Overdose in young people using heroin: associations with mental health, prescription drug use and personal circumstances.

OBJECTIVE To identify patterns of mental health, prescription drug use and personal circumstances associated with heroin overdose in young people. DESIGN Linkage of data on use of Pharmaceutical Benefits Scheme (PBS) prescription drugs with data from a self-report questionnaire. SETTING Inner metropolitan Melbourne, Australia. SUBJECTS 163 young people, 15-30 years, using heroin. MAIN OUTCOME MEASURES Personal circumstances, mental health (as measured by various scales), and PBS-listed prescription drug use. RESULTS Young people using heroin reported high rates of feelings of hopelessness, depression, antisocial behaviour, self-harm and diagnosed mental illness. A prior history of overdose was associated with previous mental illness, which in turn was associated with being female, having poor social support, being dissatisfied with relationships, and living alone or in temporary accommodation. While feelings of hopelessness and antisocial behaviour were strongly associated with overdose history, the number of PBS prescription drugs used had a very strong relationship with overdose, particularly benzodiazepines, other opioids, tricyclic antidepressants and tranquillisers. CONCLUSIONS Further research to explore causal relationships between prescription drugs and heroin overdose is warranted. Improved data linkage to PBS records for general practitioners may facilitate safer prescribing practices.