Nonfatal Overdose Experience and Medical Assistance Seeking Among Injection Drug Users in New Orleans

Background

There has been a recently alarming increase in deaths due to drug overdose in the United States. While many of these deaths could have been avoided with immediate medical assistance, several barriers prevented ready access to immediate resuscitation including felony arrest, retribution by drug sellers, and lack of availability of effective treatment options, by both peer and medical professionals.

Methods

Participants in the New Orleans arm of the National HIV Behavioral Surveillance of Injection Drug Users (IDU) were surveyed about their personal and witnessed drug overdose experiences.  Multiple logistic regression analyses were then conducted to assess predictors of lifetime overdose events and probability of seeking assistance by medical provider.  

Results

Twenty seven percent of 484 IDU surveyed had experienced at least one overdose in their lifetime, while 64% had witnessed an overdose.  Individuals were more likely to have overdosed if they were White, had undergone substance treatment, and had injected drugs for longer and more frequent periods.   IDU who were more likely to seek aid were younger, White, and reported being unafraid of legal repercussions.  Very few had used or were cognizant of the use of immediate opiate antagonists for emergent overdose management.

Discussion

While other data report sentinel events and incidence of overdose fatalities, these findings detail the high prevalence of nonfatal overdoses among IDU.  Because the majority of deaths are due to prescription and illicit opioids, the availability of opiate antagonists should be promoted.  In addition, Good Samaritan Laws for IDU seeking aid should also be enacted.