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Drug overdose fatal

Caroline Daly, Eve Griffin, Darren M Ashcroft, Roger T Webb, Ivan J Perry, Ella Arensman
Background: Intentional drug overdose (IDO) is the most common form of hospital-treated self-harm, yet no national study has systematically classified the range of drugs involved using a validated system. We aimed to determine the profile of patients engaging in overdose, to identify drugs frequently used and to quantify the contributions of multiple drug use and alcohol involvement. Methods: Between 2012 and 2014, the National Self-Harm Registry, Ireland recorded 18 329 presentations of non-fatal IDO to Irish emergency departments...
March 12, 2018: European Journal of Public Health
Michael James Zoorob
BACKGROUND: Although polydrug incidents comprise a substantial proportion of overdose deaths, scholarly and popular focus has centered on prescription opiates. This study examines the role of benzodiazepine and opioid prescriptions on overdose-both individually and synergistically-using data from Medicare Part D, a source of prescription drug claims for about 35 million Americans. METHODS: Prescribing data from the Medicare Part D Public Use Files for 2013, 2014, and 2015 (approximately 3...
March 14, 2018: Pharmacoepidemiology and Drug Safety
Adeleke D Adewumi, Samantha A Hollingworth, Joemer C Maravilla, Jason P Connor, Rosa Alati
BACKGROUND: The rate of an unintentional drug overdose involving prescription opioids continues to rise. An understanding of the threshold dose and dose(s) associated with unintentional prescription opioid overdose will help to mitigate this epidemic. OBJECTIVE: The objective of this systematic review is to systematically synthesise and meta-analyse studies on doses of prescription opioids and ascertain the doses of opioids that are associated with increased risk of severe opioid poisoning or mortality...
March 1, 2018: CNS Drugs
Rita Khoury, Jayashree Rajamanickam, George T Grossberg
Alzheimer's disease (AD) is the most common cause of major neurocognitive disorders worldwide. Despite all research efforts, therapeutic options for AD are still limited to two drug classes: cholinesterase inhibitors (ChEIs) and the NMDA-receptor antagonist memantine. Donepezil, rivastigmine and galantamine are the three ChEIs FDA-approved as first-line treatment for AD. Although they share the same mode of action, they differ in terms of their pharmacologic characteristics and route of administration, which can impact their safety and tolerability profile...
March 2018: Therapeutic Advances in Drug Safety
Mary Clare Kennedy, Ayden Scheim, Beth Rachlis, Sanjana Mitra, Geoff Bardwell, Sean Rourke, Thomas Kerr
BACKGROUND: Esclating epidemics of fatal overdose are affecting communities across Canada. In many instances, the unanticipated presence of powerful opioids, such as fentanyl, in street drugs is a contributing factor. Drug checking offered within supervised injection services (SIS) is being considered as a potential measure for reducing overdose and related harms. We therefore sought to characterize the willingness of people who inject drugs (PWID) to use drug checking within SIS. METHODS: Data were derived from a cross-sectional survey examining the feasibility of SIS in London, Canada, a mid-sized city...
February 15, 2018: Drug and Alcohol Dependence
Lauren Brinkley-Rubinstein, Alexandria Macmadu, Brandon D L Marshall, Andrew Heise, Shabbar I Ranapurwala, Josiah D Rich, Traci C Green
Overdose is the leading cause of unintentional injury-related death. Rhode Island (RI) has the highest rate of illicit drug use nationally and the 5th highest overdose mortality rate. RI has experienced an outbreak of fentanyl-related overdoses. In incarcerated populations, risk of overdose is greatly elevated. However, little is known about fentanyl-related overdose post-release. In the current analyses, we identify changes in fentanyl-related fatal overdose among those who died in 2014 and 2015 who were incarcerated in the year before death...
February 9, 2018: Drug and Alcohol Dependence
Galit Geulayov, Anne Ferrey, Deborah Casey, Claudia Wells, Alice Fuller, Clare Bankhead, David Gunnell, Caroline Clements, Navneet Kapur, Jennifer Ness, Keith Waters, Keith Hawton
The relative toxicity of anxiolytic and hypnotic drugs commonly used for self-poisoning was assessed using data on suicides, prescriptions and non-fatal self-poisonings in England, 2005-2012. Data on suicide by self-poisoning were obtained from the Office for National Statistics, information on intentional non-fatal self-poisoning was derived from the Multicentre Study of Self-harm in England and data on prescriptions in general practice from the Clinical Practice Research Datalink. We used two indices of relative toxicity: fatal toxicity (the number of fatal self-poisonings relative to the number of individuals prescribed each drug) and case fatality (the number of fatal relative to non-fatal self-poisonings)...
February 1, 2018: Journal of Psychopharmacology
Rowan P Ogeil, Jeremy Dwyer, Lyndal Bugeja, Cherie Heilbronn, Dan I Lubman, Belinda Lloyd
BACKGROUND: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. METHODS: A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013...
February 9, 2018: International Journal on Drug Policy
Gregory W Vandergrift, Arden J Hessels, Jan Palaty, Erik T Krogh, Chris G Gill
BACKGROUND: Fentanyl is a potent, synthetic opioid at the centre of an international health crisis that has seen thousands of fatal overdoses. Most analytical methods focus on the detection of fentanyl in blood and/or urine (i.e., post-drug use). Harm reduction (including pre-screening before drug use) may be an effective strategy against fentanyl overdoses. METHOD: Paper spray-mass spectrometry (PS-MS) is an inexpensive, direct sampling strategy where a small volume of sample (<10 μL) is spotted onto a piece of paper that is then wetted and connected to high voltage...
February 9, 2018: Clinical Biochemistry
Christopher J Ruhm
BACKGROUND AND AIMS: Most prior estimates of opioid-involved drug poisoning mortality counts or rates are understated because the specific drugs leading to death are frequently not identified on death certificates. This analysis provides corrected national estimates of opioid and heroin/synthetic opioid-involved counts and mortality rates, as well as changes over time in them from 1999 to 2015. METHODS: Data on drug poisoning deaths to US residents from 1999 to 2015, obtained from the Centers for Disease Control and Prevention (CDC) Multiple Cause of Death (MCOD) files, were used with the drugs involved in fatal overdoses imputed when not identified on the death certificates...
February 12, 2018: Addiction
Shannon R Kenney, Bradley J Anderson, Micah T Conti, Genie L Bailey, Michael D Stein
OBJECTIVE: Fentanyl-contaminated opioid supplies have led to rising overdose fatalities in recent years. We compared beliefs, behaviors, and risk perceptions related to fentanyl with actual toxicology reports among people who used opioids. METHOD: Participants (n=231) were patients undergoing short-term inpatient opioid withdrawal management in Fall River, Massachusetts. We compared persons testing positive and negative for fentanyl on urine toxicological testing at program entry...
March 2018: Journal of Substance Abuse Treatment
Louisa Gilbert, Timothy Hunt, Sholpan Primbetova, Assel Terlikbayeva, Mingway Chang, Elwin Wu, Tara McCrimmon, Nabila El-Bassel
OBJECTIVES: To evaluate the efficacy of a couple-based integrated HIV/HCV and overdose prevention intervention on non-fatal and fatal overdose and overdose prevention behaviors among people who use heroin or other opioids in Almaty, Kazakhstan. METHODS: We selected 479 participants who reported lifetime heroin or opioid use from a sample of 600 participants (300 couples) enrolled in a randomized controlled trial (RCT) conducted between May 2009 and February 2013...
January 27, 2018: International Journal on Drug Policy
David E Nichols, Charles S Grob
LSD (lysergic acid diethylamide) was discovered almost 75 years ago, and has been the object of episodic controversy since then. While initially explored as an adjunctive psychiatric treatment, its recreational use by the general public has persisted and on occasion has been associated with adverse outcomes, particularly when the drug is taken under suboptimal conditions. LSD's potential to cause psychological disturbance (bad trips) has been long understood, and has rarely been associated with accidental deaths and suicide...
February 1, 2018: Forensic Science International
Manyoo A Agarwal, David Flatt, Rami N Khouzam
Calcium channel blockers (CCBs) are prescribed in a wide variety of cardiovascular conditions. Overdose of this commonly used drug can result in negative physiologic consequences including severe hypotension and even death due to metabolic and hemodynamic compromise. We report the fatal case of an amlodipine overdose, which caused intractable acidosis and cardiovascular failure in a 51-year-old male.
January 2018: Annals of Translational Medicine
Lauren Brinkley-Rubinstein, Michelle McKenzie, Alexandria Macmadu, Sarah Larney, Nickolas Zaller, Emily Dauria, Josiah Rich
Recently, incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is an effective way to address opioid use disorder and prevent overdose; however, few jails and prisons in the United States initiate or continue people who are incarcerated on MMT. In the current study, the 12 month outcomes of a randomized control trial in which individuals were provided MMT while incarcerated at the Rhode Island Department of Corrections (RIDOC) are assessed. An as-treated analysis included a total of 179 participants-128 who were, and 51 who were not, dosed with methadone the day before they were released from the RIDOC...
January 31, 2018: Drug and Alcohol Dependence
Christopher J Ruhm
Death certificate data from the Multiple Cause of Death (MCOD) files were analyzed to better understand the drug categories most responsible for the increase in fatal overdoses occurring between 1999 and 2014. Statistical adjustment methods were used to account for the understatement in reported drug involvement occurring because death certificates frequently do not specify which drugs were involved in the deaths. The frequency of combination drug use introduced additional uncertainty and so a distinction was made between any versus exclusive drug involvement...
December 2017: SSM—Population Health
Ivan Zeljković, Nikola Bulj, Matea Kolačević, Vedran Čabrilo, Diana Delić Brkljačić, Šime Manola
BACKGROUND: Propafenone is a sodium-channel blocker, class IC antiarrhythmic drug, frequently used to manage supraventricular dysrhythmias, especially atrial fibrillation. We report a self mono-intoxication with propafenone. CASE REPORT: A 68-year-old woman presented with a decreased level of consciousness, hypotension, and electrocardiogram showing QRS widening with atrial asystole and extreme bradycardia < 20 beats/min. After initial stabilization with transcutaneous pacing, laboratory findings detected normal electrolyte ranges and metabolic acidosis, and her medical history revealed availability of propafenone due to paroxysmal atrial fibrillation and depressive syndrome, which led to the suspicion of intoxication...
January 11, 2018: Journal of Emergency Medicine
Kasper Petersen, Peter Hjorth
Cyclizine is sold in Denmark as an over-the-counter drug and affects not only histaminergic but also muscarinergic, serotonergic and α-adrenergic receptors, with side effects such as respiratory depression and cardiac arrhythmias, leading to fatalities. Due to the numerous side effects, it raises questions concerning the status of cyclizine as an over-the-counter drug. Data of healthcare contacts because of cyclizine intoxication in the 2014-2016 period should be analyzed to further illuminate the health risk of cyclizine poisoning...
January 15, 2018: Ugeskrift for Laeger
Claudia Rafful, Ricardo Orozco, Gudelia Rangel, Peter Davidson, Dan Werb, Leo Beletsky, Steffanie A Strathdee
AIM: To assess the effect of involuntary drug treatment (IDT) on non-fatal overdose among people who inject drugs (PWID). DESIGN: Longitudinal study. SETTING: Tijuana, Mexico. PARTICIPANTS: Baseline sample of 671 PWID included 258 (38.4%) women and 413 (61.6%) men. MEASUREMENTS: Primary independent variables were reported recent (i.e., past 6 months) non-fatal overdose event (dependent variable) and IDT...
January 14, 2018: Addiction
Melissa G Collier, Mona Doshani, Alice Asher
Epidemics of opioid use and injection drug use (IDU) are associated with an increase in HIV and viral hepatitis infections and overdose deaths in the United States. Persons who inject drugs (PWID) are also at risk for serious infections caused by skin organisms introduced via IDU. We examined National Inpatient Sample hospital discharge data to determine trends in three serious infectious disease-associated conditions that primarily affect PWID in addition to HIV and viral hepatitis: infective endocarditis (IE), central nervous system (CNS) abscesses, and osteomyelitis...
January 5, 2018: Journal of Community Health
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