TY  - JOUR
PY  - 2024//
TI  - Perception and correlates of opioid overdose risk among overdose survivors who use nonprescribed opioids in San Francisco and Boston
JO  - Substance use and addiction journal
A1  - Chang, Yi-Shin Grace
A1  - McMahan, Vanessa M.
A1  - Marti, Xochitl Luna
A1  - Pope, Emily
A1  - Wolfe, Shae
A1  - Majeski, Adam
A1  - Reed, Gabriela
A1  - Walley, Alexander Y.
A1  - Coffin, Phillip O.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Understanding opioid overdose risk perception may inform overdose prevention strategies. <br><br>METHODS: We used baseline data from a randomized overdose prevention trial, in San Francisco, CA, and Boston, MA, among people who used nonprescribed opioids, survived an overdose in the past 3 years, and had received naloxone. Participants were asked how likely they were to overdose in the next 4 months. We combined "extremely likely" and "likely" (higher risk perception) and "neutral," "unlikely," and "extremely unlikely" (lower risk perception). We performed bivariate analyses and separate multivariable logistic regression models of risk perception across (1) sociodemographic, (2) substance use, and (3) overdose risk behavior measures. Covariates were selected a priori or significant in bivariate analyses. <br><br>RESULTS: Among 268 participants, 88% reported at least 1 overdose risk behavior; however, only 21% reported higher risk perception. The adjusted odds ratio (AOR) of higher risk perception was 2.41 (95% confidence interval [CI]: 1.10-5.30) among those unhoused in the past 4 months, 2.06 (95% CI: 1.05-4.05) among those using opioids in a new place, and 5.61 (95% CI: 2.82-11.16) among those who had overdosed in the past 4 months. Living in Boston was associated with higher risk perception in all 3 models (AOR = 2.00-2.46, 95% CI: 1.04-4.88). <br><br>CONCLUSIONS: Despite prevalent risk behaviors, a minority of participants perceived themselves to be at higher risk of overdose. Nonetheless, some known risk factors for overdose were appropriately associated with risk perception. Fentanyl has been prevalent in Boston for longer than San Francisco, which may explain the higher risk perception there.<p />  <p>Language: en</p>
LA  - en
SN  - 2976-7342
UR  - http://dx.doi.org/10.1177/29767342241237202
ID  - ref1
ER  -