Nathan C Stam1,2, Dimitri Gerostamoulos3, Karen Smith2,4,5, Jennifer L Pilgrim1, Olaf H Drummer1. 1. a Department of Forensic Medicine , Monash University , Melbourne , Australia. 2. b Department of Community Emergency Health and Paramedic Practice , Monash University , Melbourne , Australia. 3. c Victorian Institute of Forensic Medicine , Melbourne , Australia. 4. d Centre for Research and Evaluation , Ambulance Victoria , Melbourne , Australia. 5. e Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , Australia.
Abstract
AIM: Take-home naloxone (THN) programs have been implemented in order to reduce the number of heroin-overdose deaths. Because of recent legislative changes in Australia, there is a provision for a greater distribution of naloxone in the community, however, the potential impact of these changes for reduced heroin mortality remains unclear. The aim of this study was to examine the characteristics of the entire cohort of fatal heroin overdose cases and assess whether there was an opportunity for bystander intervention had naloxone been available at the location and time of each of the fatal overdose events to potentially avert the fatal outcome in these cases. METHODS: The circumstances related to the fatal overdose event for the cohort of heroin-overdose deaths in the state of Victoria, Australia between 1 January 2012 and 31 December 2013 were investigated. Coronial data were investigated for all cases and data linkage was performed to additionally investigate the Emergency Medical Services information about the circumstances of the fatal heroin overdose event for each of the decedents. RESULTS AND DISCUSSION: There were 235 fatal heroin overdose cases identified over the study period. Data revealed that the majority of fatal heroin overdose cases occurred at a private residence (n = 186, 79%) and where the decedent was also alone at the time of the fatal overdose event (n = 192, 83%). There were only 38 cases (17%) where the decedent was with someone else or there was a witness to the overdose event, and in half of these cases the witness was significantly impaired, incapacitated or asleep at the time of the fatal heroin overdose. There were 19 fatal heroin overdose cases (8%) identified where there was the potential for appropriate and timely intervention by a bystander or witness. CONCLUSION: This study demonstrated that THN introduction alone could have led to a very modest reduction in the number of fatal heroin overdose cases over the study period. A lack of supervision or a witness to provide meaningful and timely intervention was evident in most of the fatal heroin overdose cases.
AIM: Take-home naloxone (THN) programs have been implemented in order to reduce the number of heroin-overdose deaths. Because of recent legislative changes in Australia, there is a provision for a greater distribution of naloxone in the community, however, the potential impact of these changes for reduced heroin mortality remains unclear. The aim of this study was to examine the characteristics of the entire cohort of fatal heroinoverdose cases and assess whether there was an opportunity for bystander intervention had naloxone been available at the location and time of each of the fatal overdose events to potentially avert the fatal outcome in these cases. METHODS: The circumstances related to the fatal overdose event for the cohort of heroin-overdose deaths in the state of Victoria, Australia between 1 January 2012 and 31 December 2013 were investigated. Coronial data were investigated for all cases and data linkage was performed to additionally investigate the Emergency Medical Services information about the circumstances of the fatal heroinoverdose event for each of the decedents. RESULTS AND DISCUSSION: There were 235 fatal heroinoverdose cases identified over the study period. Data revealed that the majority of fatal heroinoverdose cases occurred at a private residence (n = 186, 79%) and where the decedent was also alone at the time of the fatal overdose event (n = 192, 83%). There were only 38 cases (17%) where the decedent was with someone else or there was a witness to the overdose event, and in half of these cases the witness was significantly impaired, incapacitated or asleep at the time of the fatal heroinoverdose. There were 19 fatal heroinoverdose cases (8%) identified where there was the potential for appropriate and timely intervention by a bystander or witness. CONCLUSION: This study demonstrated that THN introduction alone could have led to a very modest reduction in the number of fatal heroinoverdose cases over the study period. A lack of supervision or a witness to provide meaningful and timely intervention was evident in most of the fatal heroinoverdose cases.
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
Authors: Matthew Jones; Fiona Bell; Jonathan Benger; Sarah Black; Penny Buykx; Simon Dixon; Tim Driscoll; Bridie Evans; Adrian Edwards; Gordon Fuller; Steve Goodacre; Rebecca Hoskins; Jane Hughes; Ann John; Jenna Jones; Chris Moore; Fiona Sampson; Alan Watkins; Helen Snooks Journal: Pilot Feasibility Stud Date: 2020-07-09