Non -fatal overdose among people who inject drugs in Tehran, Iran

Abstract

Background With increasing frequencies of non-fatal overdose in people who inject drugs (PWID), it is essential to improve our knowledge about associated risk factors for overdose to inform overdose prevention and assistance programs. The aim of present study was to determine the prevalence of non-fatal overdose and the associated risk factors among PWID in Tehran, Iran. Methods Snowball sampling was used to collect data from 465 participants in Tehran using a cross-sectional survey. Consenting participants who reported drug injecting in the past month and were able to speak and comprehend Farsi enough to respond to survey questions were interviewed. The endpoint of interest was non-fatal overdose in the previous 6 months, or answering “Yes” to the question: “In the last six months, have you ever overdosed by accident? (at least once)”. We used STATA v. 14 for this analysis. Statistical significance was defined as p < 0.05 for all analyses. Results Of 465 PWIDs who participated in this study, all were male, and about half had less than a high school education. The prevalence of self-reported non-fatal overdose in the past 6 months was 38% (CI95%: 34, 43%). Our findings indicate that characteristics and behaviors that were associated with an increased risk of experiencing an overdose in the past 6 months were drug use initiation under 22 years (AOR =2.2, P < 0.05), using methamphetamine (AOR =2.8, P < 0.05), and using multiple drugs at the same time (AOR =2.1, P < 0.05). Also, more recent initiates to injecting (< 2 years) had an increased risk of experiencing an overdose in the past 6 months. The odds of experiencing a non-fatal overdose among PWIDs who regularly attended NSP were 0.6 times less than for those who did not attend regularly (OR = 0.6,95% CI: 0.2–0.9). Conclusion Methamphetamine and alcohol use were the most significant association for non-fatal overdose among PWIDs. Our results indicate that intervention and prevention initiatives seeking to reduce overdoses among PWIDs should not only be focused on the primary drug used but also the use of alcohol and poly-drug use.

Prevalence and associates of non-fatal overdose among people who inject drugs in Saveh, Iran

“…NFOD was defined using one or more of the following characteristics: loss of consciousness, blue skin color, collapsing, inability to wake up, encountering convulsions, experiencing difficulties with breathing, and myocardial infarction occurring during drug use. This definition was in accordance with previous studies conducted in Australia [47], USA [48], and Iran [38]. In the participants reported any of these characteristics, they were considered as PWID who experienced an overdose.…”

“…Substance dependence and multiple biopsychosocial issues are more frequent among individuals who initiate substance use at an early age. Therefore, it is essential to evaluate further the onset age of substance use [38,51]. The inception age of opioid use is a major risk factor, and earlier research has suggested a significant association between younger onset of substance use and higher likelihood of substance dependence, causing further health and social-related problems [15,45,[52][53][54].…”

“…Data were collected using face-to-face interviews. The study used the Bio-Behavioral Questionnaire (BBQ) in previous studies [ 3 , 38 ]. The BBQ comprises four sections.…”

“…To the best of the present authors’ knowledge, investigations on the prevalence and associated risk factors of NFOD among the Iranian population are limited [ 38 , 39 ]. Moreover, no previous study has examined the associations between service use variables (such visits by a general practitioner [GP] and receiving a psychosocial intervention, and using needle and syringe programs [NSPs]), and non-fatal overdose among PWID.…”

Patterns of drug overdose deaths in Kuwait from 2014 to 2018

“…In a recent study performed in the Islamic Republic of Iran in 2020, the authors were able to collect 465 cases of IDU that suffered from episodes of non-fatal drug overdoses. No female was present in their study [ 22 ]. The reason can be attributed to the fact that the aforementioned countries are Islamic/conservative countries and females in their teenage years and even as young adults live with their parents.…”