Prevalence and correlates of opiate overdose among young injection drug users in a large U.S. city

Objectives: The current study examines the prevalence and correlates of witnessing and experiencing opiate overdoses among a sample of young, injection drug users (IDUs) and non-injection drug users (NIDUs) in Baltimore, MD. Methods: Data were derived from a longitudinal study of 15-30 year old IDUs and NIDUs (N = 309) who had initiated heroin, cocaine, and/or crack use within 5 years prior to study enrollment. Chi-square and Wilcoxon rank-sum tests were used in bivariate analyses of demographic and drug use variables with each of the two dependent variables. Multivariate logistic regression models were used to identify correlates of experiencing and witnessing overdose. Results: Twenty-nine percent of participants reported having ever experienced an opiate overdose and 57% reported having ever witnessed an overdose. Having ever experienced an opiate overdose was independently associated with being White (Adjusted Odds Ratio [AOR] = 3.2; 95% Confidence Interval [CI]: 1.6, 6.4) recent homelessness (AOR = 2.9; 95%CI: 1.5, 5.7); and length of injection, 5.6-6.9 years versus <5.6 years (AOR = 4.0; 95%CI: 1.8-8.9); injecting 7.0-7.9 years versus <5.6 years (AOR = 2.5; 95%CI: 1.03-6.1); injecting >8 versus <5.6 years (AOR = 4.7; 95%CI: 2.2-10.2). Having witnessed an opiate overdose was independently associated with being White (AOR = 2.4; 95%CI: 1.4, 4.1) and injecting >8 years versus <5.6 years (AOR = 2.2; 95%CI: 1.2, 4.0). Conclusions: This study documents the high prevalence of witnessing and experiencing opiate overdoses among young, newly initiated IDUs and NIDUs. The results could inform the growing number of overdose prevention efforts throughout the U.S.