Presented by Nathan Stam The forensic analysis of herion-related deaths: evaluating the safety of non-fatal herion overdose management by paramedics in the out of hospital

Presentation Synopsis: Most heroin overdoses in Victoria are treated and managed by paramedics in the out of hospital environment, with the majority not transported to hospital. The aim of this study was to determine the safety of the treatment of non-fatal heroin overdose cases managed by paramedics in the out of hospital environment (i.e. patients not transported to hospital). Fatal heroin overdose cases in Victoria, Australia between 1 January 2012 and 31 December 2013 were identified using the National Coronial Information System which contains all reportable deaths to an Australian Coroner. Decedent prior presentation to Ambulance Victoria was established by data linkage with the Ambulance Victoria VACIS ePCR database using probabilistic matching. 171 heroin-related death cases were linked and assessed to determine if any of the heroin-related deaths were associated with an episode of care by paramedics in the out of hospital environment. These results as well as challenges associated with the variation in the classification and reporting of heroin-related deaths will be discussed in detail. Risk factors associated with a non-fatal as well as fatal-heroin overdose will also be reviewed, in addition to both local and global trends of heroin use and overdose that will also be discussed.

Bio: Nathan Stam is a Senior Lecturer at Monash University and the Head of Postgraduate Paramedic Programs. Nathan has a clinical background as a paramedic in addition to his formal education and training in pharmacology and neurology. Nathan currently coordinates and teaches pharmacotherapy and clinical toxicology in the Graduate Diploma of Emergency Health (Intensive Care Paramedic) as well as the Master of Emergency Health programs. Nathan has a research background in molecular pharmacology as well as neuronal plasticity and neurodegeneration with research publications on Huntington’s Disease and Motor Neuron Disease. Nathan is currently completing a number of research projects related to clinical and forensic aspects of opioid toxicology, with a particular focus on heroin and methadone related deaths.