Addicts completing detox ‘at more risk’
A study published in the British Medical Journal (BMJ) found the higher death rate was due to a loss of tolerance to the drug following detox.
However, Irish drug-treatment experts, who supported the findings, said one third of deaths by overdose among addicts who had undergone detox could be prevented through a simple information campaign.
Dr Michael Ryan, founding director of the Dublin Opiate Overdose Reduction Strategy (DOORS), said educating people to recognise overdose warning signs and training them in basic first aid would save lives.
“The typical scenario of someone who checks out of a treatment programme is for them to meet friends and inject heroin. Most make the mistake of injecting the dosage they used prior to treatment.
“Their tolerance has diminished after two to three days off opiates so their body can’t take it and they go into respiratory depression, such as fingers and lips turning blue,” he said.
“If their friends recognise the warning signs and can do simple mouth-to-mouth, lives can be saved, but unfortunately, because of a lack of knowledge, people don’t always know what to do and death is the result.”
Dr Ryan said there was also a fear of legal implications, that by being at the scene of an overdose, many believed they could be charged with manslaughter, which is not the case.
“Because of that fear, the addict is often abandoned in an alleyway, left to choke on his or her own vomit when a few simple procedures could have saved a life,” he added.
“The only thing keeping this horrible number of deaths going is the lack of information.”
Tony Geoghegan, director of the Merchant’s Quay drug treatment centre, said the lack of information was now a critical issue with Ireland recording the highest number of drug-related deaths in Europe.
The British researchers, at the National Addiction Centre in London, identified 137 opiate addicts who were receiving detoxification as part of a 28-day inpatient treatment programme.
Five patients died within 12 months after their discharge from the unit, three from a drug overdose within the first four months after discharge and two unrelated to overdose.
To test whether loss of tolerance increased the risk of overdose, the team grouped the patients into three categories according to their opiate tolerance at the point of leaving treatment.
Forty-three “still tolerant” patients who failed to complete detoxification, 57 “reduced tolerance” patients who prematurely left the programme and 37 “lost tolerance” patients who completed the treatment programme.
The three overdose deaths that occurred within four months after treatment were all from the “lost tolerance” group.
The two deaths unrelated to overdose were one “lost tolerance” patient and one “reduced tolerance” patient. No deaths occurred in the “still tolerant” group.
The five patients who died were all men and had generally stayed longer in the inpatient unit.
