title: A procedure that differentiates unintentional from intentional overdose in opioid abusers.
abstract: OBJECTIVE
  The purpose of this study is to develop a procedure for assessing unintentional overdose (OD) in opiate abusers that differentiates it from intentional OD, and provides reliable information about the incident.
  
  
  METHODS
  A sample of 121 patients in a methadone maintenance program at an urban university hospital completed a baseline assessment. A total of 70 participants completed an identical assessment at least 14 days later. The ability of an OD item to differentiate unintentional OD from intentional OD was tested, as was the test-retest reliability of questions assessing symptoms and treatment of OD.
  
  
  RESULTS
  The procedure is reliable and differentiated unintentional OD from intentional OD. Questions assessing symptoms of OD were endorsed in almost every unintentional OD incident, although reliability was affected by loss of consciousness. The reliability of questions assessing emergency treatment and Narcan administration was outstanding.
  
  
  CONCLUSIONS
  Our procedure for assessing OD differentiates unintentional OD from intentional OD. The use of follow-up questions assessing acute treatment for OD is recommended. Items concerning symptoms of OD are not needed to confirm the presence of an OD, but may be used to clarify whether an event was an OD.
authors.affiliation: Center of Excellence, Department of Veteran Affairs Medical Center, Canandaigua, USA. peter.britton@va.gov
authors.forename: Peter C
authors.initials: PC
authors.lastname: Britton
authors.forename: Amy S B
authors.initials: AS
authors.lastname: Bohnert
authors.forename: James D
authors.initials: JD
authors.lastname: Wines
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Conner
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D062787:Drug Overdose / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D033182:Intention; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D015203:Reproducibility of Results; D016320:Substance Abuse Treatment Centers; D013406:Suicide, Attempted; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone