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HEALTH +

SOCIAL ISSUES

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*NEW FOR 20.9.2010*

A systematic review of optimal provision of needle and syringe exchanges
 

HEALTH AND SOCIAL PROBLEMS

Gossop, M., Marsden, J., Stewart, D., et al (1998) Substance use, health and social problems of service users at 54 drug treatment agencies Intake data from the National Treatment Outcome Research Study. British Journal of Psychiatry, 173, 166-171.

Conclusions The range and severity of problems adversely affect individual users, their families, and present a challenge to addiction treatment services. These problems create costs for the health care, social service and criminal justice system responses.

 

OVERDOSE

http://www.harmreductionjournal.com/content/4/1/3

Fatal heroin 'overdose': a review

SHANE DARKE 1 DEBORAH ZADOR 2

1 National Drug and Alcohol Research Centre, University of New South Wales, Australia 2 Drug and Akohot Services, Central Sydney Area Health Service, New South Wales, Australia

Correspondence: Dr Shane Darke, National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia.

ABSTRACT

The current paper examines critically the literature on deaths attributed to heroin overdose, and examines the characteristics and circumstances of such deaths. In particular, the dominance of the widely held belief that heroin-related fatalities are a consequence of overdose is challenged. Deaths attributed to overdose represented in the literature are typically older, heroin-dependent males not in drug treatment at the time of death. Fatalities involving only heroin appear to form a minority of overdose occasions, the presence of other drugs (primarily central nervous system depressants such as alcohol and benzodiazepines) being commonly detected at autopsy. Furthermore, deaths attributed to overdose are likely to have morphine levels no higher than those who survive, or heroin users who die from other causes. It is concluded that the term overdose is, in many cases, a misleading term, since it implies the same mechanism of death in all cases, an implication that is neither clinically useful nor consistent with published data. Implications for the prevention of heroin-related deaths are discussed.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446888/?tool=pubmed

Seal KH, Kral AH, Gee L, Moore LD, Bluthenthal RL, Lorvick J, Edlin BR: Predictors and prevention of nonfatal overdose among street-recruited injection heroin users in the San Francisco Bay Area, 1998–1999.

Am J Public Health 2001, 91(11):1842-6.

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DOMESTIC ABUSE

BMJ Editorial 2002

BMJ Article 2008

 

 

 

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