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Zhou Y, Luo W, Cao XB, Zhang B, Wu ZY. 
“[Overdose of heroin and influencing factors in intravenous drug users in parts of Yunnan]”. 
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 May 18;37(5):648-52.
OBJECTIVE: To assess the prevalence of overdose of heroin and risk factors in intravenous drug users(IDUs)in Yunnan Province.

METHODS: During July-August of 2015, IDUs were recruited from four methadone maintenance treatment(MMT)clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures, Yunnan province. The information about IDUs ' demographic characteristics and drug use history, overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey. The factors associated with overdose of heroin were evaluated with logistic regression models.

RESULTS: Of the 340 IDUs surveyed, 85.3(290/340)were males, the mean age was 37.78.7 years, 65.6(223/340)were Han ethnicity, and 49.4(167/338)were HIV positive, 22.6(77/340)reported having used club-related drugs(such as ephedrine, methamphetamine, benzodiazepines and ketamine)in the previous 12 months. Of the 340 IDUs, 41.8(142/340)had at least one overdose of heroin in their lifetime(median: 3 overdoses)and 15.6(53/340)had at least one overdose of heroin(median : 1 overdose use)in previous 12 months. The mean age of the 53 IDUs was(36.7 8.4)years, and 83.0(44/53)of them were males, the average drug use history was(16.5 7.6)years. Dosage increase(26.4, 14/53)and multidrug use(28.3, 15/53)were the main causes for overdose of heroin. Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year(OR=0.534, 95CI: 0.290-0.980)was independently associated with decreased risk of overdose of heroin, needle sharing in the past 6 months(OR=2.735, 95CI: 1.383-5.407)and being forced to receive drug rehabilitation for less than one year(OR=2.881, 95 CI: 1.226-6.767)were independently associated with increased risk of overdose of heroin.

CONCLUSIONS: Overdose of heroin is common among IDUs in Yunnan. It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin, especially before they leave drug rehabilitation centers. And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.
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