Predictors of future overdose among people who inject drugs in Baltimore, Maryland

Background: Longitudinal studies of future overdose risk among people who inject drugs (PWID) are needed to inform planning of targeted overdose preventions in the United States. Methods: The Integrating Services to Improve Treatment and Engagement (INSITE) study followed 720 PWID between June 2018...

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Main Authors: Michael P. Ramirez, Gregory M. Lucas, Kathleen R. Page, Katie Zook, Miles Landry, Amanda Rosecrans, Robert Harris, Suzanne M. Grieb, Oluwaseun Falade-Nwulia, William Clarke, Susan G. Sherman, Brian W. Weir
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Drug and Alcohol Dependence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772724624000702
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author Michael P. Ramirez
Gregory M. Lucas
Kathleen R. Page
Katie Zook
Miles Landry
Amanda Rosecrans
Robert Harris
Suzanne M. Grieb
Oluwaseun Falade-Nwulia
William Clarke
Susan G. Sherman
Brian W. Weir
author_facet Michael P. Ramirez
Gregory M. Lucas
Kathleen R. Page
Katie Zook
Miles Landry
Amanda Rosecrans
Robert Harris
Suzanne M. Grieb
Oluwaseun Falade-Nwulia
William Clarke
Susan G. Sherman
Brian W. Weir
author_sort Michael P. Ramirez
collection DOAJ
description Background: Longitudinal studies of future overdose risk among people who inject drugs (PWID) are needed to inform planning of targeted overdose preventions in the United States. Methods: The Integrating Services to Improve Treatment and Engagement (INSITE) study followed 720 PWID between June 2018 and August 2019 to evaluate the delivery of mobilized healthcare services in Baltimore, Maryland. The present analyses used logistic regression to identify baseline characteristics predictive of non-fatal or fatal overdose during the 6-month follow-up among 507 participants with overdose information. Non-fatal overdoses were self-reported and fatal overdoses were identified through the National Death Index. Results: At baseline, 121 (23 %) reported an overdose in the prior 6 months. Between baseline and follow-up, 66 (13 %) participants reported a non-fatal overdose and 6 (1 %) experienced a fatal overdose. Overdose during follow-up was positively associated with overdose in the 6 months prior to baseline (6.70 aOR; 95 % CI: 3.51, 12.78) and more than 6 months prior to baseline (2.49 aOR; 95 % CI: 1.52, 4.08) versus no prior overdose. Overdose during follow-up was also positively associated with buprenorphine treatment (2.37 aOR; CI: 1.08, 5.21) and negatively associated with non-prescribed methadone at baseline (0.59 aOR; 0.38, 0.93). Conclusions: Identifying and intervening with PWID who experienced a recent overdose could reduce short-term elevated risk of future overdose. However, as other PWID reported never experiencing an overdose at baseline nonetheless experienced an overdose during follow-up, targeted approaches should be complemented with population-level interventions. Overdose risk implications of buprenorphine treatment and non-prescribed methadone are also discussed.
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spelling doaj-art-a0471af652ad41bcbf3f50b29be984cb2024-12-12T05:24:27ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-12-0113100286Predictors of future overdose among people who inject drugs in Baltimore, MarylandMichael P. Ramirez0Gregory M. Lucas1Kathleen R. Page2Katie Zook3Miles Landry4Amanda Rosecrans5Robert Harris6Suzanne M. Grieb7Oluwaseun Falade-Nwulia8William Clarke9Susan G. Sherman10Brian W. Weir11Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Corresponding author.Johns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USA; Baltimore City Health Department, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USA; Baltimore City Health Department, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins University School of Medicine, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USABackground: Longitudinal studies of future overdose risk among people who inject drugs (PWID) are needed to inform planning of targeted overdose preventions in the United States. Methods: The Integrating Services to Improve Treatment and Engagement (INSITE) study followed 720 PWID between June 2018 and August 2019 to evaluate the delivery of mobilized healthcare services in Baltimore, Maryland. The present analyses used logistic regression to identify baseline characteristics predictive of non-fatal or fatal overdose during the 6-month follow-up among 507 participants with overdose information. Non-fatal overdoses were self-reported and fatal overdoses were identified through the National Death Index. Results: At baseline, 121 (23 %) reported an overdose in the prior 6 months. Between baseline and follow-up, 66 (13 %) participants reported a non-fatal overdose and 6 (1 %) experienced a fatal overdose. Overdose during follow-up was positively associated with overdose in the 6 months prior to baseline (6.70 aOR; 95 % CI: 3.51, 12.78) and more than 6 months prior to baseline (2.49 aOR; 95 % CI: 1.52, 4.08) versus no prior overdose. Overdose during follow-up was also positively associated with buprenorphine treatment (2.37 aOR; CI: 1.08, 5.21) and negatively associated with non-prescribed methadone at baseline (0.59 aOR; 0.38, 0.93). Conclusions: Identifying and intervening with PWID who experienced a recent overdose could reduce short-term elevated risk of future overdose. However, as other PWID reported never experiencing an overdose at baseline nonetheless experienced an overdose during follow-up, targeted approaches should be complemented with population-level interventions. Overdose risk implications of buprenorphine treatment and non-prescribed methadone are also discussed.http://www.sciencedirect.com/science/article/pii/S2772724624000702People who inject drugsPredictors of future overdoseOverdose prevention
spellingShingle Michael P. Ramirez
Gregory M. Lucas
Kathleen R. Page
Katie Zook
Miles Landry
Amanda Rosecrans
Robert Harris
Suzanne M. Grieb
Oluwaseun Falade-Nwulia
William Clarke
Susan G. Sherman
Brian W. Weir
Predictors of future overdose among people who inject drugs in Baltimore, Maryland
Drug and Alcohol Dependence Reports
People who inject drugs
Predictors of future overdose
Overdose prevention
title Predictors of future overdose among people who inject drugs in Baltimore, Maryland
title_full Predictors of future overdose among people who inject drugs in Baltimore, Maryland
title_fullStr Predictors of future overdose among people who inject drugs in Baltimore, Maryland
title_full_unstemmed Predictors of future overdose among people who inject drugs in Baltimore, Maryland
title_short Predictors of future overdose among people who inject drugs in Baltimore, Maryland
title_sort predictors of future overdose among people who inject drugs in baltimore maryland
topic People who inject drugs
Predictors of future overdose
Overdose prevention
url http://www.sciencedirect.com/science/article/pii/S2772724624000702
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