Opioid Overdose Experience, Risk Behaviors, and Knowledge in Drug Users from a Rural versus an Urban Setting.
Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined.



Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors. Participants also completed the Brief Opioid Overdose Knowledge (BOOK) questionnaire, a 12-item self-report measure of opioid overdose knowledge.



Overall, 35.6% of participants had experienced an overdose, and prevalence of overdose was significantly higher (p<.01) among rural (45.9%) vs. urban (31.6%) participants, though fewer rural participants reported past 30-day risk behaviors. There were few differences observed between the subset of rural and urban participants who had experienced an overdose, and fewer rural participants with a history of overdose reported past 30-day risk behaviors. Both rural and urban participants performed poorly on the BOOK, though the percent of correct responses was lowest among rural participants with a history of overdose.



Results demonstrate higher rates of overdose among rural opioid users, though rural participants were less likely to report recent risk behaviors. Results also suggest that knowledge regarding key factors related to opioid overdose is severely lacking, particularly among rural opioid users, which could be a potential target for future intervention efforts.
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences.
Kelly E
KE
Dunn
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences.
Frederick S
FS
Barrett
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences.
Claudia
C
Yepez-Laubach
University of Vermont, Department of Psychiatry.
Andrew C
AC
Meyer
University of Vermont, Department of Psychiatry.
Bryce J
BJ
Hruska
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Medicine.
Kathy
K
Petrush
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Medicine.
Suzan
S
Berman
University of Vermont, Department of Psychiatry; University of Vermont, Department of Psychology.
Stacey C
SC
Sigmon
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Medicine.
Michael
M
Fingerhood
Johns Hopkins University School of Medicine, Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences.
George E
GE
Bigelow
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D062787:Drug Overdose / Q000453:epidemiology*; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*
D000701:Analgesics, Opioid
BOOK; naloxone; opioid; opioid overdose; opioid use disorder
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