{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:29:23Z","timestamp":1756992563708,"version":"3.37.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR302215"],"award-info":[{"award-number":["NIHR302215"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Recent media reports highlight that drug\u2010related fatalities can occur while individuals are immersed in water in domestic settings. We aimed to determine the case characteristics, circumstances of death and type of implicated drugs among individuals dying due to unintentional drug\u2010related causes found immersed in a bath or hot tub.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study in the United Kingdom using coronial records from the National Programme on Substance Abuse Deaths, 1997\u20132023. Information was available on decedent socio\u2010demographics, characteristics of death and drugs implicated in death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred fifty\u2010six decedents were found immersed in the bath and six in a hot tub, a mean of 6.4 deaths per year (SD 3.7; range 1\u201313). Overall decedents were predominantly male (<jats:italic>n<\/jats:italic>\u2009=\u200994, 58.0%), of White ethnicity (<jats:italic>n<\/jats:italic>\u2009=\u200998, 60.5%) with a mean age of 40\u2009years (SD 13; range 19\u201374). Only 12 decedents had any physical contributory factor to death other than poisoning or drowning. The median number of drugs detected at post\u2010mortem was 3 (interquartile range 2, 5) with multiple drug toxicity implicated in the majority of cases (<jats:italic>n<\/jats:italic>\u2009=\u200990, 55.6%). The most common implicated drugs were heroin (<jats:italic>n<\/jats:italic>\u2009=\u200953, 32.7%), alcohol (<jats:italic>n<\/jats:italic>\u2009=\u200946, 28.4%) and cocaine (<jats:italic>n<\/jats:italic>\u2009=\u200933, 20.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Over the last two decades in the United Kingdom there have been consistent numbers of unintentional drug\u2010related deaths each year where individuals were found in a bath or hot tub. Polysubstance, opioid and alcohol use are overrepresented. Targeted advice to avoid bathing while intoxicated would appear to be an appropriate harm reduction message.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13950","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T05:18:27Z","timestamp":1726031907000},"page":"347-354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of drug\u2010related deaths where individuals are found submerged in a bath or hot tub in the United Kingdom, 1997\u20132023"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4152-5570","authenticated-orcid":false,"given":"Emmert","family":"Roberts","sequence":"first","affiliation":[{"name":"National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London and the South London and the Maudsley NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-1402","authenticated-orcid":false,"given":"Caroline","family":"Copeland","sequence":"additional","affiliation":[{"name":"Faculty of Life Sciences and Medicine King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug &amp; Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1076\/icsp.10.4.195.16772"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2013-041110"},{"key":"e_1_2_10_4_1","unstructured":"StevensM TaylorDB.Matthew Perry Died of \u2018Acute Effects of Ketamine \u2019 Autopsy Says. 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