Identifying Injection Drug Users at Risk of Nonfatal Overdose

Phillip O. Coffin, Melissa Tracy, Angela Bucciarelli, Danielle Ompad, David Vlahov, Sandro Galea

Research output: Contribution to journalArticle

Abstract

Objectives: Drug overdose is the second leading cause of accidental deaths among U.S. adults aged 15-64 years. Emergency physicians have a unique opportunity to provide overdose prevention interventions, because habitual drug users are in frequent need of medical care. The authors evaluated associations between individual-level risk factors and experiencing an overdose in the past six months to determine which characteristics and behaviors may be most predictive of overdose. Methods: The authors used data from a sample of street-recruited habitual drug users who participated in face-to-face interviews about overdose from November 2001 to February 2004. This analysis was restricted to 772 respondents who had been injecting for at least one year and who had injected heroin within the past two months. Results: A total of 16.6% of participants had overdosed in the past six months. Characteristics and behaviors that were independently associated with an increased risk of a recent overdose were having had a prior overdose (odds ratio [OR], 28.58; 95% confidence interval [CI] = 14.10 to 57.96), using cocaine/crack in the past six months (OR, 2.07; 95% CI = 1.25 to 3.45), using alcohol in the past six months (OR, 1.90; 95% CI = 1.01 to 3.57), experiencing serious withdrawal symptoms in the past two months (OR, 2.70; 95% CI = 1.58 to 4.61), and younger age. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)616-623
Number of pages8
JournalAcademic Emergency Medicine
Volume14
Issue number7
DOIs
StatePublished - Jul 2007

Fingerprint

Drug Users
Injections
Odds Ratio
Confidence Intervals
Crack Cocaine
Drug Overdose
Substance Withdrawal Syndrome
Heroin
Naloxone
Longitudinal Studies
Cause of Death
Emergencies
Alcohols
Interviews
Physicians
Therapeutics

Keywords

  • drug overdose
  • injection drug use

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Coffin, P. O., Tracy, M., Bucciarelli, A., Ompad, D., Vlahov, D., & Galea, S. (2007). Identifying Injection Drug Users at Risk of Nonfatal Overdose. Academic Emergency Medicine, 14(7), 616-623. https://doi.org/10.1197/j.aem.2007.04.005

Identifying Injection Drug Users at Risk of Nonfatal Overdose. / Coffin, Phillip O.; Tracy, Melissa; Bucciarelli, Angela; Ompad, Danielle; Vlahov, David; Galea, Sandro.

In: Academic Emergency Medicine, Vol. 14, No. 7, 07.2007, p. 616-623.

Research output: Contribution to journalArticle

Coffin, PO, Tracy, M, Bucciarelli, A, Ompad, D, Vlahov, D & Galea, S 2007, 'Identifying Injection Drug Users at Risk of Nonfatal Overdose', Academic Emergency Medicine, vol. 14, no. 7, pp. 616-623. https://doi.org/10.1197/j.aem.2007.04.005
Coffin, Phillip O. ; Tracy, Melissa ; Bucciarelli, Angela ; Ompad, Danielle ; Vlahov, David ; Galea, Sandro. / Identifying Injection Drug Users at Risk of Nonfatal Overdose. In: Academic Emergency Medicine. 2007 ; Vol. 14, No. 7. pp. 616-623.
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