Citation

Caudarella A, Dong H, Milloy MJ, Kerr T, Wood E, Hayashi K. Drug Alcohol Depend. 2016; 162: 51-55.

Affiliation

British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, Canada.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2016.02.024

PMID

26993373

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.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Language: en