Nathan C Stam, John Furler, Sarah Hiley, Jennifer L Schumann
{"title":"与无管制毒品市场相关的海洛因过量风险差异：澳大利亚墨尔本一家受监管注射机构的观点。","authors":"Nathan C Stam, John Furler, Sarah Hiley, Jennifer L Schumann","doi":"10.1111/add.16706","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To determine the contribution that variation in the unregulated drug market has on the risk of heroin overdose across individuals with different levels of personal overdose risk.</p><p><strong>Design: </strong>A retrospective cohort study of heroin injecting episodes and overdose cases were examined over a 12-month period between 30 June 2022 and 30 June 2023.</p><p><strong>Setting: </strong>The Medically Supervised Injecting Room in Melbourne, Australia.</p><p><strong>Cases: </strong>1474 witnessed heroin overdose cases were examined amongst a cohort of 337 individuals who were predominantly male (n = 276, 81.7%) with a median age of 43.5 years (interquartile range 37.25-49.00 years, range 20-75 years).</p><p><strong>Measurements: </strong>The daily overdose rate was used to differentiate High and Low daily overdose risk categories. The number of overdose events that an individual experienced during the study period was used to differentiate people into Standard, Moderate and High personal overdose risk categories. Each overdose case was differentiated by the personal overdose risk of the individual who experienced the overdose, as well as the overdose risk of the day that overdose occurred. A stratified overdose risk profile was then derived across the nine different daily overdose risk and personal overdose risk categories.</p><p><strong>Findings: </strong>The rate of overdose approximately doubled on High overdose risk days compared with Standard overdose risk days, increasing by a factor of 2.11, 2.41 and 2.03 times for individuals in the Standard, Moderate and High personal overdose risk groups. Conversely, the rate of overdose was also substantially reduced on Low overdose risk days to a factor of 0.17, 0.28 and 0.20, respectively.</p><p><strong>Conclusion: </strong>Among heroin users in Melbourne, Australia, there is an approximately 10-times difference in the risk of overdose on some days compared with others, which appears to be attributable to the effects of the unregulated drug market and not the effects of variation in personal overdose risk of individuals.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"285-292"},"PeriodicalIF":5.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707310/pdf/","citationCount":"0","resultStr":"{\"title\":\"Differences in heroin overdose risk associated with the unregulated drug market: Insights from a supervised injecting facility in Melbourne, Australia.\",\"authors\":\"Nathan C Stam, John Furler, Sarah Hiley, Jennifer L Schumann\",\"doi\":\"10.1111/add.16706\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To determine the contribution that variation in the unregulated drug market has on the risk of heroin overdose across individuals with different levels of personal overdose risk.</p><p><strong>Design: </strong>A retrospective cohort study of heroin injecting episodes and overdose cases were examined over a 12-month period between 30 June 2022 and 30 June 2023.</p><p><strong>Setting: </strong>The Medically Supervised Injecting Room in Melbourne, Australia.</p><p><strong>Cases: </strong>1474 witnessed heroin overdose cases were examined amongst a cohort of 337 individuals who were predominantly male (n = 276, 81.7%) with a median age of 43.5 years (interquartile range 37.25-49.00 years, range 20-75 years).</p><p><strong>Measurements: </strong>The daily overdose rate was used to differentiate High and Low daily overdose risk categories. The number of overdose events that an individual experienced during the study period was used to differentiate people into Standard, Moderate and High personal overdose risk categories. Each overdose case was differentiated by the personal overdose risk of the individual who experienced the overdose, as well as the overdose risk of the day that overdose occurred. A stratified overdose risk profile was then derived across the nine different daily overdose risk and personal overdose risk categories.</p><p><strong>Findings: </strong>The rate of overdose approximately doubled on High overdose risk days compared with Standard overdose risk days, increasing by a factor of 2.11, 2.41 and 2.03 times for individuals in the Standard, Moderate and High personal overdose risk groups. Conversely, the rate of overdose was also substantially reduced on Low overdose risk days to a factor of 0.17, 0.28 and 0.20, respectively.</p><p><strong>Conclusion: </strong>Among heroin users in Melbourne, Australia, there is an approximately 10-times difference in the risk of overdose on some days compared with others, which appears to be attributable to the effects of the unregulated drug market and not the effects of variation in personal overdose risk of individuals.</p>\",\"PeriodicalId\":109,\"journal\":{\"name\":\"Addiction\",\"volume\":\" \",\"pages\":\"285-292\"},\"PeriodicalIF\":5.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707310/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Addiction\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/add.16706\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/add.16706","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Differences in heroin overdose risk associated with the unregulated drug market: Insights from a supervised injecting facility in Melbourne, Australia.
Aims: To determine the contribution that variation in the unregulated drug market has on the risk of heroin overdose across individuals with different levels of personal overdose risk.
Design: A retrospective cohort study of heroin injecting episodes and overdose cases were examined over a 12-month period between 30 June 2022 and 30 June 2023.
Setting: The Medically Supervised Injecting Room in Melbourne, Australia.
Cases: 1474 witnessed heroin overdose cases were examined amongst a cohort of 337 individuals who were predominantly male (n = 276, 81.7%) with a median age of 43.5 years (interquartile range 37.25-49.00 years, range 20-75 years).
Measurements: The daily overdose rate was used to differentiate High and Low daily overdose risk categories. The number of overdose events that an individual experienced during the study period was used to differentiate people into Standard, Moderate and High personal overdose risk categories. Each overdose case was differentiated by the personal overdose risk of the individual who experienced the overdose, as well as the overdose risk of the day that overdose occurred. A stratified overdose risk profile was then derived across the nine different daily overdose risk and personal overdose risk categories.
Findings: The rate of overdose approximately doubled on High overdose risk days compared with Standard overdose risk days, increasing by a factor of 2.11, 2.41 and 2.03 times for individuals in the Standard, Moderate and High personal overdose risk groups. Conversely, the rate of overdose was also substantially reduced on Low overdose risk days to a factor of 0.17, 0.28 and 0.20, respectively.
Conclusion: Among heroin users in Melbourne, Australia, there is an approximately 10-times difference in the risk of overdose on some days compared with others, which appears to be attributable to the effects of the unregulated drug market and not the effects of variation in personal overdose risk of individuals.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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