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Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs Caudarella, Alexander; Dong, Huiru; Milloy, M-J; Kerr, Thomas; Wood, Evan; Hayashi, Kanna
Abstract
Objectives: To examine the relationship between non-fatal overdose and risk of subsequent fatal overdose. Methods: We assessed risk factors for overdose death among two prospective cohorts of persons who inject drugs (PWID) in Vancouver, Canada. Extended Cox regression was used to examine if reports of non-fatal overdose were associated with the time to fatal overdose while adjusting for other behavioral, social and structural confounders. Results: Between May, 1996 and December, 2011, 2317 individuals were followed for a median of 60.8 months. In total, 134 fatal overdose deaths were identified for an incidence density of 8.94 (95% confidence interval [CI]: 7.55–10.59) deaths per 1000 person-years. During the study period there were 1795 reports of non-fatal overdose. In a multivariate model, recent non-fatal overdose was independently associated with the time to overdose mortality (adjusted hazard ratio [AHR] = 1.95; 95% CI: 1.17–3.27). As well, there was a dose response effect of increasing cumulative reports of non-fatal overdose on subsequent fatal overdose. Conclusion: Reports of recent non-fatal overdose were independently associated with subsequent overdose mortality in a dose-response relationship. These findings suggest that individuals reporting recent non-fatal overdose should be engaged with intensive overdose prevention interventions.
Item Metadata
Title |
Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs
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Creator | |
Contributor | |
Publisher |
Elsevier
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Date Issued |
2016-05-01
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Description |
Objectives: To examine the relationship between non-fatal overdose and risk of subsequent fatal overdose.
Methods: We assessed risk factors for overdose death among two prospective cohorts of persons who inject drugs (PWID) in Vancouver, Canada. Extended Cox regression was used to examine if reports of non-fatal overdose were associated with the time to fatal overdose while adjusting for other behavioral, social and structural confounders.
Results: Between May, 1996 and December, 2011, 2317 individuals were followed for a median of 60.8 months. In total, 134 fatal overdose deaths were identified for an incidence density of 8.94 (95% confidence interval [CI]: 7.55–10.59) deaths per 1000 person-years. During the study period there were 1795 reports of non-fatal overdose. In a multivariate model, recent non-fatal overdose was independently associated with the time to overdose mortality (adjusted hazard ratio [AHR] = 1.95; 95% CI: 1.17–3.27). As well, there was a dose response effect of increasing cumulative reports of non-fatal overdose on subsequent fatal overdose.
Conclusion: Reports of recent non-fatal overdose were independently associated with subsequent overdose mortality in a dose-response relationship. These findings suggest that individuals reporting recent non-fatal overdose should be engaged with intensive overdose prevention interventions.
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Type | |
Language |
eng
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Date Available |
2017-11-21
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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DOI |
10.14288/1.0358033
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URI | |
Affiliation | |
Citation |
Caudarella, A., Dong, H., Milloy, M. J., Kerr, T., Wood, E., & Hayashi, K. (2016). Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs. Drug and Alcohol Dependence, 162, 51-55.
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Publisher DOI |
10.1016/j.drugalcdep.2016.02.024
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Peer Review Status |
Reviewed
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Scholarly Level |
Faculty; Researcher
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Copyright Holder |
Elsevier Ireland Ltd.
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DSpace
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Item Citations and Data
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International