Ambulance-attended opioid overdoses: an examination into overdose locations and the role of a safe injection facility [2018]

Background: Although the United States and numerous other countries are amidst an opioid overdose crisis, access to safe injection facilities remains limited.

Methods: We used prospective data from ambulance journals in Oslo, Norway to describe the patterns, severity, and outcomes of opioid overdoses, and compared these characteristics among various overdose locations. We also examined what role a safe injection facility may have had on these overdoses.

Results: Based on 48,825 ambulance calls, 1054 were for opioid overdoses from 465 individuals during 2014 and 2015. The rate of calls for overdoses was 1 out of 48 of the total ambulance calls. Males made up the majority of the sample (n = 368, 79%) and the median age was 35 (range 18-96). Overdoses occurred in public locations (n = 530, 50.3%), the safe injection facility (n = 353, 33.5%), in private homes (n = 83, 7.9%), and other locations (n = 88, 8.3%). Patients from the safe injection facility and private homes had similarly severe initial clinical symptoms (Glasgow Coma Scale median =3 and respiratory frequency median = 4 breaths per minute) when compared to other locations, yet the majority from the safe injection facility did not require further ambulance transport to the hospital (n = 302, 85.6%). Those that overdosed in public locations (OR = 1.66, 95% CI= 1.17-2.35), and when the facility was closed (OR = 1.4, 95% CI= 1.04-1.89), were more likely to receive transport for further treatment.

Conclusions: Our findings suggest that the opening hours at the safe injection facility and the overdose location may impact the likelihood of ambulance transport for further treatment.

Desiree Madah-Amiri , PhD, Arne Kristian Skulberg , MD, Anne-Cathrine Braarud , MD, PhD, Ola Dale , MD, Fridtjof Heyerdahl , MD, PhD, Philipp Lobmaier , MD, PhD & Thomas Clausen , MD, PhD
Substance Abuse, 27 Jun 2018