Accidental overdose among injecting drug users in Dorset, UK

To establish the prevalence and frequency of non-fatal accidental overdose among Dorset injecting drug users (IDUs), map their response to it and their beliefs about protective and risk behaviours.

Survey of a community sample of IDUs.

Ten Dorset towns.

Two hundred and twelve IDUs, recruited through multisource sampling, who had injected in the 2 months before interview.

Structured interview, SDS and LDQ.

In the previous year, 30% of interviewees had overdosed and 58% had witnessed another do so. Most (79%) had had a personal acquaintance die from an accidental overdose. Interviewees commonly attributed their own most recent overdose(s) to excessive consumption of drugs, mixing drugs and low tolerance, believed that these factors generally increased risk and described a repertoire of protective behaviours. Those who had overdosed in the previous year had significantly greater involvement with drug injecting. Virtually all who had witnessed another's overdose described peoples' attempts to help: many were appropriate, some dangerous. Avoiding seeking medical help was common. Half (52%) demonstrated the rudiments of putting people into the recovery position, and a minority (31%) cardio-pulmonary resuscitation. Most interviewees (55%) said that they would "probably" or "definitely" attend a workshop on Overdose Aid.

There is potential for preventing overdose by promoting protective behaviours. Since IDUs often witness overdose, training them in first aid may be valuable, and tackling the reasons that delay their seeking help is crucial.