The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56725

Theresa Perlis, PhD¹, Don C. Des Jarlais², and Joy Settembrino². (1) National Development and Research Institutes, Inc, 71 West 23rd Street, 8th floor, New York, NY 10010, 212-845-4484, perlis@ndri.org, (2) National Development and Research Institutes, Inc., 71 West 23rd. Street, 8th floor, New York, NY 10010

Background: Heroin is one of the leading causes of drug-related deaths in the U.S. We examined the occurrence of heroin overdose among a group of young geographically mobile (Urban Nomad) IDUs. Methods: Telephone or in-person structured interviews were administered to 96 traveling IDUs participating in a longitudinal study. Questions included recent (past 6 months) drug use and overdose. Results: Frequency of drug injecting was variable - only 19% injected daily and 43% were sporadic users. 83% had also used non-injected drugs whenever available, and all had drunk alcohol - over 50% on a daily basis. 76% reported using alcohol concurrently with heroin injection. 21 (22%) had experienced recent heroin overdose (14% multiple times), and 15/21 reported use of both heroin and alcohol on the last overdose occasion. When asked why they drank alcohol at the same time as injecting, the two most common reasons were "already drinking" or "usually drinking anyway" and "to intensify the effect". Overall, 63% think they are likely to overdose in the future. 49% had witnessed someone else overdose, including events where bystanders had responded only with actions of questionable efficacy, such as slapping the victim or pouring cold water over him/her. Conclusion: Concomitant alcohol and heroin use among Urban Nomads puts them at particularly high risk for overdose. Many appear to consider overdose inevitable. Programs targeted to information dissemination about the dangers of mixing drugs and to overdose management training should be implemented in drop-in centers, SEPs and other agencies serving these youth.

Learning Objectives:

• At the conclusion of the session, the participant in this session will:
• 1)Recognize the extent of the overdose problem in this young "Urban Nomad" population
• 2)Understand the need for implementation of overdose management training targeted to the Urban Nomad population

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.