Skip to content
  • Menu
  • Harm Reduction Decade

    Harm Reduction Decade

    Read our latest report calling for a Harm Reduction Decade, sign the Harm Reduction Decade Declaration, call for #10by20, and stand up for human rights of people who use drugs, their families and communities.

  • 10 by 20

    10 by 20 Campaign

    Everything you need to know about the 10 by 20 campaign

    10 by 20 Pie Chart

  • Global State of Harm Reduction

    Global State of Harm Reduction

    Our flagship publication is the biennial Global State of Harm Reduction report. First published in 2008, it involves a coordinated effort across practitioners, academics, advocates and activists to map global data and responses to HIV and hepatitis C epidemics related to unsafe injecting and non-injecting drug use. It is the only report to provide an independent analysis of the state of harm reduction in the world. The information collated within the report is stored and regularly updated on an interactive e-tool for researchers and advocates.

    The Global State of Harm Reduction report is supplemented by regular thematic reports and advisories on key issues and emerging challenges. Please search our Resource Library for more information or join our e-list for regular updates.

    Interactive e-tool

    Global State of Harm Reduction’ e-tool is an interactive resource containing up-to-date information on harm reduction policy and programming around the world. Users can select countries or regions and create tables for an at-a-glance guide to the current state of harm reduction worldwide.

  • News

    News and Announcements

    Read the latest announcements and updates from HRI.

  • About

    About HRI

    HRI is a leading non-governmental organisation working to reduce the negative health, social and human rights impacts of drug use and drug policy by promoting evidence-based public health policies and practices, and human rights based approaches to drugs. Read more about HRI’s history.

    Vision and Mission

    Our vision is a world in which individuals and communities benefit from drug laws, policies and practices that promote health, dignity and human rights.

    Staff

    Meet our staff at HRI

    Governance

    HRI is governed by a nine person Board of Directors, elected for three-year terms.

    What is harm reduction?

    Harm reduction refers to policies, programmes and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs.

    Harm reduction definition and principles in 12 languages

    Contact Us

    Please feel free to contact us if you have any questions or queries about our website, our work, membership or the international harm reduction conference.

    Donors

    HRI benefits from the generous support of the Open Society Foundations, the European Commission, the Elton John AIDS Foundation, the MAC AIDS Fund, UNAIDS, the World Health Organization, the UN Office on Drugs and Crime, the World Bank, The Robert Carr Networks Fund and the Swiss Government.

    Harm Reduction International Awards

    HRI presents a number of awards at outr international conference to acknowledge the contributions of outstanding groups or individuals in the field.

    Strategic Plan

    An international environment supportive of harm reduction scale up

  • Our Work

    Evidence for advocacy

    HRI produces groundbreaking research and policy analysis informing advocacy across our sector.

    Spending where it matters

    Funding for harm reduction services is dangerously short while billions are wasted on drug enforcement. HRI works to assess resourcing needs and advocates for a reinvestment in health.

    Human rights-based policy

    Human rights abuses and drug enforcement go hand in hand. HRI challenges laws, policies and practices that generate harm.

    The Death Penalty for Drug Offences

    HRI monitors the death penalty for drugs in law and practice worldwide, and also considers critical developments on the issue.

    Sector strengthening

    HRI builds advocacy coalitions and supports emerging harm reduction networks to strengthen the international harm reduction sector.

    International conference

    Harm reduction is a global movement. Our biennial gathering is the International Harm Reduction Conference, convened by HRI.

  • Resource Library

    Resource Library

    Use our extensive resource library to search for HRI, NGO and academic reports, articles and presentations, including materials from past international conferences.

    Harm Reduction Journal

    Harm Reduction Journal, www.harmreductionjournal.com, is an open access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies.

  • Support Us

    Donate

    HRI relies on trusts, grants and donations to continue our work. To make a donation or pay membership fees, please use our secure payment page.

    Or why not fundraise for us with ‘Discover Adventure’?

    Contact Us

    Harm Reduction International
    Unit 2C09 Southbank Technopark
    90 London Road
    London
    SE1 6LN  

    Tel: +44(0) 207 717 1592
    Fax: +44 (0) 207 922 8822
    Email: office@hri.global
    Join us on facebook at: Harm Reduction International
    Or join us on Twitter at: HRInews

    E-Updates

    Sign up to receive email updates, report launches, harm reduction advisories and information about the forthcoming international harm reduction conference

Epidemiological Research

  • Print
  • Bookmark and Share
EHRN Overdose in CEE (Russian) image

Overdose is a well-researched harm of drug use, and this is reflected in the literature on the epidemiology of both fatal and non-fatal overdoses in various populations (including released prisoners). This section highlights a few of the most recent, or most widely referenced and quoted papers. We were unable to identify a global summary or report of overdose prevalence, so this section features papers from Central and Eastern Europe and Central Asia, Australia, Canada, Iran, the USA, and Vietnam. Gaining a proper understanding of the extent and patterns of overdose is essential in planning and delivering effective prevention interventions.

Bergenstrom A, Quan VM, Van Nam L, McClausland K, Thuoc NP, Celentano D & Go V (2008) A Cross-Sectional Study on Prevalence of Non-Fatal Drug Overdose and Associated Risk Characteristics among Out-of-Treatment Injecting Drug Users in North Vietnam. Substance Use and Misuse, 43(1), pages 73 – 84.

This study from South-East Asia investigates the prevalence of drug use-related overdose through a community-based cross-sectional survey of out-of-treatment male opiate injecting drug users aged 18-45. 299 participants were recruited in a semi-urban province in North Vietnam, and 43.5% reported ever experiencing an overdose in their lifetime – more than four fifths of whom had done so recently. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view this document

Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG &
Koepsell TD (2007) Release from Prison — A High Risk of Death for Former Inmates. The New England Journal of Medicine, 356, pages 157 – 165.

This paper investigates the risk of death for newly released prisoners in Washington State, US. The researchers find that risk of death among former inmates is 3.5 times that among other state residents. More strikingly, they find that during the first two weeks after release, the risk of death among former inmates is 12.7 times that among other state residents, with a markedly elevated relative risk of death from drug overdose. They conclude that former prison inmates are at high risk for death after release from prison, particularly during the first 2 weeks. Interventions are necessary to reduce the risk of death after release from prison.

Click here to view this document online

Coffin P (2008) Overdose: A Major Cause of Preventable Death in Central and Eastern Europe in Central Asia. Recommendations and Overview of the Situation in Latvia, Kyrgyzstan, Romania, Russia and Tajikistan (English). Lithuania: EHRN.

This report – written for the Eurasia Harm Reduction Network (EHRN) and funded by the World Health Organization – summarises the current situation with regard to overdose epidemiology, services, knowledge, and policies in selected Eurasian countries. Across the region, drug overdose is one of the leading causes of death among young people and the top cause of death among injection drug users – often exceeding deaths from AIDS-related illnesses. Findings for each of five Eurasian countries are presented, with the goal of providing a status report and a resource for future planning.

Click here to view this document

Coffin P (2008) Overdose: A Major Cause of Preventable Death in Central and Eastern Europe in Central Asia. Recommendations and Overview of the Situation in Latvia, Kyrgyzstan, Romania, Russia and Tajikistan (Russian). Lithuania: EHRN.

This report – written for the Eurasia Harm Reduction Network (EHRN) and funded by the World Health Organization – summarises the current situation with regard to overdose epidemiology, services, knowledge, and policies in selected Eurasian countries. Across the region, drug overdose is one of the leading causes of death among young people and the top cause of death among injection drug users – often exceeding deaths from AIDS-related illnesses. Findings for each of five Eurasian countries are presented, with the goal of providing a status report and a resource for future planning.

Click here to see this document

Coffin PO, Galea S, Ahern J, Leon AC, Vlahov D, Tardiff K (2003) Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990–98. Addiction, 98, pages 739 – 747.

This study investigates the contribution of multiple drug combinations to overdose mortality trends in New York City between 1990 and 1998. The authors found that opiates, cocaine and alcohol were the three drugs most commonly attributed as the cause of accidental overdose deaths, accounting for 97.6% of all deaths - with 57.8% of those deaths attributed to two or more of these three drugs in combination. Overall trends in overdose deaths over these years were more affected by changes in the rates of multi-drug deaths, as the rates of overdose deaths associated with just one drug remained relatively stable. The authors conclude that interventions to prevent accidental overdose mortality must address the use of drugs such as heroin, cocaine and alcohol in combination. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Degenhardt L, Roxburgh A & Barker B (2005) Underlying Causes of Cocaine, Amphetamine and Opioid Related Deaths in Australia. Journal of Clinical Forensic Medicine, 12, pages 187 – 195.

This study investigates the characteristics of drug-related deaths in Australia between 1997 and 2002. The authors outline the extent of drug-related deaths related to opioids, amphetamines and cocaine – and found that only thirteen deaths were attributable primarily to cocaine and sixty-eight to amphetamines, compared with 4,591 to opioids. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Karbakhsh M & Zandi NS (2007) Acute Opiate Overdose in Tehran: The forgotten Role of Opium. Addictive Behaviors, 32, pages 1835 – 1842.

This report from Iran aims to examine the epidemiology of acute opiate overdose using data from a ‘poisoning center’ in Tehran. Opium was the major cause of overdose in the study – suggesting that opium is far from a harmless substance, even though its use is regarded as a historical phenomenon in many countries. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Milloy MJ, Kerr T, Mathias R, Zhang R, Montaner JS, Tyndall M & Wood E (2008) Non-Fatal Overdose among a Cohort of Active Injection Drug Users Recruited from a Supervised Injection Facility. American Journal Drug Alcohol Abuse, 34(4), pages 499 – 509.

This study aimed to evaluate patterns of non-fatal overdose among a cohort of clients from the safer injecting facility in Vancouver, Canada. A prospective sample of 1,090 participants was used, and the authors found that over half reported a history of non-fatal overdose – and this remained constant throughout the study. Previous overdose was associated with ‘sex-trade involvement’ and public drug use, but not with use of the safer injecting facility. Therefore, the study concludes that this facility may increase the likelihood of overdose – as had been previously claimed. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view this document

Rosen DL, Schoenbach VJ & Wohl DA (2008) All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980–2005. American Journal of Public Health, 98, pages 2278 – 2284.

In order to identify unmet health care needs among former prisoners, the researchers compared mortality of ex-prisoner and other state residents in North Carolina, USA. The findings illustrate that a higher number of deaths occurred within the former prisoner sample than that of the other state residents. The authors conclude that excess deaths from injuries and medical conditions among ex-prisoners highlight their medical vulnerability and the need to improve access to correctional and community preventive health services. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view the abstract via PubMed

Shah NG, Lathrop SL, Reichard RR & Landen MG (2008) Unintentional Drug Overdose Death Trends in New Mexico, USA, 1990-2005: Combinations of heroin, cocaine, prescription opioids and alcohol. Addiction, 103(1), pages 126 – 136.

This study aims to determine the contributions of heroin, prescription opioids, cocaine and alcohol to the total overdose death rates in New Mexico, and to identify changes in drug overdose patterns over 15 years. The main findings were that the total unintentional drug overdose death rate in New Mexico had increased since 1990. The drugs most commonly associated with deaths were heroin alone, heroin and alcohol together, and prescription opioids alone (especially among white males and all females). The researchers conclude that interventions to prevent drug overdose death should be targeted to specific sub-populations. Unfortunately, we are unable to provide free access to this article at this stage.

Click here to view this document