为了减少海洛因过量死亡的人数，已经实施了带回家的纳洛酮（THN）计划。由于澳大利亚最近的立法变化，有一项规定，纳洛酮在社区中的分布更大，然而,这些变化对降低海洛因死亡率的潜在影响尚不清楚.这项研究的目的是检查整个致命海洛因过量病例队列的特征，并评估在每个致命过量事件的地点和时间都有纳洛酮可用的情况下，是否有旁观者干预的机会，以潜在地避免这些病例的致命结局。
维多利亚州海洛因过量死亡队列中与致命过量事件有关的情况，澳大利亚在2012年1月1日至2013年12月31日期间进行了调查。调查了所有病例的死因数据，并进行了数据链接，以进一步调查紧急医疗服务部门有关每个死者的致命海洛因过量事件情况的信息。
在研究期间发现了235例致命的海洛因过量病例。数据显示，大多数致命的海洛因过量病例发生在私人住宅（n=186，79％），死者在致命的过量事件发生时也只有死者（n=192，83％）。只有38例（17％）死者与其他人在一起或有过量事件的目击者，在这些案件中，有一半的证人受到了严重损害，在致命的海洛因过量时丧失能力或睡着了。确定了19例致命的海洛因过量病例（8％），有可能由旁观者或证人进行适当和及时的干预。
这项研究表明，在研究期间，单独引入THN可能会导致致命海洛因过量病例的数量略有减少。在大多数致命的海洛因过量病例中，缺乏监督或证人提供有意义和及时的干预是显而易见的。
Take-home naloxone (THN) programs have been implemented in order to reduce the number of heroin-overdose deaths. Because of recent legislative changes in Australia, there is a provision for a greater distribution of naloxone in the community, however, the potential impact of these changes for reduced heroin mortality remains unclear. The aim of this study was to examine the characteristics of the entire cohort of fatal heroin overdose cases and assess whether there was an opportunity for bystander intervention had naloxone been available at the location and time of each of the fatal overdose events to potentially avert the fatal outcome in these cases.
The circumstances related to the fatal overdose event for the cohort of heroin-overdose deaths in the state of Victoria, Australia between 1 January 2012 and 31 December 2013 were investigated. Coronial data were investigated for all cases and data linkage was performed to additionally investigate the Emergency Medical Services information about the circumstances of the fatal heroin overdose event for each of the decedents.
There were 235 fatal heroin overdose cases identified over the study period. Data revealed that the majority of fatal heroin overdose cases occurred at a private residence (n = 186, 79%) and where the decedent was also alone at the time of the fatal overdose event (n = 192, 83%). There were only 38 cases (17%) where the decedent was with someone else or there was a witness to the overdose event, and in half of these cases the witness was significantly impaired, incapacitated or asleep at the time of the fatal heroin overdose. There were 19 fatal heroin overdose cases (8%) identified where there was the potential for appropriate and timely intervention by a bystander or witness.
This study demonstrated that THN introduction alone could have led to a very modest reduction in the number of fatal heroin overdose cases over the study period. A lack of supervision or a witness to provide meaningful and timely intervention was evident in most of the fatal heroin overdose cases.
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