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首页> 外文期刊>Addiction >Transient changes in behaviour lead to heroin overdose: results from a case-crossover study of non-fatal overdose.
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Transient changes in behaviour lead to heroin overdose: results from a case-crossover study of non-fatal overdose.

机译：行为的暂时变化会导致海洛因用药过量：非致命用药过量的个案研究结果。

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Background and aims Heroin overdose is a serious consequence of heroin use and one of the leading causes of premature death and illness in Australia. Despite considerable research effort little is known about the effects of transient changes in heroin user behaviour and the links to overdose. This research is the first to use a suitable methodology to allow such ephemeral changes and their effects on non-fatal heroin overdose to be examined. Methods A case-crossover design was used in which non-fatal heroin overdose survivors' recall of risk behaviours in the 12 hours prior to overdose (hazard period) was compared to their recall of risk behaviours in the 12 hours prior to a selected non-overdose heroin injection (control period). Results A total of 155 participants were able to provide valid details of hazard and control periods. A dose-response relationship was observed between the self-reported amount of heroin used and likelihood of overdose (e.g. > AUD50, OR 12.97, 95% CI 2.54-66.31). The use of benzodiazepines (OR 28, 95% CI 3.81-205.79) or alcohol (OR 2.88, 95% CI 1.29-6.43), during the hazard period was related to overdose risk, but the effect of alcohol was attenuated by the effect of benzodiazepines. Shifting from private to public locations between control and hazard periods was also related to increased risk of overdose (OR 3.63, 95% CI 1.66-7.93). Conclusions We demonstrate the value of a new methodology to explore heroin overdose, as well as discussing its limitations and ways to overcome them in future. In terms of our findings, overdose prevention messages need to highlight the impact of these transient changes in behaviour and to emphasize the risks of using higher doses of heroin as well as continuing to emphasize the risks of combining heroin with other central nervous system (CNS) depressants. Safer environments for heroin use, such as injecting rooms, may also reduce the chances of overdose.
机译：背景和目的海洛因过量是海洛因使用的严重后果，也是澳大利亚过早死亡和疾病的主要原因之一。尽管进行了大量研究工作，但对海洛因使用者行为的短暂变化及其与药物过量相关的影响知之甚少。这项研究是首次使用合适的方法来研究这种短暂变化及其对非致命海洛因过量的影响。方法采用病例交叉设计，将非致命海洛因过量的幸存者在服药过量（危险期）之前的12小时内对危险行为的回忆与他们在选定的非海洛因过量之前的12小时内的危险行为的回忆相比较。过量注射海洛因（控制期）。结果共有155名参与者提供了危险和控制时期的有效详细信息。在自我报告的海洛因使用量和服用过量的可能性之间观察到剂量反应关系（例如> AUD50，或12.97,95％CI 2.54-66.31）。在危险期内使用苯二氮卓类药物（OR 28，95％CI 3.81-205.79）或酒精（OR 2.88，95％CI 1.29-6.43）与过量用药风险有关，但酒精的作用因服用过量而减弱。苯二氮卓类。在控制期和危险期之间从私人场所转移到公共场所也与药物过量风险增加有关（OR 3.63，95％CI 1.66-7.93）。结论我们证明了探索海洛因过量的新方法的价值，并讨论了其局限性和将来克服海洛因的方法。就我们的发现而言，过量预防信息需要强调行为的这些短暂变化的影响，并强调使用高剂量海洛因的风险，并继续强调将海洛因与其他中枢神经系统（CNS）结合使用的风险镇静剂。更安全的海洛因使用环境（例如注射室）也可以减少用药过量的机会。

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