Pubdate: Mon, 31 Jan 2005
Source: Times Of Malta (Malta)
Copyright: 2005 Allied Newspapers Limited
Author: Cynthia Busuttil
Bookmark: (Heroin)


Heroin was used in 95 per cent of fatal overdoses from illicit drugs
that took place in Malta between 1999 and 2003, Anna Girard, head of
the national focal point for drugs and drug addiction, said.

In the five-year period under review, 31 fatal overdoses took place,
with 27 of the victims being male. The mean age of victims was 32 years.

Ms Girard said that in the same timeframe there were nine fatal
overdoses from non-illicit drugs. Four of the victims were aged
between 25 and 34 years while five were over the age of 45.

She explained that between 1995 and 2003 there were 277 non-fatal
overdoses caused by illicit drugs while 1,092 non-fatal overdoses
resulted from pills and the combination of alcohol and pills. In 2003
there were 15 non-fatal overdoses from illicit drugs and 149 from
pills. The majority of the victims - 96 - were females.

The national focal point, under the auspices of the National
Commission On The Abuse Of Drugs, Alcohol And Other Dependencies,
based in the Ministry for the Family and Social Solidarity, collects
data related to drugs on an annual basis. This is done in
collaboration with the unit's information network made up of treatment
agencies, health departments, the police, Customs, the courts, the
probation services, the forensic laboratory, the Substance Abuse
Therapy Unit (SATU) and the Corradino Correctional Facility (CCF).

Ms Girard said chronic relapsers, who would have been abstinent for a
while and then return to addiction, were among those at risk of
overdose because of lower tolerance to the drug. She said there is
also a high risk for those who are not daily users and who then take
the same amount as someone who would be using the drug everyday. Those
with increased social and health problems, particularly those who
abuse any psychiatric medication, could also be at risk.

"The reasons for the overdose could be various. Some victims could be
people who are extra-confident about their level of tolerance to the
substance, which happens especially if a person has not used the drug
for a while. Another reason could be that the person changed the
supplier, which would have affected the drug purity, or the victim
mixed various substances or took alcohol and drugs together," a
spokesman for Sedqa, the local agency against drug and alcohol abuse,

She said the tendency was that overdose victims, regardless of their
age, were mainly be heavy drug users. However, there have been
reported cases of both fatal and non-fatal overdoses by people still
in the experimental stage of substance abuse.

The spokesman said that if a person was abusing drugs and something
went wrong, the risk of overdose increased if s/he was on his/her own
and not in a group because there would not be anyone around to help.

A paper just published by the European Monitoring Centre for Drugs and
Drug Addiction (EMCDDA) said drug overdose is a major cause of deaths
among young people in Europe, with more than 8,000 fatalities recorded
in the continent every year. The centre said evidence shows that a
broad range of measures can be effective in reducing drug overdose and
added that overdose prevention measures, including educational and
strategic measures that can reduce mortality and morbidity, were
generally becoming more common.

Asked about the prevention scenario in Malta, Ms Girard said substance
dependent people who were in contact with treatment services - given
by Caritas, Oasi and Sedqa, and also the probation services and SATU -
were given information about the risks involved in injecting drugs,
the combination of abusing any psychiatric medication together with
illicit drug use and alcohol as well as the risks of overdosing
associated with long term abstinence and relapse.

Ms Girard said drug prevention programmes implemented in schools and
in the community also included topics related to the health risks
involved in taking drugs.

In an effort to try and prevent drug-related deaths and overdose Malta
Red Cross and St John's Ambulance personnel are present at parties
where drugs may be consumed. The Sedqa outreach team even mount stands
providing useful information at some parties. Additionally, the social
affairs committee of the House of Representatives is debating the
issue of the negative impact of the interpretation of the law as it
stands at present in connection with those accompanying an overdose
victim to hospital, who could be liable to charges of manslaughter in
the unfortunate circumstances of death.

"The best way to reduce the risk of overdosing is total abstinence,"
the Sedqa spokesman said.

She said agencies promote harm minimisation practices to reduce the
risks connected with substance abuse, including the spread of
blood-borne diseases like Hepatitis and HIV.

"Harm minimisation measures and information are passed on to every new
client coming in contact with the agency's services, individually and
regularly," she said, adding that other clients using the services
were constantly reminded about the dangers related to drug abuse.

"There is a constant flow of information passed to Seqda's existing
clients, possible future clients, people at risk of abusing substances
and the general public. This is given both through the agency's
prevention programmes and through its care services."

The first home for homeless drug users was opened in Malta by Caritas
last October.

Programme coordinator Mariella Balzan explained that homeless drug
users are among those mostly at high risk of overdose. She said the
shelter is also open to drug users who leave prison without a plan on
how to continue taking the medication which they would have been
taking while doing time. At the moment there are eight males at the

Ms Balzan said another programme which attempts to reduce the
incidence of overdoses offers a place to go to those drug users who
are not able to stop taking drugs and do not work.

Gozo is mainly dealt with by the Oasi Foundation. Noel Xerri, from the
foundation, said "an enormous amount of prevention" work is done
through the Oasi primary prevention team, which has been working with
Gozitan students for the past 13 years. The foundation also offers the
assistance of a counsellor.

"This crisis intervention service handles about 200 people annually,"
he said.

Mr Xerri said that although prevention is always better than cure
there are still some people who abuse drugs and the foundation offers
its services to reach out and be effective in a therapeutic way
towards the victims and their families. 
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