Abstract

Introduction

Heroin overdose is a leading cause of mortality among drug users. This paper aims to identify individual and contextual factors associated with lethal and non-lethal heroin-related overdoses on the basis of case reports and semi-structured proxy interviews. Typical patterns within these cases are determined by means of cluster analysis.

Methods

Within the CaRe (Case Reports of heroin-related overdoses) study, case reports (100 proxy reports of overdose events from 36 different facilities) were gathered and evaluated as part of a nationwide survey of experts conducted in Germany in 2019. Following initial descriptive analyses a two-step cluster analysis with the four binary variables of gender, age, time and place was conducted to identify patterns within the reported cases.

Results

The case reports grouped into five clusters: 1) Younger male drug users, found in a public space during the daytime; 2) Female drug users; 3) Older male drug users, found in a public space during the daytime; 4) Drug users found at home at night; 5) Drug users found outside at night. Overdoses by female drug users and those which occurred at home and/or at night were significantly more likely to have a fatal outcome.

Conclusion

Future prevention and intervention measures should aim to consider the context, i.e. typical constellations of risk, and attempt to inhibit this through appropriate counter measures.

中文翻译：

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致命和非致命的海洛因相关过量：环境和模式

摘要

介绍

海洛因过量是吸毒者死亡的主要原因。本文旨在根据病例报告和半结构化代理访谈，确定与致死和非致死海洛因相关过量服用相关的个人和背景因素。这些案例中的典型模式是通过聚类分析确定的。

方法

在 CaRe（海洛因相关过量服用案例报告）研究中，收集并评估了案例报告（来自 36 个不同机构的 100 份过量服用事件代理报告），作为 2019 年在德国进行的全国性专家调查的一部分。 经过初步描述性分析对性别、年龄、时间和地点这四个二元变量进行了两步聚类分析，以确定报告病例中的模式。

结果

病例报告分为五类：1）年轻男性吸毒者，白天在公共场所发现；2) 女性吸毒者；3) 白天在公共场所发现的老年男性吸毒者；4) 夜间在家中发现吸毒者；5) 夜间在室外发现的吸毒者。女性吸毒者吸毒过量以及在家中和/或夜间吸毒者吸毒过量更有可能导致致命后果。

结论

未来的预防和干预措施应着眼于考虑环境，即典型的风险群，并试图通过适当的对策来抑制这种情况。