwifery, Monash University, Clayton 3800, Victoria, Australia. 4. Eastern Health Clinical School, Monash University, Box Hill 3128, Victoria, Australia; Turning Point, Eastern Health, Richmond 3121, Victoria, Australia.
Abstract
BACKGROUND: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. METHODS: A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013. Information on the source of pharmaceutical opioids, co-contributing drugs, history of drug dependence, and mental illness was extracted and coded. RESULTS: Pharmaceutical opioids were involved in 587 deaths, and within these, 125 cases (21%) were witnessed. The majority of these witnessed deaths (77.6%) occurred at the deceased's residence, with the witness being a partner or unrelated acquaintance who did not realise the significance of what they were witnessing. The most common contributing pharmaceutical opioids were methadone (49.6%), codeine (32.0%), and oxycodone (19.2%), with the source more often prescribed than diverted. Co-contributing drugs were involved in 110 cases, with the most common being benzodiazepines. Evidence of current dependence and mental illness was found in 53.6% of cases. CONCLUSION: Most pharmaceutical opioid overdose deaths with a witness present occurred in the deceased's home, with symptoms of overdose being noted, but not acted upon. These findings support the trialling of education and/or naloxone to partners and family members of people who use pharmaceutical opioids in order to reduce overdose deaths.
BACKGROUND: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. METHODS: A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013. Information on the source of pharmaceutical opioids, co-contributing drugs, history of drug dependence, and mental illness was extracted and coded. RESULTS: Pharmaceutical opioids were involved in 587 deaths, and within these, 125 cases (21%) were witnessed. The majority of these witnessed deaths (77.6%) occurred at the deceased's residence, with the witness being a partner or unrelated acquaintance who did not realise the significance of what they were witnessing. The most common contributing pharmaceutical opioids were methadone (49.6%), codeine (32.0%), and oxycodone (19.2%), with the source more often prescribed than diverted. Co-contributing drugs were involved in 110 cases, with the most common being benzodiazepines. Evidence of current dependence and mental illness was found in 53.6% of cases. CONCLUSION: Most pharmaceutical opioid overdose deaths with a witness present occurred in the deceased's home, with symptoms of overdose being noted, but not acted upon. These findings support the trialling of education and/or naloxone to partners and family members of people who use pharmaceutical opioids in order to reduce overdose deaths.
Authors: Lauren Dayton; Rachel E Gicquelais; Karin Tobin; Melissa Davey-Rothwell; Oluwaseun Falade-Nwulia; Xiangrong Kong; Michael Fingerhood; Abenaa A Jones; Carl Latkin Journal: PLoS One Date: 2019-11-07 Impact factor: 3.752
Authors: Katie Kanter; Ryan Gallagher; Feyisope Eweje; Alexander Lee; David Gordon; Stephen Landy; Julia Gasior; Haideliza Soto-Calderon; Peter F Cronholm; Ben Cocchiaro; James Weimer; Alexis Roth; Stephen Lankenau; Jacob Brenner Journal: Harm Reduct J Date: 2021-07-23