RECURRENT OVERDOSE - PATIENT CHARACTERISTICS, HABITS, AND OUTCOMES

Objectives-Patients who overdose repeatedly on drugs and poisons (repe aters) are of major concern. This study aimed to examine the demograph ics, types of drugs ingested, associated self inflicted trauma, and me dium term outcome of repeaters and to compare these patients with thos e who overdosed on one occasion only (single presenters) during the st udy period. Methods-The study was undertaken in the emergency departme nt of a large, provincial Australian hospital. A retrospective case no te examination was made for all patients who presented, after drug ove rdose, during the two year study period. These patients were also foll owed up for a further 12 months after the study period. Results-The st udy identified 335 single presenters and 46 repeaters. Females formed about two thirds of each group but repeaters tended to be older (p >0. 05) and to present more frequently before midnight (p >0.05). Signific antly more repeat presentations were triaged to the low priority categ ories 4 or 5 (odds ratio (OR) 0.48; 95% confidence interval (CI) 0.26 to 0.90, p = 0.023) and this group required fewer admissions to the ho spital (OR 1.85; 95% CI 1.16 to 2.93, p = 0.009). Repeaters tended to take single drug overdoses. There were significantly more paracetamol only overdoses (OR 0.54; 95% CI 0.32 to 0.92, p = 0.024) and neurolept ic only overdoses (OR 0.27; 95% CI 0.11 to 0.67, p = 0.005) in the rep eater group. More repeaters caused self inflicted trauma during the st udy period (OR 0.20; 95% CI 0.06 to 0.64, p = 0.007). No repeater comp leted suicide during the study or the 12 month follow up periods but r epeaters presented more frequently, after overdose, during follow up ( OR 0.38; 95% CI 0.13 to 1.11, p = 0.078). Conclusions-The study conclu des that there are some significant differences between patients who o verdose repeatedly and those who overdose on one occasion only. The st udy findings suggest that the medium term suicidal risk for repeaters is relatively low. However, this risk will vary and individual patient s must be assessed thoroughly and managed accordingly.