{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T19:33:00Z","timestamp":1715974380824},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2006,6,9]],"date-time":"2006-06-09T00:00:00Z","timestamp":1149811200000},"content-version":"vor","delay-in-days":1012,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction Biology"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to investigate the association between prior exposure to naltrexone and increased risk of fatal heroin overdose using a review of toxicology reports for heroin\u2010related fatalities between July 1997 to August 1999 for two groups: those treated with oral naltrexone and those who were not treated. Additional information for the oral naltrexone group was obtained from clinic files. Naltrexone\u2010treated deaths were identified from the patient database at the Australian Medical Procedures Research Foundation (AMPRF), Perth, Western Australia (WA) through the Western Australian Department of Health, Data Linkage Project. Non\u2010treated cases were identified from the database at the Forensic Science Laboratory, State Chemistry Centre (WA). We identified and investigated blood morphine concentrations following 21 fatal heroin overdoses with prior exposure to naltrexone and in 71 non\u2010naltrexone\u2010exposed cases over the same time period. The proportion of deaths where heroin use was a major contributing factor was little different in the non\u2010naltrexone compared to the naltrexone\u2010exposed group. Furthermore, in \u2018acute opiate toxicity\u2019 deaths, blood morphine levels were lower in non\u2010naltrexone\u2010exposed compared with naltrexone\u2010exposed cases. Although there was a higher number of deaths designated as rapid (i.e. occurring within 20 minutes) in the naltrexone\u2010exposed (89%) compared with the non\u2010exposed group (72%) this was not statistically significant. Other drug use in relation to heroin\u2010related fatalities is discussed. Findings do not support the hypothesis that prior exposure to naltrexone increases sensitivity to heroin toxicity.<\/jats:p>","DOI":"10.1080\/13556210310001602266","type":"journal-article","created":{"date-parts":[[2003,11,11]],"date-time":"2003-11-11T16:23:59Z","timestamp":1068567839000},"page":"343-350","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Blood morphine levels in naltrexone\u2010exposed compared to non\u2010naltrexone\u2010exposed fatal heroin overdoses"],"prefix":"10.1111","volume":"8","author":[{"given":"DIANE","family":"ARNOLD\u2010REED","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GARY","family":"HULSE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROBERT","family":"HANSSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SEAN","family":"MURRAY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GEORGE","family":"O'NEIL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARIA","family":"BASSO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C D'ARCY J.","family":"HOLMAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,6,9]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9422216.x"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1973.04200020065009"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1984.45.440"},{"key":"e_1_2_1_5_2","first-page":"120","article-title":"Deaths of heroin uses in a general practice population","volume":"36","author":"Bucknall AB","year":"1986","journal-title":"J R Coll Gen Pract"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.81.10.1307"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.47.1.59"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9479612.x"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.3109\/03602537508993748"},{"key":"e_1_2_1_10_2","first-page":"42","article-title":"Clinical experience with naltrexone in suburban opioid addicts","volume":"45","author":"Tennant FS","year":"1984","journal-title":"J Clin Psychiatry"},{"key":"e_1_2_1_11_2","first-page":"179","article-title":"Rapid opiate detoxification with clonidine and naltrexone","volume":"1","author":"Riordan CE","year":"1980","journal-title":"Lancet"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1300\/J069v13n01_04"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb123493.x"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(97)00020-2"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595230096138"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1353-1131(96)90012-7"},{"key":"e_1_2_1_17_2","first-page":"150","article-title":"Comparison of two naltrexone treatment programs: naltrexone alone versus naltrexone plus behaviour therapy","volume":"9","author":"Callahan E","year":"1976","journal-title":"NIDA Research Monographs"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00147-7"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7129.426"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595230096174"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2001.96811135.x"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1996.tb94136.x"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(97)00070-7"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/18.1.22"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.1999.tb01297.x"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/15.1.1"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb123488.x"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.6474188"},{"key":"e_1_2_1_29_2","first-page":"975","article-title":"Heroin overdose: new directions for research","volume":"94","author":"Zador D","year":"1999","journal-title":"Addiction"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1996.911217652.x"},{"key":"e_1_2_1_31_2","first-page":"413","article-title":"Overdose among heroin users in Sydney, Australia: II","volume":"91","author":"Darke S","year":"1996","journal-title":"Responses to overdose. 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