%0 Journal Article
%T Correlates of overdose among 2711 people who use drugs and live in 7 rural US sites
%J Drug and alcohol dependence
%D 2024
%A M, Fadanelli Monica
%A Doug, Livingston Melvin
%A Peter, Friedmann
%A Vivian F, Go
%A Wiley, Jenkins
%A P Todd, Korthuis
%A William, Miller
%A Mai, Pho
%A David, Seal
%A Tom, Stopka
%A Ryan, Westergaard
%A William, Zule
%A M, Young April
%A Lf, Cooper Hannah
%V 258
%N 
%P e111261-e111261
%X BACKGROUND: Overdose rates in rural areas have been increasing globally, with large increases in the United States. Few studies, however, have identified correlates of non-fatal overdose among rural people who use drugs (PWUD). The present analysis describes correlates of nonfatal overdose among a large multistate sample of rural PWUD. <br><br>METHODS: This is a cross-sectional analysis of data gathered via surveys with PWUD recruited through seven Rural Opioid Initiative (ROI) sites. Descriptive analyses were conducted to assess the prevalence of past 30-day overdose. Generalized estimating equations were used to estimate a series of multivariable models quantifying relationships of select factors to past-month overdose; factors were selected using the Risk Environment Framework. <br><br>RESULTS: The multisite sample included 2711 PWUD, 6% of whom reported overdosing in the past 30 days. In the fully adjusted model, houselessness (AOR=2.27, 95%CI[1.48, 3.48]), a positive test result for Hepatitis C infection (AOR=1.73 95%CI[1.18, 2.52]) and heroin/fentanyl use (AOR= 8.58 95%CI [3.01, 24.50]) were associated with an increased risk of reporting past 30-day overdose, while having a high-school education or less was associated with reduced odds of overdose (AOR=0.52, 95% CI[0.37, 0.74]). <br><br>CONCLUSION: As in urban areas, houselessness, Hepatitis C infection, and the use of heroin and fentanyl were significant correlates of overdose. Widespread access to overdose prevention interventions - including fentanyl test strips and naloxone - is critical in this rural context, with particular outreach needed to unhoused populations, people living with Hepatitis C, and people using opioids.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0376-8716
%U http://dx.doi.org/10.1016/j.drugalcdep.2024.111261