Evidence map›Paper›PMID 41001827›Full record

ArticleAddiction (Abingdon, England)2026

Analysis of rapid onset heroin overdose cases from a supervised injecting facility in Melbourne, Australia.

Nathan C Stam, Monika Shrestha, Basak Tas, John Furler, Yvonne Bonomo, John Strang

Abstract read
In one paragraph

Article in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Nathan C StamMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.ORCID 0000-0002-0176-1237
Monika ShresthaMedically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia.ORCID 0000-0003-2517-4608
Basak TasNational Addiction Centre, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-3137-7631
John FurlerMedically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia.ORCID 0000-0003-0339-5848
Yvonne BonomoDepartment of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Australia.ORCID 0000-0003-2583-0687
John StrangNational Addiction Centre, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-5413-2725

Funding

NIHR Maudsley BRC (Biomedical Research Centre)
6 · The paper itself

Abstract

aimsTo characterise the clinical condition of rapid onset heroin overdose cases, and to determine the incidence and characteristics of such cases.

designA retrospective cohort study of witnessed heroin overdose cases over a 12-month period (1 July 2023 to 30 June 2024).

settingThe Medically Supervised Injecting Room in Melbourne, Australia. CASES: Individuals who experienced a rapid onset overdose. A control group of standard onset cases amongst those same individuals was used for comparison. MEASUREMENTS: The severity of acute opioid toxicity for rapid versus standard onset heroin overdose cases, using a clinical severity scale regularly used at the Medically Supervised Injecting Room.

findingsFrom a total of 1727 heroin overdoses, 202 were identified as rapid onset cases that occurred amongst a cohort of 98 individuals. There were 997 standard overdoses from 75 individuals from this same cohort used as a control. Rapid onset overdoses presented with greater severity of respiratory depression. Forty-one percent (n = 82) of cases required positive pressure ventilation, including 19% (n = 38) classified as Grade 2 severity and 22% (n = 44) classified as Grade 3a severity. The standardised rate of rapid overdoses was approximately doubled on High overdose risk days (0.151/overdose) compared with that on Low overdose risk days (0.077/overdose).

conclusionRapid onset heroin overdoses typically present as medical emergencies involving severe respiratory depression shortly after heroin administration. Some people appear more likely to experience a rapid onset overdose than others, but factors for this are unclear. Rapid onset heroin overdoses also more commonly occur on some days compared with others, which may indicate an interrelationship between personal risk and the unregulated drug market. Rapid onset overdose cases may play a substantial role in hypoxic-related morbidity and mortality associated with heroin overdoses.

Indexed as

Drug OverdoseHeroinHeroin DependenceNeedle-Exchange ProgramsOpiate OverdoseSubstance Abuse, IntravenousAdultAustraliaFemaleHumansIncidenceMaleMiddle AgedRespiratory InsufficiencyRetrospective StudiesSeverity of Illness IndexHeroinacute opioid toxicityheroin overdoseopioid induced ventilatory impairmentopioid‐related deathsrapid onset overdoseunregulated drug market

Identifiers

PMID41001827
PMCPMC12779582

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.