Macedonian Red Cross Harm reduction Programme Overdose a major cause of avoidable death. ____________________________________ Elena Eftimovska, MD Health Coordinator in Macedonian RC HQ. Relevant information on the drug situation in Macedonia . Total population 2. 022 547.
a major cause of
Elena Eftimovska, MD
Health Coordinator in Macedonian RC HQ
the drug situation in Macedonia
2. 022 547
Registered drug users 8618
Forensic Medicine Institute - Medical faculty in Skopje
Forensic medicine wards - general hospitals all over Macedonia
Possible quantity data inaccuracy - autopsies with a toxicology analysis are not always carried out ( exp. religious reasons)
1. In the period from 2002 to 2007 the total number of drug-related deaths is increasing among the male population and decreasing among the female population.
Total number in 2002 - 6 ( 4 males + 2 females)
Total number in 2007 - 19 (all males)
2. Most common reason for drug-related death is opiate (mostly heroin) overdose - 78.9 %
10,5 % methadone in combination with other drugs
3. Age distribution in drug-related deaths
63,2 % - among the age group 25 - 29 years
21% - among the age group 20 - 24 years
Although the overall number of overdose deaths in the EU remains very high, in recent years a positive trend has been observed in some countries. Some new Member States may face a development similar to the one observed in west European countries at the beginning of the heroin epidemic.
Substitution treatment centers
Reducing the individual and community harm inflicted by drug use.
The aim is to increase knowledge and awareness around the behaviors that increase users’ risk of overdose.
The messages have been developed in four key risk areas – purity, tolerance, drug half-life and using alone. These messages target people who use heroin and are designed to communicate safer ways of using heroin.
WHAT ARE RISK FACTORS behaviors that increase users’ risk of overdose.
• Loss of Tolerance: Regular use of opioids leads to greater tolerance, i.e. more is needed to achieve the same effect (same high). Overdoses occur when people start using again following a period of not using (abstinence) such as incarceration, detox or “drug free” drug treatment.
• Mixing Drugs: Mixing opioids with other drugs, especially depressants such as benzodiazepines or alcohol can lead to an overdose. These combined drugs are “synergistic”, i.e., the effect of taking mixed drugs is greater than the effect one would expect if taking the drugs separately.
Special note :Cocaine is a stimulant but in high doses it can also depress the urge to breath, so it too can be particularly risky when combined with opiates.
• Variation in strength of ‘street’ drugs: Street drugs may vary in strength and effect based on the purity of the heroin ( in Macedonia app. 6% in a single dose) and the amount of other ingredients used to cut the drug. Users should use small amounts of new batches or inject slowly enough to get a feel of the quality/strength of the drug (s).
• Serious illness: If users have a serious illness including HIV/AIDS, liver disease, diabetes and/or heart disease, they are at greater risk for an overdose. Care should be taken when using to check the strength of the drug, avoid mixing drugs and/or using alone.
Using Drugs Alone is a Risk Factor for Overdose Death
When using drugs alone, there is a particularly high risk that overdose death may occur, because there is no one present to initiate rescue measures.
Individual overdose risk assessments should be done! behaviors that increase users’ risk of overdose.
Drug users who have previously experienced a nonfatal overdose are at very high risk of experiencing future overdoses.
The individual risky behaviors should be identified and addressed if possible.
Obstacles/Challenges behaviors that increase users’ risk of overdose.
- overdose prevention-
Future plans behaviors that increase users’ risk of overdose.
PARTICIPATORY TEAM WORK behaviors that increase users’ risk of overdose.