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Paul Dietze - One of the best experts on this subject based on the ideXlab platform.

  • Coding and classification of Heroin Overdose calls by MPDS dispatch software: Implications for bystander response with naloxone.
    Resuscitation, 2020
    Co-Authors: Paul Dietze, Stephen Burgess, Rose Crossin, Debbie Scott, Karen Smith, James Wilson, Dan I. Lubman, Kate Cantwell
    Abstract:

    Abstract Background and aims Take-home naloxone, a key response to Heroin Overdose, may be compromised by the way in which Overdose cases are coded in EMS dispatch systems as call-takers direct callers at cardiac arrest events against using any medication. We examined the ways in which confirmed Heroin Overdose cases attended by ambulances are coded at dispatch to determine whether incorrect coding of Overdoses as cardiac arrests may limit the use of take-home naloxone. Methods We conducted a retrospective analysis of coded ambulance clinical records collected in Victoria, Australia from 2012–2017. Counts of Heroin Overdose cases were examined by dispatch coding (Heroin Overdose, cardiac/respiratory arrest and ‘other’), along with age, sex, GCS and respiratory rate. Data were analysed using chi-square and Poisson regression for quarterly counts, adjusting for age, sex and patient GCS. Results A total of 5637 Heroin Overdose cases were attended over the period 2012–2017 (71.4% male, 36.4% aged under 35 years). Almost half (n = 2674, 47.4%) were coded as cardiac/respiratory arrest at dispatch, with 36.8% (n = 2075) coded as Heroin Overdose and 15.7% (n = 886) coded as other/unknown. Discussion and conclusions Almost half of the Heroin Overdoses were dispatched according to a protocol that would preclude the use of take-home naloxone prior to ambulance arrival and this changed little over the period in which take-home naloxone programs were operating in Victoria, Australia. EMS should move as quickly as possible to newer versions of dispatch systems that enable the use of naloxone in cases of obvious opioid Overdose that may be classified as cardiac/respiratory arrest.

  • take home emergency naloxone to prevent deaths from Heroin Overdose
    BMJ, 2014
    Co-Authors: J. Strang, Paul Dietze, Sheila M. Bird, Gilberto Gerra, Thomas A Mclellan
    Abstract:

    Time to save lives A paradigm shift is occurring in the treatment of Heroin Overdose. On 5 November the World Health Organization launched guidelines on the community management of Heroin and opioid Overdose and emergency administration of naloxone by people who are not medically trained.1 Historically, naloxone has been used only in hospitals and by ambulance workers to reverse the effects of an opioid Overdose. Today, several countries are providing emergency naloxone to patients, their families, and other potential non-medical first responders. This is important because these Overdoses contribute substantially to drug related deaths worldwide, with an estimated 69 000 people dying from opioid Overdose each year.1 Of nearly 3000 drug related deaths registered in England and Wales in 2013, more than half (56%) involved opioids.2 Last month Scotland (the first country to introduce a national programme to provide naloxone) released results from the first three years of its naloxone programme.3 The proportion of deaths from opioid Overdose among people just released from prison (a particularly high risk group) was down substantially from 9.8% (193/1970) in 2006-10 to 6.3% (76/1212) during 2011-13.4 Providing emergency naloxone to take home was first seriously mooted in 1996.5 Since then policy and practice implications have been explored, with studies of acceptability and feasibility, reports of implementation, and observational studies on the training of staff (medical, nursing and drug workers), at risk populations, family members, and non-medical personnel such as hostel workers and police officers (see web appendix for references). Several countries …

  • randomized controlled trial comparing the effectiveness and safety of intranasal and intramuscular naloxone for the treatment of suspected Heroin Overdose
    Addiction, 2009
    Co-Authors: Debra Kerr, Paul Dietze, Anne-maree Kelly, Damien Jolley, Bill Barger
    Abstract:

    Aims Traditionally, the opiate antagonist naloxone has been administered parenterally; however, intranasal (i.n.) administration has the potential to reduce the risk of needlestick injury. This is important when working with populationsknowntohaveahighprevalenceof blood-borneviruses.Preliminaryresearchsuggeststhati.n.administration mightbeeffective,butsuboptimalnaloxonesolutionswereused.Thisstudycomparedtheeffectivenessof concentrated (2 mg/ml) i.n. naloxone to intramuscular (i.m.) naloxone for suspected opiate Overdose. Methods This randomized controlledtrialincludedpatientstreatedforsuspectedopiateOverdoseinthepre-hospitalsetting.Patientsreceived2 mg of either i.n. or i.m. naloxone.The primary outcome was the proportion of patients who responded within 10 minutes of naloxone treatment. Secondary outcomes included time to adequate response and requirement for supplementary naloxone. Data were analysed using multivariate statistical techniques. Results A total of 172 patients were enrolled into the study. Median age was 29 years and 74% were male. Rates of response within 10 minutes were similar: i.n. naloxone (60/83, 72.3%) compared with i.m. naloxone (69/89, 77.5%) [difference: -5.2%, 95% confidence interval (CI) -18.2 to 7.7]. No difference was observed in mean response time (i.n.: 8.0, i.m.: 7.9 minutes; difference 0.1, 95% CI -1.3 to 1.5). Supplementary naloxone was administered to fewer patients who received i.m. naloxone (i.n.: 18.1%; i.m.: 4.5%) (difference: 13.6%, 95% CI 4.2‐22.9). Conclusions Concentrated intranasal naloxone reversed Heroin Overdose successfully in 82% of patients.Time to adequate response was the same for both routes, suggesting that the i.n. route of administration is of similar effectiveness to the i.m. route as a first-line treatment for Heroin Overdose.

  • An evaluation of a Heroin Overdose prevention and education campaign
    Drug and alcohol review, 2009
    Co-Authors: Danielle Horyniak, Paul Dietze, Peter Higgs, Jennifer Anne Lewis, Rebecca Winter, Campbell Aitken
    Abstract:

    Introduction and Aims. Following detection of an upward trend in the frequency of fatal Heroin Overdoses in Victoria between 2001 and 2003, Victoria's Department of Human Services planned a campaign aimed at increasing injecting drug users' (IDU) awareness of Overdose risks and prevention strategies. Stickers, wallet cards and posters featuring five key messages were distributed via needle and syringe programs (NSP) and other drug and alcohol services between November 2005 and April 2006. An evaluation of the campaign was commissioned to be conducted in late 2006. Design and Methods. The evaluation consisted of analysis of three independent data sets––quantitative data collected from IDU during the campaign period (n = 855 at baseline; and a range of 146–656 at follow up); qualitative interviews with IDU who were NSP clients during the campaign period (n = 16) and qualitative interviews with NSP staff and other key stakeholders (n = 9). Results. While key experts felt that the campaign messages had engendered lasting impact for at least some IDU, these positive impressions were not borne out by the NSP client data, with less than one quarter of all campaign messages being mentioned by a significantly higher proportion of clients during the post-campaign period compared with baseline. Key experts perceived the greatest weakness of the campaign to be the delay between issue identification and the introduction of campaign materials. Discussion and Conclusions. While IDU are generally responsive to health promotion campaigns, future initiatives in this domain should be designed and implemented rapidly and in ways that are sufficiently flexible to cope with shifts in drug markets which could influence the reception of key messages.[Horyniak D, Higgs P, Lewis J, Winter R, Dietze P, Aitken C. An evaluation of a Heroin Overdose prevention and education campaign. Drug Alcohol Rev 2009]

  • Improved response by peers after witnessed Heroin Overdose in Melbourne.
    Drug and alcohol review, 2009
    Co-Authors: Debra Kerr, Paul Dietze, Anne-maree Kelly, Damien Jolley
    Abstract:

    Introduction and Aims. In response to concerns about the prevalence of Heroin-related morbidity and mortality, Overdose response training programs have been implemented in Victoria, with the aim of improving outcomes after Heroin Overdose. The aim of this study was to examine reported Overdose response by current injecting drug users (IDU) during Overdose events, in comparison with previous studies. Design and Methods. A total of 99 IDU (median age 35 years, 72% male) were administered a questionnaire that collected information on knowledge and experience regarding recognition of Heroin Overdose and response. The primary outcome measure was the rate of ambulance notification and expired air resuscitation during witnessed Heroin Overdose. Data were analysed using descriptive statistics and univariate analysis. Results. Sixty participants had Overdosed at least once, and 84% had witnessed an Overdose. 78% recognised altered consciousness as a sign of Heroin Overdose, but less were aware of depressed breathing (42%) or cyanosis (61%). Reported Overdose interventions included correct positioning (39%), expired air resuscitation (32%), ambulance notification (76%) and staying with the victim (87%). Discussion and Conclusions. Our study has found improved responses to Heroin Overdose during witnessed Heroin Overdose among current IDU, compared with earlier work. However, a lack of knowledge regarding appropriate first-aid response persists, which might improve with the development and implementation of training initiatives in this area, ranging from identification of Overdose to the administration of life-saving measures.[Kerr D, Dietze P, Kelly A-M, Jolley D. Improved response by peers after witnessed Heroin Overdose in Melbourne. Drug Alcohol Rev 2009;28:327–330]

Shane Darke - One of the best experts on this subject based on the ideXlab platform.

  • Addiction classics: Heroin Overdose.
    Addiction (Abingdon England), 2016
    Co-Authors: Shane Darke
    Abstract:

    Background and aims This narrative review aims to provide a brief history of the development of the Heroin Overdose field by discussing a selection of major ‘classics’ from the latter part of the 20th century. Methods Papers considered landmarks were selected from 1972, 1977, 1983, 1984 and 1999. Results Findings of earlier works suggest much of what later research was to demonstrate. These include arguing that Overdoses occurred primarily among tolerant older users, that most ‘Overdose’ deaths involved low morphine concentrations, that most Overdoses involve polypharmacy, that drug purity has only a moderate influence on Overdose rates and that instant death following Heroin administration is rare. Conclusions Landmark studies of Heroin Overdose from the 1970s, 1980s and 1990s laid the foundations for subsequent Overdose research, mainly by identifying the major demographic characteristics of Overdose cases, risk factors, survival times and behaviours at Overdose events.

  • patterns and correlates of non fatal Heroin Overdose at 11 year follow up findings from the australian treatment outcome study
    Drug and Alcohol Dependence, 2014
    Co-Authors: Shane Darke, Joanne Ross, Katherine L. Mills, Christina Marel, Tim Slade, Lucy Burns, Maree Teesson
    Abstract:

    Abstract Background Overdose is a major cause of morbidity and mortality amongst opioid users. This paper reported recent non-fatal Overdose amongst the Australian Treatment Outcome Study (ATOS) cohort at 11-year follow-up, and characteristics that predict recent Overdose. Methods Longitudinal cohort, with 431 (70.1%) of the original 615 participants interviewed. Participants were administered the ATOS structured interview, addressing demographics, treatment history, drug use, Heroin Overdose, criminality, health and psychopathology. Findings Mean time since Heroin initiation was 20.4 years. By 11-year follow-up, the proportion who had Overdosed was 67.5%, and 24.4% had experienced five or more Overdoses. In the 12 months preceding 11-year follow-up, 4.9% had Overdosed (11.8% of those who had used Heroin in that period). Of the 21 participants who had recently Overdosed, 20 (95.2%) had Overdosed previously, and 19 (90.5%) were not enrolled in a treatment programme at the time. Those who had recently Overdosed reported higher levels of use of opiates other than Heroin (57.1% vs 24.9%), benzodiazepines (61.9% vs 30.5%,), methamphetamine (38.1% vs 16.8%) and cocaine (19.0% vs 3.7%). They also had exhibited higher levels of Heroin use and other drug use at baseline, 12 and 24 month follow-ups. Conclusions While the prevalence had declined, Overdoses still occurred. A history of Overdose and polydrug use patterns continued to provide strong markers for those at continued risk.

  • Comparative toxicology of intentional and accidental Heroin Overdose.
    Journal of forensic sciences, 2010
    Co-Authors: Shane Darke, Johan Duflou, Michelle Torok
    Abstract:

    The demographic and toxicological characteristics of deliberate (SUI, n = 50) and accidental (ACC, n = 927) fatal Heroin Overdose cases were examined. SUI cases were more likely to be female, had lower body mass indices, were more likely to be enrolled in treatment and less likely to have hepatic pathology. The median blood morphine concentration of SUI cases was significantly higher than that of ACC cases (0.70 vs. 0.40 mg/L, p 1 mg/L were seen among 38.0% of SUI cases compared to 13.9% of ACC cases. Being a member of the SUI group remained a significant independent predictor of higher morphine concentrations after controlling for the effects of potential confounders (p < 0.001), other significant predictors being the absence of alcohol (p < 0.001), the presence of methadone (p < 0.05), and the presence of cocaine (p < 0.05). The current data are consistent with the view that suicide forms a small, but distinct, category of Heroin Overdose cases, rather than Overdose being a parasuicidal phenomenon per se.

  • A reduction in blood morphine concentrations amongst Heroin Overdose fatalities associated with a sustained reduction in street Heroin purity
    Forensic Science International, 2010
    Co-Authors: Shane Darke, Johan Duflou, Michelle Torok
    Abstract:

    To determine the effects of a sudden and sustained reduction in Heroin purity on the toxicology of Heroin Overdose, 959 consecutive Heroin Overdose cases autopsied at the NSW Department of Forensic Medicine (1/1/1998-31/12/2006) were analysed. There was a significant reduction in blood morphine concentration across the study period (beta=-0.07), declining from a median of 0.50mg/L in the years 1998-2000 prior to 0.40mg/L in the period 2001-2006. There was no significant change in the proportion of alcohol positive cases, but the proportion of benzodiazepine positive cases increased across time (OR 1.11), as did methadone positive cases (OR 1.12). The decline in blood morphine concentrations remained significant after controlling for these factors (beta=-0.07). In determining toxic and lethal morphine concentrations, the fact that the toxicology of Overdose is responsive to changes in the opioid street market needs to be borne in mind.

  • comparative toxicology of fatal Heroin Overdose cases and morphine positive homicide victims
    Addiction, 2007
    Co-Authors: Shane Darke, Johan Duflou, Sharlene Kaye
    Abstract:

    Aims To compare the blood toxicology of Heroin Overdose cases and morphine positive homicide victims. Design Analysis of coronial cases. Setting Sydney, Australia. Cases A total of 705 cases of death due to opioid toxicity and 28 morphine positive homicide cases (1 January 1998-31 December 2002). Findings There was no significant difference between the median morphine concentrations of the Overdose and homicide groups (0.50 versus 0.45 mg/l). The Overdose group was more likely to have blood alcohol (OR 3.21) present, but less likely to have methadone (OR 0.26) and cannabis (OR 0.04). There was a significant negative correlation between blood morphine and alcohol concentrations among the Overdose group (rho = -0.32), but not among the homicide group (rho = -0.03). Independent predictors of a higher blood morphine concentration were a lower alcohol concentration and a higher methadone concentration. Conclusions Morphine concentrations per se are not diagnostic of Overdose. The study confirms the salience of concomitant alcohol consumption in such events. Language: en

Karin E Tobin - One of the best experts on this subject based on the ideXlab platform.

Joanne Ross - One of the best experts on this subject based on the ideXlab platform.

  • patterns and correlates of non fatal Heroin Overdose at 11 year follow up findings from the australian treatment outcome study
    Drug and Alcohol Dependence, 2014
    Co-Authors: Shane Darke, Joanne Ross, Katherine L. Mills, Christina Marel, Tim Slade, Lucy Burns, Maree Teesson
    Abstract:

    Abstract Background Overdose is a major cause of morbidity and mortality amongst opioid users. This paper reported recent non-fatal Overdose amongst the Australian Treatment Outcome Study (ATOS) cohort at 11-year follow-up, and characteristics that predict recent Overdose. Methods Longitudinal cohort, with 431 (70.1%) of the original 615 participants interviewed. Participants were administered the ATOS structured interview, addressing demographics, treatment history, drug use, Heroin Overdose, criminality, health and psychopathology. Findings Mean time since Heroin initiation was 20.4 years. By 11-year follow-up, the proportion who had Overdosed was 67.5%, and 24.4% had experienced five or more Overdoses. In the 12 months preceding 11-year follow-up, 4.9% had Overdosed (11.8% of those who had used Heroin in that period). Of the 21 participants who had recently Overdosed, 20 (95.2%) had Overdosed previously, and 19 (90.5%) were not enrolled in a treatment programme at the time. Those who had recently Overdosed reported higher levels of use of opiates other than Heroin (57.1% vs 24.9%), benzodiazepines (61.9% vs 30.5%,), methamphetamine (38.1% vs 16.8%) and cocaine (19.0% vs 3.7%). They also had exhibited higher levels of Heroin use and other drug use at baseline, 12 and 24 month follow-ups. Conclusions While the prevalence had declined, Overdoses still occurred. A history of Overdose and polydrug use patterns continued to provide strong markers for those at continued risk.

  • Patterns of nonfatal Heroin Overdose over a 3-year period: findings from the Australian treatment outcome study
    Journal of urban health : bulletin of the New York Academy of Medicine, 2007
    Co-Authors: Shane Darke, Joanne Ross, Anna Williamson, Katherine L. Mills, Alys Havard, Maree Teesson
    Abstract:

    To determine annual patterns and correlates of nonfatal Heroin Overdose across 3 years, data were analyzed on 387 Heroin users recruited for the Australian Treatment Outcome Study (ATOS), interviewed at 12, 24, and 36 months. A Heroin Overdose across follow-up was reported by 18.6%, and naloxone had been administered to 11.9%. Annual rates of Overdose declined between baseline and 12 months and then remained stable. Previous Overdose experience was strongly related to subsequent Overdose. Those with a history of Overdose before ATOS were significantly more likely to Overdose during the study period. In particular, there was a strong association between Overdose experience in any 1 year and increased Overdose risk in the subsequent year. This is the first study to examine long-term annual trends in nonfatal Heroin Overdose. While Overdose rates declined after extensive treatment, substantial proportions continued to Overdose in each year, and this was strongly associated with Overdose history.

  • non fatal Heroin Overdose treatment exposure and client characteristics findings from the australian treatment outcome study atos
    Drug and Alcohol Review, 2005
    Co-Authors: Shane Darke, Joanne Ross, Anna Williamson, Maree Teesson
    Abstract:

    The relationship between treatment exposure, drug use, psychosocial variables and non-fatal Heroin Overdose was examined among a cohort of 495 Heroin users, re-interviewed at 12 months. The 12-month Overdose rate declined from 24% to 12%, and the proportion administered naloxone declined from 15% to 7%. There were significant reductions in Overdose among those who entered maintenance therapies (22% to 4%) and residential rehabilitation (33% vs. 19%) at baseline, but not among those who entered detoxification or were not entering treatment. The total number of treatment days received over the follow-up period was associated independently with a reduced risk of Overdose. Each extra treatment day was associated with a 1% reduction in risk of Overdose over the follow-up period. By contrast, more treatment episodes were associated with an increased risk of Overdose (OR 1.62). Other independent predictors of Overdose over follow-up were more extensive polydrug use (OR 1.40), and having Overdosed in the year preceding the study (OR 7.87).

  • Hair morphine concentrations of fatal Heroin Overdose cases and living Heroin users
    Addiction (Abingdon England), 2002
    Co-Authors: Shane Darke, Joanne Ross, Wayne Hall, Sharlene Kaye, Johan Duflou
    Abstract:

    Aims To compare Heroin and other opiate use of Heroin Overdose fatalities, current street Heroin users and drug-free therapeutic community clients. Design Hair morphine concentrations that assess Heroin use and other opiate use in the 2 months preceding interview or death were compared between Heroin Overdose fatalities diagnosed by forensic pathologists (fOD) (n = 42), current street Heroin users (CU) (n = 100) and presumably abstinent Heroin users in a drug-free therapeutic community (TC) (n = 50). Setting Sydney, Australia. Findings The mean age and gender breakdown of the three samples were 32.3 years, 83% male (FOD), 28.7 years, 58% male (CU) and 28.6 years, 60% male (TC). The median blood morphine concentration among the FOD cases was 0.35 mg/l, and 82% also had other drugs detected. There were large differences between the three groups in hair morphine concentrations, with the CU group (2.10 ng/mg) having concentration approximately four times that of the FOD group (0.53 ng/mg), which in turn had a concentration approximately six times that of the TC group (0.09 ng/mg). There were no significant differences between males and females in hair concentrations within any of the groups. Hair morphine concentrations were correlated significantly with blood morphine concentrations among FOD cases (r = 0.54), and self-reported Heroin use among living participants (r = 0.57). Conclusions The results indicate that fatal cases had a lower degree of chronic opiate intake than the active street users, but they were not abstinent during this period.

  • The relationship between suicide and Heroin Overdose among methadone maintenance patients in Sydney, Australia.
    Addiction (Abingdon England), 2001
    Co-Authors: Shane Darke, Joanne Ross
    Abstract:

    Aims. To examine the relationship between attempted suicide and non-fatal Heroin Overdose among methadone maintenance patients. Design. Cross-sectional survey. Setting. Sydney, Australia. Participants. Two hundred and twenty-three methadone maintenance patients. Findings. Forty per cent of participants reported a history of at least one suicide attempt. Females were significantly more likely than males to have attempted suicide (50% vs. 31%), and to have done so on more than one occasion (28% vs. 15%). There was a large difference between males and females in the onset of attempted suicide. Females reported an initial attempt, on average, 6 years earlier than males (18.3 vs. 24.7 years), and were significantly more likely than males to have attempted suicide prior to the onset of Heroin use (69% vs. 11%). While Heroin Overdose was common among the sample (66%), the most common methods employed for suicide attempts were Overdose of a non-opioid drug (21%) and slitting of wrists (20%). A deliberate Heroin Overdose as a means of attempted suicide was reported by 10% of participants. Heroin Overdoses appeared overwhelmingly to be accidental. Ninety-two per cent of those who had Overdosed reported that their most recent Overdose was accidental. Conclusions. Attempted suicide presents a major clinical problem to staff at drug treatment programmes, but one distinct from Heroin Overdose. While both Overdose and suicide present increasing clinical problems, they are separate problems, and require different responses.

Robert Kronstrand - One of the best experts on this subject based on the ideXlab platform.

  • Rapid communication Evaluation of the role of abstinence in Heroin Overdose deaths using segmental hair analysis
    2007
    Co-Authors: Henrik Druid, Joakim J Strandberg, Kanar Alkass, Fredrik C Kugelberg, Robert Kronstrand
    Abstract:

    In the body Heroin is rapidly metabolized to 6-acetylmorphine and morphine. Victims of lethal Heroin Overdose often present with fairly low blood concentrations of morphine. Reduced tolerance due to abstinence has been proposed to account for this finding. The aim of the present study was to examine the role of abstinence in drug-related deaths by comparing recent and past exposure to opioids using segmental hair analysis with the postmortem blood morphine concentrations in deceased Heroin users. The study included 60 deceased drug addicts in the Stockholm area, Sweden. In 32 cases, death was not related to Heroin intake. In 18 of the 28 Heroin fatalities, opioids were absent in the most recent hair segment, suggesting a reduced tolerance to opioids. However, the blood morphine levels were similar to those found in the 10 subjects that showed continuous opioid use. Hair and blood analysis disclosed an extensive use of additional drugs that directly or indirectly may influence the opioid system. The results suggest that abstinence is not a critical factor for Heroin Overdose death. Obviously tolerant subjects die after intake of similar doses. Other factors, particularly polydrug use, seem to be more causally important for these deaths. # 2006 Elsevier Ireland Ltd. All rights reserved.

  • Evaluation of the role of abstinence in Heroin Overdose deaths using segmental hair analysis.
    Forensic science international, 2006
    Co-Authors: Henrik Druid, Joakim J Strandberg, Kanar Alkass, Ingrid Nyström, Fredrik C Kugelberg, Robert Kronstrand
    Abstract:

    In the body Heroin is rapidly metabolized to 6-acetylmorphine and morphine. Victims of lethal Heroin Overdose often present with fairly low blood concentrations of morphine. Reduced tolerance due to abstinence has been proposed to account for this finding. The aim of the present study was to examine the role of abstinence in drug-related deaths by comparing recent and past exposure to opioids using segmental hair analysis with the postmortem blood morphine concentrations in deceased Heroin users. The study included 60 deceased drug addicts in the Stockholm area, Sweden. In 32 cases, death was not related to Heroin intake. In 18 of the 28 Heroin fatalities, opioids were absent in the most recent hair segment, suggesting a reduced tolerance to opioids. However, the blood morphine levels were similar to those found in the 10 subjects that showed continuous opioid use. Hair and blood analysis disclosed an extensive use of additional drugs that directly or indirectly may influence the opioid system. The results suggest that abstinence is not a critical factor for Heroin Overdose death. Obviously tolerant subjects die after intake of similar doses. Other factors, particularly polydrug use, seem to be more causally important for these deaths.

  • incidence of opiates amphetamines and cocaine in hair and blood in fatal cases of Heroin Overdose
    Forensic Science International, 1998
    Co-Authors: Robert Kronstrand, Robert Grundin, John Jonsson
    Abstract:

    The purpose of the present study was to investigate the occurrence in hair, of some drugs of abuse in deaths caused by Heroin Overdose, in comparison to findings in blood. Blood, urine and hair sam ...