Background: People who inject drugs (PWID) experience high rates of drug overdose death with the risk of mortality increasing after each non-fatal event. Racial differences exist in drug overdose rates, with higher rates among Black people who use drugs. Psychological factors may predict drug overdose.
Methods: Cross-sectional data from a survey administered to PWID in Baltimore, MD enrolled in a social network-based intervention were analyzed. Linear regression methods with generalized estimating equations were used to analyze data from indexes and network members to assess for psychological factors significantly associated with self-reported number of lifetime drug overdoses. Factors associated with number of overdoses were assessed separately by race.
Results: Among 111 PWID enrolled between January 2018 and January 2019, 25.2% were female, 65.7% were Black, 98.2% reported use of substances in addition to opioids, and the mean age was 49.0 ± 8.3 years. Seventy-five individuals (67.6%) had a history of any overdose with a mean of 5.0 ± 9.7 lifetime overdoses reported. Reports of feeling fearful (β = 9.74, P = 0.001) or feeling lonely all of the time (β = 5.62, P = 0.033) were independently associated with number of drug overdoses. In analyses disaggregated by race, only the most severe degree of fearfulness or loneliness was associated with overdose among Black participants, whereas among White participants, any degree of fearfulness or loneliness was associated with overdose.
Conclusions: In this study of PWID loneliness and fearfulness were significantly related to the number of reported overdose events. These factors could be targeted in future interventions.
Competing Interests: OF: Funds by NIH/NIDA and AbbVie Inc paid to the Johns Hopkins University, and funds paid by Gilead Sciences (medical advisory); KDW: Research grants from NIH/NIDA, Chestnut Health (Data and Safety Monitoring Board for NIH-funded study of medications for opioid use disorder), University of California San Diego and Boston University (Data and Safety Monitoring Board for NIH-funded study of PrEP). MS: Funds by NIH/NIDA, Janssen, Vir, and GSK paid to the Johns Hopkins University, funds paid by AbbVie Inc, Antios, Assembly Bio, Atea, GSK, Gilead, Precision Bio, Vir, and Immunocore; CL: NIH Grants paid to the Johns Hopkins University; HK: HK is an academic editor in the PLOS One journal; KW, JH, and EN: None. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2024 Falade-Nwulia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)