Collaboration with Scottish Ambulance Service and University of Glasgow.
Scotland is experiencing a crisis of drug-related deaths (DRD) and has the highest rate in the UK. In 2018, there were 1,187 DRD, an increase of 107% since 2008. Several factors are thought to underpin this increase, including an ageing population of drug users and changes in patterns of drugs used with more polydrug use; however very few studies, and none recently from Scotland have been able to analyse overdose circumstances in detail.
Pathology reports can provide limited information on fatal overdoses, but no comparable data is available for non-fatal overdoses to date. The ratio of fatal to non-fatal overdoses is not consistently monitored. Understanding trends in survival versus death rates, along with the specific circumstances of each, may play an important part in understanding how to reduce the number of people who die.
A second factor that has not yet been studied in any detail, is the role of the Scottish Ambulance Service (SAS) in responding to suspected drug overdoses, providing on-the-scene emergency clinical care, signposting of services, and providing conveyance to hospital for further assessment (subject to patient acceptance). Electronic records of all ambulance call-outs in Scotland are completed at the time of each call and include patient age, gender, datazone (location of call-out), reason for call-out, outcome of call-out, resources incurred, whether or not specific substances were a known factor in the call-out and free text clinical notes. These data have yet to be fully explored to inform understanding of Scottish drug-related overdoses.
We propose a mixed methods study to examine SAS records and interview paramedics and other stakeholders to help inform developments in the Scottish response to DRD.
We will examine SAS data to identify trends and patterns in overdose call-outs in Scotland and explore the feasibility and utility of using free text data to contribute to better identification of overdose-related call-outs than using system codes alone.
We will explore the experience of attending, and management of, overdose call-outs by paramedics in order to identify potential areas for improvement of management or support for paramedics. This will draw on the SAS data analysis, but will use in-depth interviews to explore the experience and practices of paramedics attending and managing overdose presentations.
This will be a collaborative project between the University of Stirling and Scottish Ambulance Service.