TY  - JOUR
PY  - 2023//
TI  - Correlates of nonfatal overdose among treatment-seeking individuals with non-heroin opioid use disorder: findings from a pragmatic, pan-Canadian, randomized control trial
JO  - Journal of substance use and addiction treatment
A1  - Crepeault, Hannah
A1  - Ti, Lianping
A1  - Jutras-Aswad, Didier
A1  - Wood, Evan
A1  - Le Foll, Bernard
A1  - Lim, Ron
A1  - Bach, Paxton
A1  - Brar, Rupinder
A1  - Socias, M. Eugenia
SP  - e209158
EP  - e209158
VL  - 
IS  - 
N2  - Introduction  Misuse of prescription and synthetic opioids is a primary contributor to the escalating overdose crisis in North America. However, factors associated with nonfatal overdose (NFO) in this context are poorly understood. We examined individual and socio-structural level correlates of NFO among treatment-seeking adults with an opioid use disorder (OUD) not attributed to heroin (nonheroin opioid use disorder [NH-OUD]).   Methods  The study drew data from OPTIMA, a pan-Canadian, multicenter, pragmatic, two-arm randomized control trial comparing supervised methadone and flexible take-home dosing buprenorphine/naloxone models of care among adults with NH-OUD conducted between 2017 and 2020. We used bivariable and multivariable logistic regression to determine factors associated with a lifetime history of NFO among participants enrolled in the trial.   Results  Of 267 included participants, 154 (58 %) reported a NFO in their lifetime, of whom 83 (55 %) had an NFO in the last 6 months. In multivariable analyses, positive urine drug test (UDT) for methamphetamine/amphetamine (Adjusted Odds Ratio [AOR] = 2.59; 95 % confidence interval [CI]: 1.17-5.80), positive UDT for fentanyl (AOR = 2.31; 95 % CI: 1.01-5.30), receiving income assistance (AOR = 2.17; 95 % CI: 1.18-4.09) and homelessness (AOR = 2.40; 95 % CI: 1.25-4.68) were positively associated with a lifetime history of NFO.   Conclusions  We found a high prevalence of NFO history in treatment-seeking adults with NH-OUD, particularly among participants with certain drug use patterns and markers of socio-structural marginalization at the time of enrollment. Given the known impact of prior NFO on future harms, these findings highlight the need for comprehensive care approaches that address polysubstance use and social determinants of health to mitigate future overdose risk.<p />
LA  - en
SN  - 2949-8767
UR  - http://dx.doi.org/10.1016/j.josat.2023.209158
ID  - ref1
ER  -