Non‐fatal heroin overdose, treatment exposure and client characteristics: Findings from the Australian Treatment Outcome Study (ATOS)

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Abstract
The relationship between treatment exposure, drug use, psychosocial variables and non‐fatal heroin overdose was examined among a cohort of 495 heroin users, re‐interviewed at 12 months. The 12‐month overdose rate declined from 24% to 12%, and the proportion administered naloxone declined from 15% to 7%. There were significant reductions in overdose among those who entered maintenance therapies (22% to 4%) and residential rehabilitation (33% vs. 19%) at baseline, but not among those who entered detoxification or were not entering treatment. The total number of treatment days received over the follow‐up period was associated independently with a reduced risk of overdose. Each extra treatment day was associated with a 1% reduction in risk of overdose over the follow‐up period. By contrast, more treatment episodes were associated with an increased risk of overdose (OR 1.62). Other independent predictors of overdose over follow‐up were more extensive polydrug use (OR 1.40), and having overdosed in the year preceding the study (OR 7.87).