Predictors of accidental fatal drug overdose among a cohort of injection drug users.
OBJECTIVE
This study evaluated factors associated with accidental fatal drug overdose among a cohort of injection drug users (IDUs).


METHODS
In a prospective cohort study of 2849 IDUs in King County, Washington, deaths were identified by electronically merging subject identifiers with death certificate records. Univariate and multivariate Cox regression analyses were performed to identify predictors of overdose mortality.


RESULTS
Thirty-two overdoses were observed. Independent predictors of overdose mortality were bisexual sexual orientation (relative risk [RR] = 4.86; 95% confidence interval [CI] = 2.30, 13.2), homelessness (RR = 2.30; 95% CI = 1.06, 5.01), infrequent injection of speedballs (RR = 5.36; 95% CI = 1.58, 18.1), daily use of powdered cocaine (RR = 4.84; 95% CI = 1.13, 20.8), and daily use of poppers (RR = 22.0; 95% CI = 1.74, 278).


CONCLUSIONS
Sexual orientation, homelessness, and drug use identify IDUs who may benefit from targeted interventions.
O'Driscoll
P T
PT
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, USA. odriscol@umbi.umd.edu
McGough
J
J
Hagan
H
H
Thiede
H
H
Critchlow
C
C
Alexander
E R
ER
D000059:Accidents / Q000401:mortality; D000328:Adult; D015331:Cohort Studies; D003644:Death Certificates; D062787:Drug Overdose / Q000145:classification / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000401:mortality*; D013405:Suicide / Q000706:statistics & numerical data; D014861:Washington / Q000453:epidemiology