Predictors and Prevention of Nonfatal Overdose Among Street-Recruited Injection Heroin Users in the San Francisco Bay Area, 1998-1999

• Published in: American journal of public health (1971) Vol. 91; no. 11; pp. 1842 - 1846
• Main Authors: Seal, Karen H, Kral, Alex H, Gee, Lauren, Moore, Lisa D, Bluthenthal, Ricky N, Lorvick, Jennifer, Edlin, Brian R
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.11.2001; American Public Health Association; American Journal of Public Health 2001
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Data collection; Drug addiction; Drug dosages; Drug overdose; Drug Overdose - epidemiology; Drug use; Emergency medical care; Ethnicity; Female; Gays & lesbians; Health Behavior; Health Education; Health risk assessment; Heroin; Heroin - administration & dosage; Heroin - adverse effects; Humans; Injections; Intravenous drug addicts; Logistic Models; Male; Medical sciences; Methadone; Middle Aged; Overdoses; Participants; Pharmacists; Predictors; Prevalence; Prevention; Preventive medicine; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Ratios; Recruitment; Regression analysis; Risk Factors; San Francisco - epidemiology; San Francisco Bay Area; Sex industry; Social exclusion; Studies; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Survival analysis; Transgender persons; Urban Health; USA; Variables; California; United States; North America; America; San Francisco; United States > US; San Francisco California; Human; Prevention; Drug addiction; Intravenous administration; Risk factor; Street; Overdose; Epidemiology; Heroin; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.91.11.1842

This study sought to determine prevalence of and risk factors for nonfatal recent overdose among street-recruited injection heroin users. From August 1998 through July 1999, 1427 heroin injectors were recruited from 6 inner-city neighborhoods in the San Francisco Bay Area, Calif, and interviewed. Factors hypothesized to be associated with recent overdose were analyzed with logistic regression. Of the 1427 participants, 684 (48%) had had an overdose, 466 (33%) had experienced 2 or more overdose events, and 182 (13%) had had a recent overdose. In multiple logistic regression, being younger (adjusted odds ratio [OR] for each year of increasing age = 0.95; 95% confidence interval [CI] = 0.94, 0.97), having been arrested 3 or more times in the past year (adjusted OR = 2.50; 95% CI = 1.61, 3.87), drinking 4 or more alcoholic drinks per day (adjusted OR = 2.05; 95% CI = 1.37, 3.05), and having participated in methadone detoxification during the past year (adjusted OR = 1.47; 95% CI = 1.03, 2.09) were independently associated with recent overdose. Being homeless; identifying as gay, lesbian, bisexual, or transgender; having spent 5 or more years in prison or jail; and having engaged in sex work also were associated with recent overdose. Targeted interventions that decrease risk for overdose are urgently needed.