Drug overdose: new insights, innovative surveillance, and promising interventions.

Abstract

2 Unlike other localities, cocaine accounts for a substantial portion of overdose mortality in New York City. 3 Cocaine admissions in the city declined steadily, from 264 per 100,000 in 1996 to 166 per 100,000 in 2000 and 2001. Thus, while estimates of overdose prevalence evidence waxing and waning over the past decade, drug overdose persists as a significant cause of morbidity and mortality in our city and in many others worldwide. This issue of the Journal brings together 11 original research articles that focus attention on the persistent problem of drug overdose. These articles summarize the burden of overdose that persists worldwide, as well as promising research and interventions that may contribute to a reduction in both the incidence of overdose and its consequences. In a review, Darke and Hall, who have made seminal contributions to overdose research, summarize the known determinants of heroin overdose and suggest prin- cipal areas for urgent research—the role of polydrug use in overdose, demographics and circumstances of overdose, and interventions that can affect the incidence and outcome of overdose. Additions to this list by other contributors include the intro- duction of innovative surveillance and monitoring methods and the role of mental health conditions in the etiology of overdose. The articles that follow elaborate on these points, suggest answers, and raise more questions. Two articles in this issue highlight areas in the study of overdose demographics and their correlates that have thus far received inadequate attention. Galea et al. discuss the racial/ethnic disparities in overdose mortality in New York City during the past decade. The authors show that, although rates of overdose death were con- sistently higher among blacks and Latinos compared to whites throughout the