Article

Witnessing heroin-related overdoses: the experiences of young injectors in San Francisco.

Department of Epidemiology and Biostatistics, University of California, San Francisco, 94143, USA.
Addiction (Impact Factor: 4.6). 01/2003; 97(12):1511-6. DOI: 10.1046/j.1360-0443.2002.00210.x
Source: PubMed

ABSTRACT Assessment of young injectors' exposure and response to others' heroin-related overdose.
Cross-sectional survey.
San Francisco, CA, United States.
Nine hundred and seventy-three street-recruited current injectors under 30 years old.
Self-reported experiences of witnessing heroin-related overdoses from structured interviews.
Seven hundred and nine of 973 (73%) had ever witnessed at least one heroin-related overdose, and 491 of 973 (50%) had witnessed an overdose in the last 12 months. Fourteen per cent of those who had witnessed an overdose in the past year reported that the outcome of the overdose was death. Emergency services were called to 52% of most recent witnessed overdoses. Cardiopulmonary resuscitation (CPR) or expired air resuscitation (EAR or 'rescue breathing') was performed in 61% of cases. Inappropriate strategies such as injection with stimulants or application of ice were rare. In 67% of cases in which emergency services were not called the witness said this was because the victim regained consciousness. In the remaining 33%, 56% stated emergency services were not called due to fear of the police.
Respondents were willing to act at overdoses at which they were present, but frequently did not do so in the most efficacious manner. Fear of police was identified as the most significant barrier to the ideal first response of calling emergency services.

0 Followers
 · 
100 Views
  • Source
    Addiction 08/2014; 109(8). DOI:10.1111/add.12585 · 4.60 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Reçue le 27 mai 2004 ; version révisée reçue le 27 avril 2005 ; validée le 28 avril 2005 Résumé La première réponse aux risques liés à l'injection illicite de drogues dans la plupart des situations implique une répression renforcée, dans un effort de limiter l'offre et la demande de drogues. Depuis les années 1980, les approches politiques sont de plus en plus appliquées sur le marché des drogues illicites, malgré une confirmation scientifique limitée de leur efficacité. A contrario, un corpus grandissant de recherches indique que ces approches ont le potentiel non négligeable de produire des impacts sociaux et sanitaires néfastes, y compris l'interruption de la fourniture de soins aux utilisateurs de drogues injectables (UDI), ce qui augmente les comportements à risques associés à la transmission de maladies infectieuses et aux overdoses et exposent des communautés auparavant non affectées aux risques liés à l'usage de drogues illicites. Il existe toutefois d'autres solutions aux approches répressives ciblées traditionnelles qui peuvent potentiellement générer bien moins de conséquences négatives pour la santé et la société et plus d'avantages nets pour la communauté. Certaines de ces approches nécessitent de modifier les pratiques de politique, d'encourager les partenariats entre police et agences de santé publique et de développer des systèmes de surveillance des pratiques policières. D'autres possibilités impliquent la fourniture de services de réduction des risques, comme les centres d'injection sécurisée qui aident à minimiser les risques liés à la drogue, et les services de traitement de l'addiction qui finissent par contribuer à la réduction de la demande en drogues illégales. © 2005 Elsevier B.V. Tous droits réservés.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Overdose is a significant cause of death among heroin users. Frequently, other heroin users are present when an overdose occurs, which means the victim's life could be saved. There is a lack of studies that, based on heroin users own stories, examine their views, assessments, and responses to witnessed overdoses. Methods The study is based on qualitative interviews with thirty-five heroin users who witnessed someone else's overdose. Results The heroin users generally had a positive attitude towards assisting peers who had overdosed. A number of factors and circumstances, however, contribute to witnesses often experiencing resistance to or ambivalence about responding. The witness's own high, the difficulty in assessing the seriousness of the situation, an unwillingness to disturb someone else's high, uncertainty about the motive behind the overdose and whether the victim does or does not want assistance as well as fear of police involvement, were common factors that acted as barriers to adequate responses in overdose situations. Conclusion The fact that being high makes it difficult to respond to overdoses, using traditional methods, argues for simpler and more effective response techniques. This can include intranasal naloxone programs for heroin users. The findings regarding the uncertainty about the intention of the overdose victim and the sensitivity to the experience of a good high argue for more up-front communication and discussion amongst using peers so that they can make their intentions clear to each other. Issues like this can be addressed in overdose education interventions. Overdose prevention measures also need to address the fact that fear of the police acts as a barrier to call emergency services.
    International Journal of Drug Policy 01/2014; 26(1). DOI:10.1016/j.drugpo.2014.07.006 · 2.40 Impact Factor

Full-text (2 Sources)

Download
35 Downloads
Available from
Sep 9, 2014