{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:25:35Z","timestamp":1760646335703},"reference-count":41,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2015,6,3]],"date-time":"2015-06-03T00:00:00Z","timestamp":1433289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To describe work undertaken over a 20\u2010year period, investigating overdose characteristics among survivors, effects of acute heroin administration, clustering of risk of overdose fatality and potential interventions to reduce this fatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Privileged\u2010access interviewers obtained data from non\u2010treatment as well as treatment samples; experimental study of drop in oxygen saturation following heroin\/opiate injection; investigation of clusterings of death following prison release and treatment termination; and study of target populations as intervention work\u2010force, including family as well as peers, and action research built into pilot implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overdose has been experienced by about half of heroin\/opiate misusers, with even higher proportions having witnessed an overdose, and with high levels of willingness to intervene. Heroin\/opiates are associated with the majority of drug\u2010related deaths, despite relative scarcity of use. Heroin injection causes a rapid drop in oxygen saturation, recovering only slowly over the next half hour. Deaths from drug overdose are greatly more likely on prison release and post\u2010discharge from detoxification and other in\u2010patient or residential settings. High levels of declared willingness to intervene are matched by active interventions. Both drug\u2010using peers and family members show ability to improve knowledge and gain confidence from training. Audit study of take\u2010home schemes finds approximately 10% of dispensed naloxone is used in real\u2010life emergency situations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overdose is experienced by most users, with heroin\/opiates contributing disproportionately to drug overdose deaths. High\u2010risk times (e.g. after prison release) are now clearly identified. Peers and family are a willing potential intervention work\u2010force, but are rarely trained or given pre\u2010supply of naloxone. Large\u2010scale naloxone provision (e.g. national across Scotland and Wales) is now being delivered, while large\u2010scale randomized trials (e.g. N\u2010ALIVE prison\u2010release trial) are finally under way. Better naloxone products and better\u2010organized provision are needed. The area does not need more debate; it now needs proper implementation alongside good scientific study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12904","type":"journal-article","created":{"date-parts":[[2015,6,4]],"date-time":"2015-06-04T05:13:29Z","timestamp":1433394809000},"page":"27-35","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Death matters: understanding heroin\/opiate overdose risk and testing potential to prevent deaths"],"prefix":"10.1111","volume":"110","author":[{"given":"John","family":"Strang","sequence":"first","affiliation":[{"name":"National Addiction Centre (Institute of Psychiatry\/The Maudsley)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,3]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Advisory Council on the Misuse of Drugs (ACMD).Reducing Drug\u2010related Deaths2000. URL:http:\/\/www.drugsandalcohol.ie\/5017\/1\/Home_Office_Reducing_drug_related_deaths_2000.pdf. Accessed: 2015\u201005\u201001. (Archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/6YCYBIBIs)"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1988.tb03022.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.304.6836.1222"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1997.tb02927.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1994.tb00896.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02036.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7054.402"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7129.426"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00264.x"},{"key":"e_1_2_6_11_1","unstructured":"N. Singleton E. Pendry C. Taylor M. Farrell J Marsden 2003 Home Office Research Development and Statistics Directorate London"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.02081.x"},{"key":"e_1_2_6_13_1","first-page":"3","volume-title":"Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction","author":"Strang J.","year":"2003"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7396.959"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.11.008"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.04066.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5475"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/09595239800187551"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb127675.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.02025.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.4.435"},{"key":"e_1_2_6_22_1","volume-title":"Task Force to Review Services for Drug Misusers: Report of an Independent Review of Drug Treatment Services in England","author":"Department of Health (DoH)","year":"1996"},{"key":"e_1_2_6_23_1","first-page":"198","volume-title":"Heroin Addiction and the British System: Volume II Treatment and Policy Responses","author":"Polkinghorne J.","year":"2004"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00057-5"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.270"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.272"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1997.tb02894.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.01762.x"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4851"},{"key":"e_1_2_6_30_1","unstructured":"BirdS. StrangJ. HallW. HickmanM.Straight Statistics[Internet].2010. URL:http:\/\/straightstatistics.fullfact.org\/article\/how\u2010better\u2010methadone\u2010prescribing\u2010has\u2010saved\u2010more\u20102500\u2010lives. Accessed: 2015\u201005\u201001. (Archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/6YCYM3KNB)"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7044.1435"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9444712.x"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9421993.x"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0955-3959(00)00070-0"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/0959523021000002732"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/002204260203200406"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02314.x"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7291.895"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/09687630701731205"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.02.007"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12360"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-013-9803-1"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.12904","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.12904","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T20:25:07Z","timestamp":1696019107000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.12904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,3]]},"references-count":41,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1111\/add.12904"],"URL":"https:\/\/doi.org\/10.1111\/add.12904","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,3]]},"assertion":[{"value":"2015-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}