Response to overdose among injection drug users

Intravenous drug users are likely to experience or witness a drug overdose, but they don't know how to deal with one when it happens.

A study of IV drug users in Baltimore found that more than two-thirds had witnessed an overdose. But only two-thirds of those called 911 for emergency medical help, and even then, they delayed making the call by five minutes or more.

Often, witnesses to an overdose tried their own remedies, such as walking the victim around, shaking them or inflicting pain, and one in four injected a home-made solution of salt water in an attempt to reverse the overdose, said Robin Pollini, Ph.D., lead author of the study, which appears in the September issue of the American Journal of Preventive Medicine.

Most witnesses did not call 911 promptly because they thought the victim could be revived without help, but many reported fearing involvement by the police, said Pollini, with the University of California at San Diego. Mortality rates from overdoses could improve if intravenous drug users were given good information on how to deal with an overdose and if overdoses were handled by health care personnel rather than the police.

"An overdose event should be viewed as a health care emergency. An ambulance should respond," said Pollini.

The study surveyed 924 drug users in Baltimore between August 2003 and September 2004. Since then, deaths due to overdose have dropped greatly in Baltimore, according to more recent data collected by Maryland's chief medical examiner. In 2005, 218 people died of a drug overdose in Baltimore, the lowest number in 10 years.

The Open Society Institute, funded by billionaire George Soros, has been underwriting several programs in Baltimore to reduce drug use and its mortality and the city has been making a huge effort to increase the availability of drug treatment. The city is teaching drug users and others how to properly deal with an overdose. This includes training on how to use Narcan (naloxone), an injected medicine that rapidly reverses opiate overdoses.

By Valerie DeBenedette

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