Non-fatal opioid overdose and major depression among street-recruited young heroin users.
OBJECTIVE
Non-fatal opioid overdose (NFOO) and major depression (MD) are highly prevalent in heroin users. Many risk factors are known for NFOO, but studies in non-clinical samples on its relationship with MD are lacking. We aimed to examine this relationship in a street-recruited sample, controlling for potential well-known confounders.


METHODS
A cross-sectional study in 452 heroin users street-recruited by chain referral methods in three Spanish cities. Eligibility criteria were: age≤30 years, heroin use at least 12 days in the last year and at least once in the last 3 months. Depression was assessed using the Composite International Diagnostic Interview. A precise definition of NFOO was used. Adjusted odds ratios (AORs) for the NFOO predictors were obtained by logistic regression.


RESULTS
The prevalence of NFOO and MD in the last 12 months was 9.1 and 23.2%, respectively. After adjusting for potential confounders, NFOO and MD were significantly associated (AOR 2.2; 95% CI 1.01-4.74). Other associated factors were imprisonment (AOR 4.1; 95% CI 1.4-12.1), drug injection (AOR 6.7; 95% CI 2.4-18.4) and regular use of tranquillisers/sleeping pills (AOR 2.9; 95% CI 1.16-7).


CONCLUSIONS
Drug and mental health treatment facilities should consider the relationship between MD and NFOO when contacting and treating heroin users. Imprisonment, drug injection and use of tranquillisers/sleeping pills are also risk factors for NFOO.
Escuela Nacional de Sanidad, Madrid, Spain.
Marcela
M
Chahua
Luis
L
Sordo
Gregorio
G
Barrio
Antonia
A
Domingo-Salvany
M Teresa
MT
Brugal
Gemma
G
Molist
Luis
L
de la Fuente
María J
MJ
Bravo
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D062787:Drug Overdose / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D013030:Spain / Q000453:epidemiology; D015813:Substance Abuse Detection / Q000379:methods* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
D000701:Analgesics, Opioid