Temporal Clustering of Heroin Overdoses in Washington, DC

    Volume 34, Issue 1 (January 1989)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 8


    Ruttenber, AJ
    Medical epidemiologists, Center for Environmental Health, Centers for Disease Control, NE Atlanta, GA

    Kalter, HD
    Medical epidemiologist, Centers for Disease Control and Department of Epidemiology and Statistical Analysis, National Institute on Drug Abuse, Rockville, MD

    Zack, MM
    Medical epidemiologists, Center for Environmental Health, Centers for Disease Control, NE Atlanta, GA

    (Received 24 March 1988; accepted 15 April 1988)

    Abstract

    During the 5-day period from 28 Feb. 1985 through 4 March 1985, 24 heroin overdoses occurred in the District of Columbia. Statistical tests for clustering of fatal and nonfatal overdoses during this interval identified 7 heroin-related deaths that occurred on March 1 to 2 as a statistically significant cluster (p = 0.007). An extension of the analysis for clustering to a 15-month period identified 2 additional clusters, 1 of fatal overdoses and 1 of nonfatal ones. When all victims of fatal overdose in cluster intervals were combined and compared with all other heroin-related deaths, no significant differences were noted for levels of morphine or ethanol in blood. However, bile morphine concentrations of cluster decedents were significantly lower than those of noncluster decedents (p = 0.033), suggesting that these decedents were less tolerant to the effects of narcotics than the comparison group. Heroin concentrations in street-level heroin samples collected during clusters did not differ from those collected during comparison intervals. These data conflict with the traditional explanation of overdose clusters, which attributes these events to unusually potent street-level heroin.


    Paper ID: JFS12619J

    DOI: 10.1520/JFS12619J

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    Title Temporal Clustering of Heroin Overdoses in Washington, DC
    Symposium , 0000-00-00
    Committee E30