World Health Organization : Year 1998 ; World Health Organization, Social Change and Mental Health, Substance Abuse, No. 98.4: Opioid Overdose Trends, Risk Factors, Interventions and Priorities for Action

By World Health Organization

Book Id: WPLBN0000106166
Format Type: PDF eBook:
File Size: 2.42 MB
Reproduction Date: 2005

Title:	World Health Organization : Year 1998 ; World Health Organization, Social Change and Mental Health, Substance Abuse, No. 98.4: Opioid Overdose Trends, Risk Factors, Interventions and Priorities for Action
Author:	World Health Organization
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Health Organization, B. W. (n.d.). World Health Organization : Year 1998 ; World Health Organization, Social Change and Mental Health, Substance Abuse, No. 98.4. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
Abstract International illicit production of opioids has increased in recent years, as has illicit opioid use in many countries, especially the injection of heroin. The number of opioid overdose deaths, though difficult to assess, appears to have risen in a number of countries over the past decade but lack of agreement on the definition and classification of opioid overdoses and other drug-related deaths hampers comparisons between countries. There are many difficulties in defining and recording overdose and other drug-related deaths. Reliable cause-specific mortality data for opioid users is particularly lacking. Research from a number of countries suggests that individual variations in tolerance and polydrug use are contributory factors to fatal and non-fatal opioid (primarily heroin) overdoses. Despite this evidence the view persists that opioid purity is the sole cause of opioid overdose deaths. This diverts attention away from potentially modifiable factors that may reduce overdose deaths. It also de-emphasizes the fact that overdoses often occur in the company of others which provide an opportunity to intervene. Delays in response to overdoses may be a major remediable cause of overdose deaths.

Table of Contents
Contents Page Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Nature and extent of opioid use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Opioid-related mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4. 3.1. Overall mortality rates among opioid users . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3.2. Cause-specific mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Methadone-related overdose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8. Difficulties in defining and recording overdose and other drug-related deaths . . . . . 10 Riskfactors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.2 6.1 Opioid purity and individual tolerance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 2 6.2. Consumption of alcohol. benzodiazepines and other drugs . . . . . . . . . . . . . 13 6.3 Contaminants and adulterants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 3 6.4 General health status of opioid users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 6.5 Other factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 4 7.1 Risk assessment and management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 7.2 Outreach. peer education and social network interventions . . . . . . . . . . . . . 15 7.3 Strategies targeting individual risk reduction . . . . . . . . . . . . . . . . . . . . . . . . 16 7.4 Increasing access to emergency and other health services . . . . . . . . . . . . . . . 17 7.5 Creating safer drug using environments . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 7.6 Opioid antagonists . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . .1 8 7.7 Drug treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 8 7.8 Drug and policing policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Priorities for action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.0 8.1 Improved quality of information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 8.2 Identify risk factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 8.3 Design and evaluate effective interventions . . . . . . . . . . . . . . . . . . . . . . . . . .21 Related WHO activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3 Appendix ICD-10 Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.3