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Addict Behav. 2019 Dec;99:106036. doi: 10.1016/j.addbeh.2019.106036. Epub 2019 Jun 25.

Military veterans' overdose risk behavior: Demographic and biopsychosocial influences.

Author information

1
National Development & Research Institutes, 71 W. 23rd St, 4th Fl., New York, NY 10100, United States of America; Center for Drug Use and HIV/HCV Research, College of Global Public Health, New York University, 665 Broadway, 11th Fl., New York, NY 10012, United States of America. Electronic address: bennett@ndri.org.
2
National Development & Research Institutes, 71 W. 23rd St, 4th Fl., New York, NY 10100, United States of America; Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, 82 Washington Square E, New York, NY 10003, United States of America.
3
National Development & Research Institutes, 71 W. 23rd St, 4th Fl., New York, NY 10100, United States of America; Center for Drug Use and HIV/HCV Research, College of Global Public Health, New York University, 665 Broadway, 11th Fl., New York, NY 10012, United States of America.

Abstract

BACKGROUND:

U.S. military veterans face many biopsychosocial (BPS) challenges post-service that may elevate risk for opioid-related overdose including physical pain, mental health concerns and social stressors. Some veterans use opioids to manage pain and cope with social readjustment. This study assessed associations between BPS factors and recent engagement in overdose risk behavior in a community sample of post-9/11 veterans who used opioids in New York City.

METHODS:

Participants (n = 218) were recruited through convenience sampling and completed a baseline assessment including a validated Opioid Risk Behavior Scale (ORBS) that measured past-30-day engagement in 22 opioid-related overdose risk behaviors. Analyses examined associations between ORBS scores and hypothesized demographic, biological/physical, psychological and social predictors. Incident rate ratios estimated the expected relative difference in ORBS score associated with each predictor.

RESULTS:

Participants reported an average of 4.72 overdose risk behaviors in the past 30 days. Significant independent predictors of higher ORBS score, after adjustment for demographics and current prescription medications, were past-30-day: depression symptoms; unsheltered or living in a homeless shelter (vs. private housing); history of mental health treatment; experiencing stressful life events; average pain severity; and pain interference.

CONCLUSION:

Veterans face myriad BPS challenges and, while drug-related overdose risks are well understood, findings suggest that other factors-including mental health, pain and stressful life events-may also be associated with overdose risk among opioid-using veterans. The larger challenges veterans face should be considered in the context of BPS forms of pain management when tailoring and delivering overdose prevention interventions.

KEYWORDS:

Biopsychosocial framework; Opioid misuse; Opioids; Overdose; US military veterans

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