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Syndemic factors associated with non-fatal overdose among young opioid users in New York City.
Guarino, Honoria; Frank, David; Quinn, Kelly; Kim, Dongah; Gile, Krista; Ruggles, Kelly; Friedman, Samuel R; Mateu-Gelabert, Pedro.
Afiliación
  • Guarino H; Institute for Implementation Science in Population Health, CUNY Graduate School of Public Health & Health Policy, New York, NY, United States.
  • Frank D; Behavioral Science Training Program in Drug Abuse Research, NYU Rory Myers College of Nursing, New York University, New York, NY, United States.
  • Quinn K; Behavioral Science Training Program in Drug Abuse Research, NYU Rory Myers College of Nursing, New York University, New York, NY, United States.
  • Kim D; Department of Population Health, New York University School of Medicine, New York, NY, United States.
  • Gile K; Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA, United States.
  • Ruggles K; Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, MA, United States.
  • Friedman SR; Department of Population Health, New York University School of Medicine, New York, NY, United States.
  • Mateu-Gelabert P; Department of Population Health, New York University School of Medicine, New York, NY, United States.
Front Public Health ; 11: 1195657, 2023.
Article en En | MEDLINE | ID: mdl-37435512
Introduction: Rates of illicit opioid use are particularly high among young adults, yet research on overdose experience and factors associated with overdose in this population remains limited. This study examines the experiences and correlates of non-fatal overdose among young adults using illicit opioids in New York City (NYC). Methods: 539 participants were recruited via Respondent-Driven Sampling in 2014-2016. Eligibility criteria included: aged 18-29 years old; current residence in NYC; and nonmedical prescription opioid (PO) use and/or heroin use in the past 30 days. Participants completed structured interviews to assess their socio-demographics, drug use trajectories, current substance use and lifetime and most recent overdose experiences, and were tested on-site for hepatitis C virus (HCV) antibodies. Results: 43.9% of participants reported lifetime overdose experience; of these, 58.8% had experienced two or more overdose events. The majority of participants' most recent overdoses (63.5%) were due to polysubstance use. In bivariable analyses, after RDS adjustment, having ever overdosed was correlated with: household income of >$100,00 growing up (vs. $51,000-100,000); lifetime homelessness; HCV antibody-positive status; lifetime engagement in regular nonmedical benzodiazepine use, regular heroin injection and regular PO injection; and using a non-sterile syringe in the past 12 months. Multivariable logistic regression identified childhood household income >$100,00 (AOR=1.88), HCV-positive status (AOR=2.64), benzodiazepine use (AOR=2.15), PO injection (AOR=1.96) and non-sterile syringe use (AOR=1.70) as significant independent correlates of lifetime overdose. A multivariable model with multiple overdoses (vs. one) found only lifetime regular heroin use and PO injection to be strong correlates. Discussion: Results indicate a high prevalence of lifetime and repeated overdose among opioid-using young adults in NYC, highlighting a need for intensified overdose prevention efforts for this population. The strong associations of HCV and indices of polydrug use with overdose suggest that prevention efforts should address the complex risk environment in which overdose occurs, attending to the overlapping nature of disease-related risk behavior and overdose risk behavior among young people who inject opioids. Overdose prevention efforts tailored for this group may find it useful to adopt a syndemic conception of overdose that understands such events as resulting from multiple, and often interrelated, risk factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatitis C / Trastornos Relacionados con Opioides Tipo de estudio: Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Front Public Health Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatitis C / Trastornos Relacionados con Opioides Tipo de estudio: Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Adolescent / Adult / Child / Humans País/Región como asunto: America do norte Idioma: En Revista: Front Public Health Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza