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Sporer, Karl A (2003) Strategies for preventing heroin overdose. British Medical Journal, 326, (7386), pp. 442-444.

This paper looks at measures that might be used to reduce deaths associated with heroin overdose. Epidemiology of non-fatal and fatal heroin overdoses show that most deaths occur among IV users between 20 and 30 and are heavily dependent on it, with on 17% occurring in new users. There are few links between overdoses and sudden changes in the drugs purity. Periods of abstinence may reduce tolerance of addicts and place them at particular risk to overdosing. Several measures are suggested to reduce the incidence of overdoses. Methadone maintenance reduces overdose levels while methadone detoxification actually increases the risk of heroin overdose. The use of Naloxone is also mooted.

Naloxone is a specific opiate antagonist with no agonist properties and produces no euphoric effects. This drug can be administered intravenously or subcutaneously by someone in the company of the person overdosing. The drug can cause complications and further research is required. There are some concerns as to whether its availability would encourage heroin use or that heroin users might be encouraged to take larger doses of heroin without the fear of overdose.

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