• Anne Bartu, Jag Atrie, and Frank Fs Daly.
• Department of Emergency Medicine, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia. daniel.fatovich@health.wa.gov.au
• Emerg Med Australas. 2010 Jun 1;22(3):240-5.

IntroductionTo examine hospitalizations in a cohort of 224 patients who presented with non-fatal heroin overdose to an ED.MethodsA record linkage study, using the morbidity, mental health and mortality databases in the Data Linkage Unit of the Department of Health, Western Australia. The main outcome measures were hospital separations 5 years before and after entry into the cohort.ResultsBefore entry into the cohort, 199 (89%) patients had an admission to mental health services. These 199 had a combined total of 1367 separations, most commonly for a mental health condition, injury or poisoning. Women had more than twice the relative risk (RR) of men for all separations (RR 2.35, 95% confidence interval [CI] 1.96-2.82, P < 0.001) and for injury and poisoning separations (RR 2.04, 95% CI 1.56-2.66, P < 0.001). The highest concentrations of separations occurred within 1 year before and 1 year after entry into the cohort. There were 12 (5.4%, 95% CI 2.9-9.4%) deaths, most commonly from overdose.ConclusionNon-fatal heroin overdose ED presentations are associated with a cluster of hospitalizations around that episode, likely to be related to heroin availability. Presentation to hospital by heroin users represents an opportunity to counsel less risky behaviour.

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