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Overdose is a well-researched harm of drug use, and this is reflected in the literature on the epidemiology of both fatal and non-fatal overdoses in various populations (including released prisoners). This section highlights a few of the most recent, or most widely referenced and quoted papers. We were unable to identify a global summary or report of overdose prevalence, so this section features papers from Central and Eastern Europe and Central Asia, Australia, Canada, Iran, the USA, and Vietnam. Gaining a proper understanding of the extent and patterns of overdose is essential in planning and delivering effective prevention interventions.
Bergenstrom A, Quan VM, Van Nam L, McClausland K, Thuoc NP, Celentano D & Go V (2008) A Cross-Sectional Study on Prevalence of Non-Fatal Drug Overdose and Associated Risk Characteristics among Out-of-Treatment Injecting Drug Users in North Vietnam. Substance Use and Misuse, 43(1), pages 73 – 84.
This study from South-East Asia investigates the prevalence of drug use-related overdose through a community-based cross-sectional survey of out-of-treatment male opiate injecting drug users aged 18-45. 299 participants were recruited in a semi-urban province in North Vietnam, and 43.5% reported ever experiencing an overdose in their lifetime – more than four fifths of whom had done so recently. Unfortunately, we are unable to provide free access to this article at this stage.
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Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG &
Koepsell TD (2007) Release from Prison — A High Risk of Death for Former Inmates. The New England Journal of Medicine, 356, pages 157 – 165.
This paper investigates the risk of death for newly released prisoners in Washington State, US. The researchers find that risk of death among former inmates is 3.5 times that among other state residents. More strikingly, they find that during the first two weeks after release, the risk of death among former inmates is 12.7 times that among other state residents, with a markedly elevated relative risk of death from drug overdose. They conclude that former prison inmates are at high risk for death after release from prison, particularly during the first 2 weeks. Interventions are necessary to reduce the risk of death after release from prison.
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Coffin P (2008) Overdose: A Major Cause of Preventable Death in Central and Eastern Europe in Central Asia. Recommendations and Overview of the Situation in Latvia, Kyrgyzstan, Romania, Russia and Tajikistan (English). Lithuania: EHRN.
This report – written for the Eurasia Harm Reduction Network (EHRN) and funded by the World Health Organization – summarises the current situation with regard to overdose epidemiology, services, knowledge, and policies in selected Eurasian countries. Across the region, drug overdose is one of the leading causes of death among young people and the top cause of death among injection drug users – often exceeding deaths from AIDS-related illnesses. Findings for each of five Eurasian countries are presented, with the goal of providing a status report and a resource for future planning.
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Coffin P (2008) Overdose: A Major Cause of Preventable Death in Central and Eastern Europe in Central Asia. Recommendations and Overview of the Situation in Latvia, Kyrgyzstan, Romania, Russia and Tajikistan (Russian). Lithuania: EHRN.
This report – written for the Eurasia Harm Reduction Network (EHRN) and funded by the World Health Organization – summarises the current situation with regard to overdose epidemiology, services, knowledge, and policies in selected Eurasian countries. Across the region, drug overdose is one of the leading causes of death among young people and the top cause of death among injection drug users – often exceeding deaths from AIDS-related illnesses. Findings for each of five Eurasian countries are presented, with the goal of providing a status report and a resource for future planning.
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Coffin PO, Galea S, Ahern J, Leon AC, Vlahov D, Tardiff K (2003) Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990–98. Addiction, 98, pages 739 – 747.
This study investigates the contribution of multiple drug combinations to overdose mortality trends in New York City between 1990 and 1998. The authors found that opiates, cocaine and alcohol were the three drugs most commonly attributed as the cause of accidental overdose deaths, accounting for 97.6% of all deaths - with 57.8% of those deaths attributed to two or more of these three drugs in combination. Overall trends in overdose deaths over these years were more affected by changes in the rates of multi-drug deaths, as the rates of overdose deaths associated with just one drug remained relatively stable. The authors conclude that interventions to prevent accidental overdose mortality must address the use of drugs such as heroin, cocaine and alcohol in combination. Unfortunately, we are unable to provide free access to this article at this stage.
Click here to view the abstract via PubMed
Degenhardt L, Roxburgh A & Barker B (2005) Underlying Causes of Cocaine, Amphetamine and Opioid Related Deaths in Australia. Journal of Clinical Forensic Medicine, 12, pages 187 – 195.
This study investigates the characteristics of drug-related deaths in Australia between 1997 and 2002. The authors outline the extent of drug-related deaths related to opioids, amphetamines and cocaine – and found that only thirteen deaths were attributable primarily to cocaine and sixty-eight to amphetamines, compared with 4,591 to opioids. Unfortunately, we are unable to provide free access to this article at this stage.
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Karbakhsh M & Zandi NS (2007) Acute Opiate Overdose in Tehran: The forgotten Role of Opium. Addictive Behaviors, 32, pages 1835 – 1842.
This report from Iran aims to examine the epidemiology of acute opiate overdose using data from a ‘poisoning center’ in Tehran. Opium was the major cause of overdose in the study – suggesting that opium is far from a harmless substance, even though its use is regarded as a historical phenomenon in many countries. Unfortunately, we are unable to provide free access to this article at this stage.
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Milloy MJ, Kerr T, Mathias R, Zhang R, Montaner JS, Tyndall M & Wood E (2008) Non-Fatal Overdose among a Cohort of Active Injection Drug Users Recruited from a Supervised Injection Facility. American Journal Drug Alcohol Abuse, 34(4), pages 499 – 509.
This study aimed to evaluate patterns of non-fatal overdose among a cohort of clients from the safer injecting facility in Vancouver, Canada. A prospective sample of 1,090 participants was used, and the authors found that over half reported a history of non-fatal overdose – and this remained constant throughout the study. Previous overdose was associated with ‘sex-trade involvement’ and public drug use, but not with use of the safer injecting facility. Therefore, the study concludes that this facility may increase the likelihood of overdose – as had been previously claimed. Unfortunately, we are unable to provide free access to this article at this stage.
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Rosen DL, Schoenbach VJ & Wohl DA (2008) All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980–2005. American Journal of Public Health, 98, pages 2278 – 2284.
In order to identify unmet health care needs among former prisoners, the researchers compared mortality of ex-prisoner and other state residents in North Carolina, USA. The findings illustrate that a higher number of deaths occurred within the former prisoner sample than that of the other state residents. The authors conclude that excess deaths from injuries and medical conditions among ex-prisoners highlight their medical vulnerability and the need to improve access to correctional and community preventive health services. Unfortunately, we are unable to provide free access to this article at this stage.
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Shah NG, Lathrop SL, Reichard RR & Landen MG (2008) Unintentional Drug Overdose Death Trends in New Mexico, USA, 1990-2005: Combinations of heroin, cocaine, prescription opioids and alcohol. Addiction, 103(1), pages 126 – 136.
This study aims to determine the contributions of heroin, prescription opioids, cocaine and alcohol to the total overdose death rates in New Mexico, and to identify changes in drug overdose patterns over 15 years. The main findings were that the total unintentional drug overdose death rate in New Mexico had increased since 1990. The drugs most commonly associated with deaths were heroin alone, heroin and alcohol together, and prescription opioids alone (especially among white males and all females). The researchers conclude that interventions to prevent drug overdose death should be targeted to specific sub-populations. Unfortunately, we are unable to provide free access to this article at this stage.
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