A Prospective Study of Non‐fatal Heroin Overdose

Aims: We aimed to study the prevalence, characteristics and outcomes of patients presenting with non‐fatal heroin overdose.Design: Prospective observational study.Setting: Emergency Department (ED).Participants: Patients attending with non‐fatal heroin overdose.Intervention: Nil.Measurement: Descriptive and epidemiological data.Findings: Two‐hundred‐and‐forty‐nine overdoses in 224 patients (61.2% male, range 15–49 years). Mean reported age of first heroin use was 18.8 years (range 10–42). Forty‐two per cent reported a previous heroin overdose requiring hospital intervention. Co‐ingestants included benzodiazepines (61, 27.2%), alcohol (35, 15.6%), cannabis (25, 11.1%), amphetamines (13, 5.8%) and hallucinogens (3, 1.3%). Most patients experienced a benign course; 81 of 115 ambulance presentations (70.4%) received prehospital naloxone and 23 (9.2%) received naloxone in the ED; 67.9% had no investigations and complications were uncommon (two aspiration, one hypoxic brain injury). Median length of stay was 180 min (15 min to 48 h). Only 29 (11.6%) presentations required admission. There were 15 individuals (6.7%) who had 40 (16.1% of the total) repeat presentations.Conclusions: Heroin overdose tends to occur in experienced users who commonly co‐ingest other drugs. There is a trend of overdose occurring with increasing frequency in teenage females. Repeat overdosing is common. However, while morbidity is low, these patients require considerable resources.