A Prospective Study of Non-Fatal Heroin Overdose

Abstract

We aimed to study the prevalence, characteristics and outcomes of patients presenting with non-fatal heroin overdose. Two hundred and forty nine overdoses in 224 patients (61% male, range 15-49 years). Mean reported age of first heroin use was 18.8 years (range 10-45). forty-two percent reported a previous heroin overdose requiring hospital intervention. Co-ingestants incluxded benzodiazepines (61, 27.2%), alcohol (35, 15.6%), cannabis (25,11.1%), amphetamines (13, 5.8%) and hallucinogens (3, 1.3%). Most patients experienced a benign course; 81 of 115 ambulance presentations (70.4%) received prehospital naloxone and 23(9.2%) received naloxone in the ED; 67.9% had no investigations and complications were uncommon (two aspiration, one hypoxic brain injury). Median length of stay was 180min (15 min to 48h). Only 29 (11.6%) presentations required admission. There were 15 individuals (6.7%) who had 40 (16.1% of the total) repeat presentations. Heroin overdose tends to occur in experienced users who commonly co-ingest other drugs. There is a trend of overdose occurring with increasing frequency in teenage females. Repeat overdosing is common. However, while morbidity is low, these patients require considerable resourses