Availability of overdose resuscitation facilities: a survey of drug agencies in England and Wales

Abstract

Overdose is a common cause of death among intravenous drug users, with an inadequate response of witnesses cited as a contributory factor. Drug agencies provide a potential site for intervention both in acute management of overdose and in provision of overdose-related training to staff and clients. Five hundred and thirty-nine drug agencies in England and Wales were surveyed by postal questionnaire to assess the provision of resuscitation facilities and training for the management of opiate overdose as well as the agencies own experience of on-site overdose. Three hundred and fifty-six (66%) agencies returned questionnaires suitable for analysis. Although over 80% of agencies had staff trained in resuscitation, less than a quarter had access to either oxygen or naloxone. Over 20% of the agencies had witnessed an overdose on site, with eight having administered resuscitation prior to transfer to hospital. Only a third of agencies provided clients with any training in the management of overdose. It is suggested that drug agencies should provide basic resuscitation facilities and client training in the management of overdose, with protocols to ensure effective application.