Relationship between prescribing and risk of opiate overdose among drug users in and out of maintenance treatment.
Opiate users (n = 135) from southern England, Glasgow and Edinburgh were interviewed about opiate overdose (lifetime). Fifty-six percent had overdosed. The majority (66%) reported mixing opiates with at least one other drug (mainly alcohol and/or benzodiazepines) at their last overdose. Patients identified misjudgements of purity, mixing drugs and misjudgements of tolerance as causes of overdose. The sample was divided into groups: (1) 'no prescription', (2) prescribed 'diazepam only', (3) prescribed 'methadone only' and (4) prescribed 'methadone + diazepam'. The 'methadone + diazepam' group reported more lifetime and deliberate overdoses, the 'methadone only' group were more likely to have used several drugs at the time of their last overdose and the 'no prescription' group to have used only heroin. Drug users' overdose risk may vary as a result of their prescribed and non-prescribed drug use. Interventions should be developed and tailored according to clients' needs and current use patterns.
Man
Lan-Ho
LH
National Addiction Centre, London, UK. LMan@iop.kcl.ac.uk
Best
David
D
Gossop
Michael
M
Stillwell
Garry
G
Strang
John
J
D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000534:rehabilitation*; D001569:Benzodiazepines / Q000506:poisoning* / Q000627:therapeutic use; D015984:Causality; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D015897:Comorbidity; D016578:Crack Cocaine; D003431:Cross-Cultural Comparison; D003975:Diazepam / Q000506:poisoning* / Q000627:therapeutic use; D004347:Drug Interactions; D062787:Drug Overdose / Q000453:epidemiology* / Q000534:rehabilitation; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D015994:Incidence; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000506:poisoning* / Q000627:therapeutic use; D018570:Risk Assessment / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D006113:United Kingdom / Q000453:epidemiology
D016578:Crack Cocaine; D009294:Narcotics; D001569:Benzodiazepines; D003975:Diazepam; D008691:Methadone