Circumstances and Users' Perceptions of Heroin Overdose at the Time of the Event and at One-Week Follow-Up in Sydney, Australia: Implications for Prevention

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Abstract
One hundred and forty-one (141) heroin users were interviewed at the time of their most recent overdose of which 34% returned for in-depth interviews within seven days. Subjects were predominantly male (77%), aged between 18 and 29 (53%), highly dependent, and unlikely to be (8%) or to have ever been (68%) in MMT. Poly-drug use was prevalent (54%) at the time of overdose despite most subjects' awareness of the association between poly-drug use and overdose. Subjects consumed other drugs with heroin in order to increase the pleasurable effects of drug use rather than to medicate symptoms of withdrawal or depression. The overdose did not appear to change subjects' low level of concern about overdosing - only a minority (11 %) said they would seek treatment following overdose. Experience of overdose therefore does not appear to be a motivating factor for entry into treatment. A variety of harm reduction initiatives needs to be supported in order to reduce the frequency and hazards of overdose.