This section provides a broad introduction to overdose and overdose prevention. In particular, the two papers by David Best and his colleagues neatly outline the main causes of overdose and the ways in which it can be prevented.
Advisory Council on the Misuse of Drugs (2000) Reducing Drug Related Deaths. UK: The Stationary Office.
This detailed report was commissioned in order to inform policy and programming responses to drug related deaths in England and Wales. It examines the epidemiology of overdose related death by substance as well as mortality associated with chronic drug related illnesses. It explores the various social, structural and societal risk factors for drug related death and the current data collection methods in this area, before outlining priorities for a policy framework.
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Best D, Man L, Zador D, Darke S, Bird S, Strang J & Ashton M (2000) Overdosing on Opiates: Part 1 – Causes. Drug and Alcohol Findings, Issue 4.
This is the first instalment of a two-part series of thematic review papers. It consolidates findings on the causes and epidemiology of opiate overdoses, drawing on research and experiences from Western Europe and Australia.
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Best D, Man L, Zador D, Darke S, Bird S, Strang J & Ashton M. (2001) Overdosing on opiates: Prevention. Drug and Alcohol Findings, Issue 5.
This is the second instalment of a two-part series of thematic review papers. It consolidates findings on methods of preventing opiate overdoses, and explores the various interventions that have been implemented – including naloxone distribution, peer education, extending maintenance therapy, and prison through-care.
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Coffin P & Strodaha A (2002) Overdose in Central and Eastern Europe and the Former Soviet Union. New York: Open Society Institute.
Recent developments and public interest in overdose prevention approaches led the Open Society Institute’s ‘International Harm Reduction Development’ programme to explore the situation across Central and Eastern Europe. The results of this survey, based on the perceptions of harm reduction programme stakeholders throughout the region, suggest that there is a significant opportunity to stimulate overdose prevention initiatives in the region. More overdose prevention initiatives would help prevent fatalities, contribute to the value society places on the lives of drug users, and give even more legitimacy to harm reduction.
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Darke S & Hall W (2003) Heroin Overdose: Research and Evidence-Based Intervention. Journal of Urban Health, 80 (2), pages 189 – 200.
This article provides an overview of research into heroin overdose, in order to inform interventions that will reduce the rate of overdose-related death. The demographic characteristics of overdose cases are discussed, including factors associated with overdose (such as poly-drug use, drug purity, drug tolerance, routes of administration, and suicide), and responses by heroin users upon witnessing overdoses. The paper then explores potential interventions to reduce the rate of overdose and overdose-related morbidity. Unfortunately, we are unable to provide free access to this article at this stage.
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Darke S & Zador D (1996) Fatal Heroin “Overdose”: A Review. Addiction, 91(12), pages 1765–1772.
This paper provides an analytic review of the literature on fatal heroin overdose – including the circumstances accompanying overdoses, overdose causes and features, as well as possible strategies to lower mortality associated with heroin use. The report found that deaths attributed to overdose are typically among older heroin-dependent males who are not in drug treatment at the time of death – and the minority involve heroin alone. The authors conclude that the term overdose is perhaps misleading, since it implies the same mechanism of death in all cases.
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Eurasian Harm Reduction Network (2009) Overdose (website).
This dedicated section of the Eurasian Harm Reduction Network website features a regional situation analysis for overdose, an overview of overdose programmes in the region, and links to resources on overdose prevention, first aid, and service provision.
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Eurasian Harm Reduction Network (2008) Drug Overdose in Selected Eurasian Countries: Key Points. Lithuania: EHRN.
This short factsheet introduces some key points around overdose and overdose responses, with particular reference to countries in Eastern Europe and Central Asia. It covers overdose data and research, overdose services, knowledge and skills as well as current policies and laws.
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Harm Reduction Coalition (2009) Overdose (website).
This web-page from the Harm Reduction Coalition in the USA includes a range of resources such as key research, guide materials, training materials, and a description of the Harm Reduction Coalition’s own overdose prevention programmes.
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Preston A, Hunt N & Derricott J (2001) Preventing Overdose: A Briefing Paper. UK: Exchange Supplies / Department of Health.
This twelve page document is a comprehensive briefing paper on drug overdose, and aims to provide workers, advocates and people who use drugs with a clear understanding of the prevalence of overdose, the associated risks, and the responses which can help reduce this ultimately preventable cause of death. The guide sets out the case for providing injecting drug users with first aid information and advice to help them to respond appropriately to overdose situations.
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Stancliff S, Rath C (2008) Building Capacity in Overdose Prevention. Power Point Presentation. USA: Harm Reduction Coalition.
This presentation from the Harm Reduction Coalition outlines the key arguments and the main challenges for the provision of overdose prevention services in needle and syringe programmes, homeless shelters, hospitals, drug treatment and HIV programmes, prisons, and with formerly incarcerated individuals. It also provides a good summary of the overdose prevention services that are delivered in New York. For more information about the Harm Reduction Coalition’s work on overdose, visit www.harmreduction.org.
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Warner-Smith M, Lynskey M, Darke S, Hall W (2000) Heroin Overdose: Prevalence, Correlates, Consequences and Interventions. National Drug and Alcohol Research Council Monograph No. 46. Australia: University of South Wales.
This detailed monograph outlines the prevalence of heroin use, dependence and both non-fatal and fatal overdose in Australia. Related risk factors are examined as well as the causes, mechanisms and health consequences of overdose. The authors conclude with recommendations for policy and research in this area.
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World Health Organization Substance Use Department (1998) Opiate Overdose: Trends, Risk Factors, Interventions and Priorities for Action. Geneva: WHO.
This document reviews international data on trends in illicit opioid use and opioid overdose deaths, in order to identify research priorities and strategies for overdose prevention. It covers the risk factors for opioid overdose and suggests a number of potential interventions that may reduce opioid overdose deaths. The document concludes with priorities for action to better define and record overdose and other drug-related deaths and to reduce the toll of overdose deaths.
