EXPERIENCE OF NONFATAL OVERDOSE AMONG HEROIN USERS IN ADELAIDE, AUSTRALIA - CIRCUMSTANCES AND RISK PERCEPTIONS

Aims. To ascertain the prevalence and risk factors for non-fatal overd ose among heroin users to assist in the development of an effective in tervention. Design. Cross-sectional design. Setting. Community setting , principally metropolitan Adelaide. Participants. Current heroin user s (used heroin in the previous six months). Measurements. A structured questionnaire including the Severity of Dependence Scale. Finding. Of 218 current South Australian heroin users interviewed in 1996, 48% ha d experienced at least one non-fatal overdose their life-time (median: two overdoses), and 11% had overdosed in the previous 6 months. At so me time, 70% had been present at someone else's overdose (median: thre e overdoses). At the time of their own most recent overdose, 52% had b een using central nervous system depressants in addition to heroin, pr incipally benzodiazepines (33%) and/or alcohol (22%). The majority of overdoses occurred in a private home (81%) and in the presence of othe r people (88%). Unrealistic optimism regarding the risk of overdose wa s evident across the sample. Despite almost half the sample reporting having had an overdose, and the belief expressed by respondents that o n average about 50% of regular heroin users would overdose during thei r life-time 73% had, during the previous 6 months, ''rarely'' or ''nev er'' worried about possibly overdosing. Optimism regarding the possibi lity of future overdose was reduced in those with recent experience of overdose in comparison to the rest of the sample. A targeted interven tion aimed at the reduction of overdose among heroin users is outlined .