Citation

Thylstrup B, Seid AK, Tjagvad C, Hesse M. Drug Alcohol Depend. 2019; ePub(ePub): ePub.

Affiliation

Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Bartholins Allé, 8000 Aarhus C, Denmark. Electronic address: mh.crf@psy.au.dk.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2019.107714

PMID

31753733

Abstract

BACKGROUND: Drug overdoses remain a significant public health burden throughout the world. This study assessed the incidence and predictors of non-fatal and fatal drug overdoses among patients with an opioid use, treated for drug use disorders (DUD) at public treatment centers in Denmark.

METHODS: A consecutive cohort of patients (n = 11,199) were tracked from date of first registered enrollment between the year 2000 and 2010 to first registered drug overdose, death or December 31st 2010, whichever occurred first. Competing-risks regression models were fitted to estimate the sub hazard ratios (SHRs) of non-fatal and fatal drug overdoses and confounding risk factors.

RESULTS: A total of 3186 (28%) patients experienced a non-fatal drug overdose during follow-up, and 572 (6%) died from an overdose. Use of benzodiazepines (SHR: 1.15 95% CI 1.03, 1.28) was significantly associated with non-fatal overdose. Intravenous drug use and previous hospitalization for a non-fatal overdose increased the risk of later non-fatal (SHR: 1.57 95% CI 1.42, 1.73) and fatal overdoses (SHR: 1.43 95% CI 1.12, 1.82).

CONCLUSIONS: Patients who use opioids remain at risk of overdoses for a long time after discharge from drug treatment. Besides relevant monitoring and psychosocial support in opioid maintenance treatment, there is a need for informing and educating opioid users in risk factors and preventive measures in settings where they are often difficult to access for traditional treatment services.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Longitudinal; Methadone; Opioid; Overdose; Risk; Substance use disorders