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Addiction. 2018 Jun;113(6):1056-1063. doi: 10.1111/add.14159. Epub 2018 Feb 13.

Increased non-fatal overdose risk associated with involuntary drug treatment in a longitudinal study with people who inject drugs.

Author information

1
Division of Global Public Health, School of Medicine, University of California, San Diego, CA, USA.
2
School of Public Health, San Diego State University, San Diego, CA, USA.
3
Centre for Urban Health Solutions, St Michael's Hospital, Toronto, Canada.
4
National Institute of Psychiatry, México City, Mexico.
5
Secretariat of Health, Mexico City, Mexico.
6
Mexico-United States Border Health Commission, Mexico City, Mexico.
7
School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.

Abstract

AIM:

To assess the effect of involuntary drug treatment (IDT) on non-fatal overdose among people who inject drugs (PWID).

DESIGN:

Longitudinal study.

SETTING:

Tijuana, Mexico.

PARTICIPANTS:

Baseline sample of 671 PWID included 258 (38.4%) women and 413 (61.6%) men.

MEASUREMENTS:

Primary independent variables were reported recent (i.e. past 6 months) non-fatal overdose event (dependent variable) and IDT. Substance use the day of the non-fatal overdose was also examined.

FINDINGS:

From 2011 to 2017, 213 participants (31.7%) reported a recent non-fatal overdose and 103 (15.4%) reported recent IDT. Heroin, in combination with methamphetamine and tranquilizers, were the drugs most reported at the day of the event. IDT significantly increased the odds of reporting a non-fatal overdose event [adjusted odds ratio (aOR) = 1.76; 95% confidence interval (CI) = 1.04-2.96]. Odds of non-fatal overdose also increased independently for each additional injection per day (aOR = 1.05; 95% CI = 1.02-1.08), recent tranquilizer use (aOR = 1.92; 95% CI = 1.41-2.61) and using hit doctors (aOR = 1.68; 95% CI = 1.29-2.18) and decreased with age (aOR = 0.97 per year, 95% CI = 0.95-0.99).

CONCLUSIONS:

Recent involuntary drug treatment in Mexico is a risk factor for non-fatal drug overdose.

KEYWORDS:

Cohort study; Tijuana; generalized estimating equation; involuntary treatment; non-fatal overdose; people who inject drugs

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