title: Circumstances surrounding non-fatal opioid overdoses attended by ambulance services.
abstract: Opioid overdose fatalities are a significant concern globally. Non-fatal overdoses have been described as a strong predictor for future overdoses, and are often attended by the ambulance services. This paper explores characteristics associated with non-fatal overdoses and aims to identify possible trends among these events in an urban area in Norway.
  
  
  
  This is a retrospective analysis of non-fatal overdoses from Bergen ambulance services from 2012 to 2013. Demographic, temporal and geographic data were explored.
  
  
  
  During the two years, 463 non-fatal opioid overdoses were attended by ambulance services. Ambulance call-outs occurred primarily during the late afternoon and evening hours of weekdays. Summer months had more overdoses than other seasons, with a peak in August. Overdoses were nearly twice as likely to occur in a public location in August (risk ratio 1.92, P = 0.042). Ambulance response times were more likely to be longer to private locations, and these victims were more likely to be treated and left at the scene. There was no difference in arrival time for drug-related and non-drug related dispatch.
  
  
  
  The temporal patterns suggest that non-fatal overdoses occur during non-recreational time periods. The longer ambulance response time and disposition for private addresses indicate potential opportunities for peer interventions. Our analysis describes circumstances surrounding non-fatal overdoses and can be useful in guiding relevant, targeted prevention interventions. [Madah-Amiri D, Clausen T, Myrmel L, Brattebø G, Lobmaier P. Circumstances surrounding non-fatal opioid overdoses attended by ambulance services. Drug Alcohol Rev 2017;36:288-294].
authors.affiliation: The Norwegian Centre for Addiction Research, The University of Oslo, Oslo, Norway.
authors.forename: Desiree
authors.initials: D
authors.lastname: Madah-Amiri
authors.affiliation: The Norwegian Centre for Addiction Research, The University of Oslo, Oslo, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Clausen
authors.affiliation: Bergen Emergency Medical Services, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Myrmel
authors.affiliation: Bergen Emergency Medical Services, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.
authors.forename: Guttorm
authors.initials: G
authors.lastname: Brattebø
authors.affiliation: The Norwegian Centre for Addiction Research, The University of Oslo, Oslo, Norway.|Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lobmaier
mesh_terms: D000293:Adolescent; D000328:Adult; D000552:Ambulances; D000701:Analgesics, Opioid / Q000009:adverse effects*; D062787:Drug Overdose / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone
keywords: EMS; ambulance; non-fatal overdose; opioid; pre-hospital