PubMed Update February/March 2013

Another 8 papers on opioid overdose issues.

1) 'It's more about the heroin': injection drug users' response to an overdose warning campaign in a Canadian setting.

Kerr T, Small W, Hyshka E, Maher L, Shannon K.

Addiction. 2013 Mar 28. doi: 10.1111/add.12151. [Epub ahead of print]

Comment: Interesting qualitative analysis of warnings issued regarding high-potency heroin. Respondents instead sought out the suspect drug.

2) Opioid Agonist Treatments and Heroin Overdose Deaths in Baltimore, Maryland, 1995-2009.

Schwartz RP, Gryczynski J, O'Grady KE, Sharfstein JM, Warren G, Olsen Y, Mitchell SG, Jaffe JH.

Am J Public Health. 2013 Mar 14. [Epub ahead of print]

Comment: This analysis failed to consider heroin overdose prevention programming – i.e. naloxone distribution – that was scaled up over the exact same period that buprenorphine treatment expanded and heroin overdoses declined. While not all variables can be considered in the interrupted time series approach, not considering the impact of a naloxone-based “overdose prevention program” seems to be a major flaw in the presentation. Disappointing that this was not rigorously addressed.

3) Determination of substance overdose in two Iranian centers: Comparison between opioids and non-opioids.

Taghaddosinejad F, Arefi M, Fayaz AF, Tanhaeivash R.

J Forensic Leg Med. 2013 Apr;20(3):155-7.

Comment: Interesting exploration of overdose in Iran – opioids still predominate (1782) compared to other drugs (94).

4) Opioid overdose fatality prevention.

Leece P, Orkin A.

JAMA. 2013 Mar 6;309(9):873-4.

Comment: This reply to Beletsky, et al’s, November 2012 commentary Prevention of fatal opioid overdose is followed by the authors’ response.

5) Development of Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales for take-home naloxone training evaluation.

Williams AV, Strang J, Marsden J.

Drug Alcohol Depend. 2013 Feb 28.

Comment: We are in desperate need of standardized and validated measures for overdose and naloxone distribution. These scales may be useful, although as a word of caution several elements are specific to UK programming.