澳大利亚墨尔本一监管注射设施中快速发作的海洛因过量病例分析。

IF 5.3 1区 医学 Q1 PSYCHIATRY
Addiction Pub Date : 2025-09-26 DOI:10.1111/add.70199
Nathan C Stam, Monika Shrestha, Basak Tas, John Furler, Yvonne Bonomo, John Strang
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引用次数: 0

摘要

目的:了解快速发作的海洛因过量病例的临床特点,确定此类病例的发生率和特点。设计:对12个月期间(2023年7月1日至2024年6月30日)的海洛因过量病例进行回顾性队列研究。背景:澳大利亚墨尔本的医学监督注射室。病例:经历快速发作过量的个体。在这些相同的个体中使用标准发病病例的对照组进行比较。测量方法:使用医学监督注射室常用的临床严重程度量表,比较快速发作与标准发作海洛因过量病例的急性阿片类药物毒性的严重程度。结果:在总共1727例海洛因过量中,202例被确定为快速发病病例,发生在98人的队列中。作为对照的同一队列中有75个人的997种标准过量。快速发作的过量表现为更严重的呼吸抑制。41% (n = 82)病例需要正压通气,其中19% (n = 38)为2级严重程度,22% (n = 44)为3a级严重程度。高剂量过量风险日的快速过量标准化率(0.151/过量)约为低剂量过量风险日的两倍(0.077/过量)。结论:快速发作的海洛因过量通常是在海洛因给药后不久出现的医疗紧急情况,包括严重的呼吸抑制。有些人似乎比其他人更容易出现快速发作的过量,但原因尚不清楚。与其他日子相比,在某些日子里快速发作的海洛因过量也更常见,这可能表明个人风险与不受管制的毒品市场之间存在相互关系。快速发作的过量病例可能在与海洛因过量有关的缺氧相关发病率和死亡率中起重要作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of rapid onset heroin overdose cases from a supervised injecting facility in Melbourne, Australia.

Aims: To characterise the clinical condition of rapid onset heroin overdose cases, and to determine the incidence and characteristics of such cases.

Design: A retrospective cohort study of witnessed heroin overdose cases over a 12-month period (1 July 2023 to 30 June 2024).

Setting: The Medically Supervised Injecting Room in Melbourne, Australia.

Cases: Individuals who experienced a rapid onset overdose. A control group of standard onset cases amongst those same individuals was used for comparison.

Measurements: The severity of acute opioid toxicity for rapid versus standard onset heroin overdose cases, using a clinical severity scale regularly used at the Medically Supervised Injecting Room.

Findings: From a total of 1727 heroin overdoses, 202 were identified as rapid onset cases that occurred amongst a cohort of 98 individuals. There were 997 standard overdoses from 75 individuals from this same cohort used as a control. Rapid onset overdoses presented with greater severity of respiratory depression. Forty-one percent (n = 82) of cases required positive pressure ventilation, including 19% (n = 38) classified as Grade 2 severity and 22% (n = 44) classified as Grade 3a severity. The standardised rate of rapid overdoses was approximately doubled on High overdose risk days (0.151/overdose) compared with that on Low overdose risk days (0.077/overdose).

Conclusion: Rapid onset heroin overdoses typically present as medical emergencies involving severe respiratory depression shortly after heroin administration. Some people appear more likely to experience a rapid onset overdose than others, but factors for this are unclear. Rapid onset heroin overdoses also more commonly occur on some days compared with others, which may indicate an interrelationship between personal risk and the unregulated drug market. Rapid onset overdose cases may play a substantial role in hypoxic-related morbidity and mortality associated with heroin overdoses.

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来源期刊
Addiction
Addiction 医学-精神病学
CiteScore
10.80
自引率
6.70%
发文量
319
审稿时长
3 months
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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