Correlates of overdose risk perception among illicit opioid users. (1st February 2016)

• Record Type: Journal Article
• Authors: Rowe, Christopher; Santos, Glenn-Milo; Behar, Emily; Coffin, Philip O.
• Is Part Of: Drug and alcohol dependence. Volume 159(2016)
• Page Start: 234
• Page End: 239
• Publication Date: 2016-02-01
• Subjects: Opioid overdose -- Risk perception -- Substance use -- Risk factors; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.12.018
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Some overdose risk factors were not associated with higher perceived overdose risk. Opioid users who injected more frequently had lower perceived overdose risk. Older opioid users had lower perceived overdose risk. Use of opioid analgesics was not associated with perceived overdose risk. Mixing opioids with cocaine/benzodiazepines was not associated with perceived risk. Abstract: Background: Opioid-related mortality continues to increase in the United States. The current study assesses demographic and behavioral predictors of perceived overdose risk among individuals who use opioids illicitly. By examining these correlates in the context of established overdose risk factors, we aim to assess whether characteristics and behaviors that have been associated with actual overdose risk translate to higher perception of risk. Methods: We conducted a cross-sectional survey of 172 adult illicit opioid users in San Francisco, CA and used multivariable logistic regression to identify predictors of perception of high risk for opioid overdose. Results: Age (aOR = 0.96, 95%CI = 0.93–1.00) and number of injection days per month (0.91, 0.86–0.97) were associated with a lower odds of perceived high overdose risk. There was no independent association between use of opioid analgesics, concurrent use of opioids and benzodiazepines or cocaine, or HIV status and overdose risk perception. Conclusions: Opioid users who injected more frequently and those who were older were less likely to perceive themselves as being at risk of overdose, notwithstanding that those who inject more are at higher risk of overdose and those who are older are at higher risk overdose mortality. In addition, despite being established overdose risk factors, there was no relationship between use of opioid analgesics, concurrent use of opioids and cocaine or benzodiazepines, or self-reported HIV status and overdose risk perception. These findings highlight key populations of opioid users and established risk factors that may merit focused attention as part of education-based overdose prevention and opioid management strategies.