High prevalence of non-fatal overdose among people who inject drugs in Malaysia: Correlates of overdose and implications for overdose prevention from a cross-sectional study

被引：43

作者：

Bazazi, Alexander R. ^{[1
,2
]}

Zelenev, Alexei ^{[2
]}

Fu, Jeannia J. ^{[1
,2
,3
]}

Yee, Ilias ^{[3
]}

Kamarulzaman, Adeeba ^{[2
,3
,4
]}

Altice, Frederick L. ^{[1
,2
,3
]}

机构：

[1] Yale Univ, Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT 06510 USA

[2] Yale Univ, Sch Med, AIDS Program, Dept Internal Med,Sect Infect Dis, New Haven, CT 06510 USA

[3] Univ Malaya, Fac Med, Ctr Excellence Res AIDS CERiA, Kuala Lumpur, Malaysia

[4] Univ Malaya, Fac Med, Infect Dis Unit, Kuala Lumpur 50603, Malaysia

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2015年 / 26卷 / 07期

关键词：

Non-fatal overdose; Opioids; Injection drug use; Malaysia; Harm reduction; HEROIN OVERDOSE; HARM REDUCTION; USERS; RISK; DEATHS; COHORT; HIV; AUSTRALIA; MORTALITY; NALOXONE;

D O I：

10.1016/j.drugpo.2014.11.010

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: Overdose is the leading cause of death among opioid users, but no data are available on overdose among people who inject drugs in Malaysia. We present the first estimates of the prevalence and correlates of recent non-fatal overdose among people who inject drugs in Malaysia. Methods: In 2010, 460 people who inject drugs were recruited using respondent-driven sampling (RDS) in Kiang Valley to assess health outcomes associated with injection drug use. Self-reported history of non-fatal overdose in the previous 6 months was the primary outcome. Sociodemographic, behavioral and structural correlates of non-fatal overdose were assessed using multivariable logistic regression. Results: All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Most injected daily (91.3%) and were male (96.3%) and ethnically Malay (90.4%). Overall, 20% of participants had overdosed in the prior 6 months, and 43.3% had ever overdosed. The RDS-adjusted estimate of the 6-month period prevalence of overdose was 12.3% (95% confidence interval [CI] 7.9-16.6%). Having injected for more years was associated with lower odds of overdose (adjusted odds ratio [AOR] 0.6 per 5 years of injection, CI: 0.5-0.7). Rushing an injection from fear of the police nearly doubled the odds of overdose (AOR 1.9, CI: 1.9-3.6). Alcohol use was associated with recent non-fatal overdose (AOR 2.1, CI: 1.1-4.2), as was methamphetamine use (AOR 2.3, CI: 1.3-4.6). When adjusting for past-month drug use, intermittent but not daily methadone use was associated with overdose (AOR 2.8, CI: 1.5-5.9). Conclusion: This study reveals a large, previously undocumented burden of non-fatal overdose among people who inject drugs in Malaysia and highlights the need for interventions that might reduce the risk of overdose, such as continuous opioid substitution therapy, provision of naloxone to prevent fatal overdose, treatment of polysubstance use, and working with police to improve the risk environment. (C) 2014 Elsevier B.V. All rights reserved.

引用

页码：675 / 681

页数：7