Patterns, circumstances and risk factors associated with non-fatal substance overdose in a cohort of homeless population: an observational study

Jennifer Anderson; Om Kurmi; Richard Lowrie; Adnan Araf; Vibhu Paudyal

doi:10.1007/s11096-024-01812-z

Patterns, circumstances and risk factors associated with non-fatal substance overdose in a cohort of homeless population: an observational study

Jennifer Anderson
, Om Kurmi
, Richard Lowrie
, Adnan Araf
, Vibhu Paudyal

University of Birmingham, College of Medical and Dental Sciences
University of Edinburgh
Birmingham and Solihull Mental Health NHS Trust
King's College London

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

50 Downloads (Pure)

Abstract

Background: Non-fatal overdoses frequently precede fatal overdoses, thus identifying risk factors for non-fatal overdoses could help develop strategies to prevent substance related deaths. Aim: This study aimed to identify patterns, circumstances and risk factors leading to non-fatal substance overdose in people experiencing homelessness. Method: All recorded cases of non-fatal substance overdose from a population of people experiencing homelessness registered at a specialist homelessness primary care centre in England were identified using electronic medical records. Overdose details and patient characteristics were extracted. The heterogeneity between variables in people with and without a recorded non-fatal overdose were tested and multivariable logistic regressions were used to identify the risk factors of non-fatal overdoses. Results: From the 1221 registered patients, 194(16%) were identified as having had a non-fatal overdose with 428 overdoses between them. Half were polypharmacy events with the main substances of overdose being: heroin, paracetamol, benzodiazepines, cocaine, antipsychotics, SSRIs and synthetic cannabinoids. Risk of non-fatal overdose was greater in females, white ethnicity, ages 36–45, and in those with a recorded use of tobacco, alcohol or illicit substance use. Chronic physical and mental health conditions increased the risk of non-fatal overdose including respiratory conditions, blood borne viruses, migraines, anxiety and depression. Conclusion: With a high number of non-fatal overdoses within this population, identifying individuals at risk based on the factors identified in this research could enable primary care providers to apply prevention actions such as overdose awareness and naloxone provision to avoid drug harm and deaths. Future work should explore the role of chronic physical conditions and their treatment on non-fatal overdose risks.

Original language	English
Pages (from-to)	107-118
Number of pages	12
Journal	International Journal of Clinical Pharmacy
Volume	47
Issue number	1
Early online date	19 Nov 2024
DOIs	https://doi.org/10.1007/s11096-024-01812-z
Publication status	Published - 1 Feb 2025

Bibliographical note

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Primary care
Substance overdose
Non-fatal overdose
Homelessness
Drug overdose

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10.1007/s11096-024-01812-z

Kurmi2024VORFinal published version, 1.25 MBLicence: CC BY

Cite this

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title = "Patterns, circumstances and risk factors associated with non-fatal substance overdose in a cohort of homeless population: an observational study",

abstract = "Background: Non-fatal overdoses frequently precede fatal overdoses, thus identifying risk factors for non-fatal overdoses could help develop strategies to prevent substance related deaths. Aim: This study aimed to identify patterns, circumstances and risk factors leading to non-fatal substance overdose in people experiencing homelessness. Method: All recorded cases of non-fatal substance overdose from a population of people experiencing homelessness registered at a specialist homelessness primary care centre in England were identified using electronic medical records. Overdose details and patient characteristics were extracted. The heterogeneity between variables in people with and without a recorded non-fatal overdose were tested and multivariable logistic regressions were used to identify the risk factors of non-fatal overdoses. Results: From the 1221 registered patients, 194(16\%) were identified as having had a non-fatal overdose with 428 overdoses between them. Half were polypharmacy events with the main substances of overdose being: heroin, paracetamol, benzodiazepines, cocaine, antipsychotics, SSRIs and synthetic cannabinoids. Risk of non-fatal overdose was greater in females, white ethnicity, ages 36–45, and in those with a recorded use of tobacco, alcohol or illicit substance use. Chronic physical and mental health conditions increased the risk of non-fatal overdose including respiratory conditions, blood borne viruses, migraines, anxiety and depression. Conclusion: With a high number of non-fatal overdoses within this population, identifying individuals at risk based on the factors identified in this research could enable primary care providers to apply prevention actions such as overdose awareness and naloxone provision to avoid drug harm and deaths. Future work should explore the role of chronic physical conditions and their treatment on non-fatal overdose risks.",

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N2 - Background: Non-fatal overdoses frequently precede fatal overdoses, thus identifying risk factors for non-fatal overdoses could help develop strategies to prevent substance related deaths. Aim: This study aimed to identify patterns, circumstances and risk factors leading to non-fatal substance overdose in people experiencing homelessness. Method: All recorded cases of non-fatal substance overdose from a population of people experiencing homelessness registered at a specialist homelessness primary care centre in England were identified using electronic medical records. Overdose details and patient characteristics were extracted. The heterogeneity between variables in people with and without a recorded non-fatal overdose were tested and multivariable logistic regressions were used to identify the risk factors of non-fatal overdoses. Results: From the 1221 registered patients, 194(16%) were identified as having had a non-fatal overdose with 428 overdoses between them. Half were polypharmacy events with the main substances of overdose being: heroin, paracetamol, benzodiazepines, cocaine, antipsychotics, SSRIs and synthetic cannabinoids. Risk of non-fatal overdose was greater in females, white ethnicity, ages 36–45, and in those with a recorded use of tobacco, alcohol or illicit substance use. Chronic physical and mental health conditions increased the risk of non-fatal overdose including respiratory conditions, blood borne viruses, migraines, anxiety and depression. Conclusion: With a high number of non-fatal overdoses within this population, identifying individuals at risk based on the factors identified in this research could enable primary care providers to apply prevention actions such as overdose awareness and naloxone provision to avoid drug harm and deaths. Future work should explore the role of chronic physical conditions and their treatment on non-fatal overdose risks.

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Patterns, circumstances and risk factors associated with non-fatal substance overdose in a cohort of homeless population: an observational study

Abstract

Bibliographical note

UN SDGs

Keywords

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