Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention

作者：Wagner Karla D^*; Liu Lin; Davidson Peter J; Cuevas Mota Jazmine; Armenta Richard F; Garfein Richard S

来源：Drug and Alcohol Dependence, 2015, 153: 215-220.

DOI：10.1016/j.drugalcdep.2015.05.026

• Opioids
• Overdose
• Overdose prevention
• People who inject drugs
• Naloxone

Background: Accidental overdose, driven largely by opioids, is a leading cause of death among people who inject drugs (PWIDs). We conducted secondary analysis of data from a cohort of PWIDs to identify venues where high-risk PWID could be targeted by overdose education/naloxone distribution (OEND) programs.
Methods: 573 PWIDs completed a quantitative survey between June, 2012 and January, 2014, which was analyzed using multivariable logistic regression. The dependent variable was a dichotomous indicator of experiencing a heroin/opioid-related overdose in the past six months. Independent variables included: demographics, drug use behavior, and encounters with two venues - the health care and criminal justice systems - that could serve as potential venues for OEND programs.
Results: Almost half (41.5%) reported ever experiencing a heroin/opioid overdose, and 45(7.9%) reported experiencing at least one heroin/opioid overdose in the past six months. In the final multivariable model, receiving care in a hospital in the past six months (Adjusted Odds Ratio [AdjOR] 4.08, 95% Confidence Interval [C.I.] 2.07, 8.04, p <0.001) and being arrested for drug possession in the past six months (AdjOR 5.17,95% C.I. 2.37, 11.24, p <0.001) were associated with experiencing an opioid overdose in the past six months.
Conclusions: Identifying venues outside of those that traditionally target services to PWIDs (i.e., syringe exchange programs) will be critical to implementing OEND interventions at a scale sufficient to address the growing epidemic of heroin/opioid related deaths. Clinical settings, such as hospitals, and drug-related encounters with law enforcement officers are promising venues for the expansion of OEND programs.

• 出版日期2015-8-1