title: Overdose experiences among injection drug users in Bangkok, Thailand.
abstract: BACKGROUND
  Although previous studies have identified high levels of drug-related harm in Thailand, little is known about illicit drug overdose experiences among Thai drug users. We sought to investigate non-fatal overdose experiences and responses to overdose among a community-recruited sample of injection drug users (IDU) in Bangkok, Thailand.
  
  
  METHODS
  Data for these analyses came from IDU participating in the Mit Sampan Community Research Project. The primary outcome of interest was a self-reported history of non-fatal overdose. We calculated the prevalence of past overdose and estimated its relationship with individual, drug-using, social, and structural factors using multivariate logistic regression. We also assessed the prevalence of ever witnessing an overdose and patterns of response to overdose.
  
  
  RESULTS
  These analyses included 252 individuals; their median age was 36.5 years (IQR: 29.0 - 44.0) and 66 (26.2%) were female. A history of non-fatal overdose was reported by 75 (29.8%) participants. In a multivariate model, reporting a history of overdose was independently associated with a history of incarceration (Adjusted Odds Ratio [AOR] = 3.83, 95% Confidence Interval [CI]: 1.52 - 9.65, p = 0.004) and reporting use of drugs in combination (AOR = 2.48, 95% CI: 1.16 - 5.33, p = 0.019). A majority (67.9%) reported a history of witnessing an overdose; most reported responding to the most recent overdose using first aid (79.5%).
  
  
  CONCLUSIONS
  Experiencing and witnessing an overdose were common in this sample of Thai IDU. These findings support the need for increased provision of evidence-based responses to overdose including peer-based overdose interventions.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 667-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: M-J
authors.initials: MJ
authors.lastname: Milloy
authors.forename: Nadia
authors.initials: N
authors.lastname: Fairbairn
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
authors.forename: Paisan
authors.initials: P
authors.lastname: Suwannawong
authors.forename: Karyn
authors.initials: K
authors.lastname: Kaplan
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
references.citation: Soc Sci Med. 2009 Feb;68(4):740-8
references.pmid: 19070413
references.citation: Med J Aust. 1996 Feb 19;164(4):204-7
references.pmid: 8604187
references.citation: Am J Prev Med. 2006 Sep;31(3):261-4
references.pmid: 16905039
references.citation: J Urban Health. 2003 Jun;80(2):291-301
references.pmid: 12791805
references.citation: Int J Drug Policy. 2009 Mar;20(2):121-30
references.pmid: 17981451
references.citation: Addiction. 2008 Feb;103(2):251-5
references.pmid: 18199304
references.citation: Am J Public Health. 2001 Nov;91(11):1842-6
references.pmid: 11684613
references.citation: Am J Epidemiol. 1999 Mar 15;149(6):558-64
references.pmid: 10084245
references.citation: Addiction. 1999 Feb;94(2):199-204
references.pmid: 10396785
references.citation: Addiction. 2008 Aug;103(8):1333-42
references.pmid: 18855822
references.citation: Drug Alcohol Depend. 2000 Apr 1;59(1):17-31
references.pmid: 10706972
references.citation: PLoS One. 2008 Oct 07;3(10):e3351
references.pmid: 18839040
references.citation: Eur J Public Health. 2006 Apr;16(2):198-202
references.pmid: 16157612
references.citation: Subst Use Misuse. 2008;43(7):858-70
references.pmid: 18570021
references.citation: Sex Transm Dis. 2008 Apr;35(4):400-5
references.pmid: 18362863
references.citation: Drug Alcohol Depend. 2007 Feb 23;87(1):39-45
references.pmid: 16959438
references.citation: Drug Alcohol Rev. 2005 Sep;24(5):425-32
references.pmid: 16298837
references.citation: N Engl J Med. 2007 Jan 11;356(2):157-65
references.pmid: 17215533
references.citation: Addiction. 2008 Jun;103(6):979-89
references.pmid: 18422830
references.citation: Am J Drug Alcohol Abuse. 2007;33(4):505-16
references.pmid: 17668336
references.citation: AIDS. 2001 Feb 16;15(3):397-405
references.pmid: 11273220
references.citation: J Urban Health. 2003 Jun;80(2):261-73
references.pmid: 12791802
references.citation: AIDS Behav. 2003 Jun;7(2):153-61
references.pmid: 14586200
references.citation: J Urban Health. 2003 Jun;80(2):189-200
references.pmid: 12791795
references.citation: Drug Alcohol Depend. 2005 Aug 1;79(2):181-90
references.pmid: 16002027
references.citation: Am J Trop Med Hyg. 2006 Jun;74(6):1111-6
references.pmid: 16760529
references.citation: J Addict Dis. 2006;25(3):89-96
references.pmid: 16956873
references.citation: AIDS Behav. 2008 Jan;12(1):146-57
references.pmid: 17364148
references.citation: J Urban Health. 2003 Dec;80(4 Suppl 3):iii97-105
references.pmid: 14713676
references.citation: BMJ. 2003 Feb 8;326(7384):308
references.pmid: 12574043
references.citation: Subst Use Misuse. 2008;43(1):73-84
references.pmid: 18189206
references.citation: Drug Alcohol Depend. 2004 Jan 7;73(1):61-7
references.pmid: 14687960
references.citation: J Infect Dis. 2006 Dec 15;194(12):1661-71
references.pmid: 17109337
references.citation: Addiction. 2002 Dec;97(12):1511-6
references.pmid: 12472634
references.citation: J Urban Health. 2007 Mar;84(2):283-91
references.pmid: 17265131
references.citation: Drug Alcohol Depend. 2005 Dec 12;80(3):297-302
references.pmid: 15961257
references.citation: Sex Transm Infect. 2006 Jun;82 Suppl 3:iii10-17
references.pmid: 16735287
references.citation: Addict Behav. 1999 Jul-Aug;24(4):559-63
references.pmid: 10466851
references.citation: J Urban Health. 2005 Jun;82(2):303-11
references.pmid: 15872192
references.citation: MMWR Morb Mortal Wkly Rep. 2007 Feb 9;56(5):93-6
references.pmid: 17287712
references.citation: AIDS. 2004 Nov 19;18(17):2295-303
references.pmid: 15577542