Non-fatal opioid overdose and major depression among street-recruited young heroin users

Eur Addict Res. 2014;20(1):1-7. doi: 10.1159/000346787. Epub 2013 Aug 1.

Abstract

Background/aims: Non-fatal opioid overdose (NFOO) and major depression (MD) are highly prevalent in heroin users. Many risk factors are known for NFOO, but studies in non-clinical samples on its relationship with MD are lacking. We aimed to examine this relationship in a street-recruited sample, controlling for potential well-known confounders.

Methods: A cross-sectional study in 452 heroin users street-recruited by chain referral methods in three Spanish cities. Eligibility criteria were: age≤30 years, heroin use at least 12 days in the last year and at least once in the last 3 months. Depression was assessed using the Composite International Diagnostic Interview. A precise definition of NFOO was used. Adjusted odds ratios (AORs) for the NFOO predictors were obtained by logistic regression.

Results: The prevalence of NFOO and MD in the last 12 months was 9.1 and 23.2%, respectively. After adjusting for potential confounders, NFOO and MD were significantly associated (AOR 2.2; 95% CI 1.01-4.74). Other associated factors were imprisonment (AOR 4.1; 95% CI 1.4-12.1), drug injection (AOR 6.7; 95% CI 2.4-18.4) and regular use of tranquillisers/sleeping pills (AOR 2.9; 95% CI 1.16-7).

Conclusions: Drug and mental health treatment facilities should consider the relationship between MD and NFOO when contacting and treating heroin users. Imprisonment, drug injection and use of tranquillisers/sleeping pills are also risk factors for NFOO.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects*
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology
  • Drug Overdose / diagnosis
  • Drug Overdose / epidemiology*
  • Drug Overdose / psychology
  • Female
  • Follow-Up Studies
  • Heroin Dependence / diagnosis
  • Heroin Dependence / epidemiology*
  • Heroin Dependence / psychology
  • Humans
  • Male
  • Spain / epidemiology
  • Substance Abuse Detection / methods*
  • Substance Abuse Detection / psychology
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Analgesics, Opioid