Identifying Injection Drug Users at Risk of Nonfatal Overdose

Abstract

Drug users who have previously experienced a nonfatal overdose are at very high risk of experiencing future overdoses. Further longitudinal studies are needed to identify robust predictors of overdose risk over time in habitual drug users, but these data suggest that drug users who have overdosed warrant aggressive prevention efforts such as agonist maintenance treatment or provision of take-home naloxone.

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

“…The association between young age and overdose in multivariate Model 1 has been demonstrated in other studies. 10,11,14,32 Multiple studies have shown that young IDU are more likely to share syringes. [33][34][35] Over 63% of participants under 26 shared syringes or paraphernalia, compared to 42% of those 26 and over (pG 0.0001).…”

“…[7][8][9] Polydrug use, binge drug use, alcohol use, and withdrawal symptoms have also been found to be associated with nonfatal overdose. 8,[10][11][12] Longer heroin-using career and greater heroin dependence have also been linked to nonfatal overdose. 12 Other risk factors include lifetime or recent incarceration experience, homelessness, syringe sharing, and homosexual or bisexual behavior.…”

“…8,9,11,13 Prior history of overdose has also been identified as a risk factor. 10,14,15 There are conflicting findings regarding the impact of age, with both younger and older age predicting nonfatal overdose in multivariate analyses. 8,10,11 At least one study identified female gender as a risk factor, though gender has not generally been significant in most multivariate analysis.…”

“…10,14,15 There are conflicting findings regarding the impact of age, with both younger and older age predicting nonfatal overdose in multivariate analyses. 8,10,11 At least one study identified female gender as a risk factor, though gender has not generally been significant in most multivariate analysis. 7 Interventions to prevent overdose vary widely by country, state, and city.…”

Tangled‐up and blue: releasing the regulatory chokehold on take‐home naloxone

“…Opioid dependence causes a significant amount of disease burden globally [1], and an Australian study estimated that 86% of deaths among patients receiving opioid substitution therapy were potentially preventable [2]. It is important to contextualize the discussion of unlicensed drug formulations so that we can weigh the risks versus the benefits in response to this timely question raised by Strang and colleagues, as well as keep in mind that it is the formulation and not the drug itself that is the focus of debate.We have a health state that causes significant premature mortality globally and a reversal agent that is not only efficacious, but also has an excellent safety profile [3] and is highly cost-effective [4]. Intranasal (i.n.)…”