Individual and network factors associated with non-fatal overdose among rural Appalachian drug users.
BACKGROUND
Fatal overdoses involving prescription opioids have increased significantly in recent years in the United States--especially in rural areas. However, there are scant data about non-fatal overdose among rural drug users. The purpose of this study is to examine the prevalence and correlates of non-fatal overdose and witnessed overdose among rural Appalachian drug users.


METHODS
Rural drug users were participants in a longitudinal study of social networks and HIV transmission. An interviewer-administered questionnaire elicited information in the following domains: sociodemographic characteristics, drug use (including lifetime overdose and witnessed overdose), psychiatric disorders, HIV risk behaviors and social networks (support, drug and sex networks). Negative binomial regression was used to model the number of lifetime overdoses and witnessed overdoses.


RESULTS
Of the 400 participants, 28% had ever experienced a non-fatal overdose, while 58.2% had ever witnessed an overdose (fatal or non-fatal). Factors independently associated with a greater number of overdoses included having ever been in drug treatment, past 30-day injection of prescription opioids, meeting the criteria for post-traumatic stress disorder and/or antisocial personality disorder and having more members in one's support network.


CONCLUSIONS
Rural drug users with history of overdose were more likely to have injected with prescription opioids--which is different from urban heroin users. However, the remaining correlates of non-fatal overdose among this cohort of rural drug users were similar to those of urban heroin users, which suggests current overdose prevention strategies employed in urban settings may be effective in preventing fatal overdose in this population.
Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY 40504, United States. Jennifer.havens@uky.edu
Jennifer R
JR
Havens
Carrie B
CB
Oser
Hannah K
HK
Knudsen
Michelle
M
Lofwall
William W
WW
Stoops
Sharon L
SL
Walsh
Carl G
CG
Leukefeld
Alex H
AH
Kral
D000328:Adult; D001061:Appalachian Region / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055553:Prescription Drugs; D012424:Rural Population; D012944:Social Support
D055553:Prescription Drugs