Scotland

Drug death risk up for injectors after hospital discharge

Drug injector Image copyright SPL
Image caption Drug injectors discharged from hospital have increased risk of drug-related death

Addicts with a history of drug injecting are at significant risk of a fatal overdose in the four weeks after being released from hospital, a study has shown.

Researchers, drawing on Scottish NHS records, said this means doctors must now alter their advice to patients.

In the years 2006-10 there were 1,970 opioid-related deaths in Scotland.

The Cambridge University study revealed 11.2% (125) of the patients had recently been treated in hospital.

The researchers at the MRC Biostatistics Unit at the Cambridge Institute of Public Health had earlier revealed the high risk of drug-related death among injectors released from prison.

They said that risk, first identified in Scotland, is well-known and users, their peers and families accept they must take precautions against fatal overdose.

Important message

This includes the use of naloxone, a drug which can reverse the effects of an overdose caused by heroin or other opioid such as methadone.

The scientists, along with a team from Glasgow Caledonian University, said their new findings carried an important message for injectors and health professionals.

Scotland was the first country in the world to introduce a national naloxone programme, after concern was raised that the rate of drug-related deaths there was considerably higher than in other parts of the UK.

A monitoring report, issued by NHS Scotland in October 2015 suggested it had recorded significant success.

It said: "The percentage of all opioid-related deaths that occurred within four weeks of prison release fell steadily from 9.8% during 2006-10 (before the programme) to 3.1% in 2014.

"This substantial fall reflects both increasing total opiate-related deaths and falls in the relatively small number of deaths within four weeks of prison release."

The research is published in the open-access journal Plos One.

Dr Simon White, senior investigator statistician at the biostatistics unit said: "There is a well known increased risk of drugs-related death soon after release from prison.

"What we have shown, and is lesser known, is an increased risk of drugs-related death soon after discharge from hospital among self-reported injectors."

He said these patients, who had been treated for a wide variety of conditions, many not related to their injecting history, would benefit from GPs and hospital staff being made aware of that risk.

Prof Sheila Bird, the research programme leader, said drug injectors discharged from prison or hospital should take precautions, especially in the first four weeks.

These included ensuring someone else is present if they take opioids, that naloxone is also available, and the amount of alcohol they drank was limited.

She said: "The public health evidence is strong, and by reacting to it, can help to keep you safer from fatal overdose."

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