Crisis within a crisis: Risk factors of overdose among those with severe concurrent disorders.
Recent heroin or fentanyl use linked to much higher odds of frequent overdose
Crisis within a crisis: Risk factors of overdose among those with severe concurrent disorders.
People with concurrent substance use and mental disorders (CD) experience a disproportionately higher risk of overdose compared to people with substance use disorder alone.
We aimed to identify factors associated with frequent non-fatal overdose using statistical learning methods.
Data were obtained from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) longitudinal cohort of individuals with severe concurrent disorders treated at three tertiary centres in British Columbia (N = 326).
recent heroin or fentanyl use raised odds of frequent overdose nearly sevenfold
Recent heroin or fentanyl use was the most stable predictor of frequent overdose (100% selection), followed by Hepatitis C diagnosis (98%), being single (98%), recent crack cocaine use (95%), history of sexual abuse (88%), and history of physical abuse (87%).
Being unhoused, prior hospitalization, and life-threatening illness were also associated with increased risk.
Variables inversely associated with frequent overdose included recent cannabis use (94%), white ethnicity (87%), and perceived access to instrumental support (84%).
The model demonstrated moderate discrimination (area under the curve (AUC) = 0.78; sensitivity 66.2%; specificity 77.5%).
To address the prolonged overdose crisis, findings suggest that integrated treatment of patients' polysubstance use, comorbidities, and social support is important for risk prevention.
Future studies should involve validation in a larger, demographically diverse, sample.