Drug type and risk behaviors associated with non-fatal overdose among people who use drugs: a systematic review and meta-analysis

Abstract

The present study aimed to determine the association between drug type, risk behaviors and non-fatal overdose among people who use drugs (PWUD). We searched for studies in English published before February 1, 2021, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. After a detailed assessment of over 13,845 articles, a total of 49 studies met the eligibility criteria. We found that non-injection opioid use, heroin injection, cocaine use, concurrent use of buprenorphine and benzodiazepines, benzodiazepine use, incarceration, injecting drugs, and duration of injecting were associated with greater odds of non-fatal overdose among PWUD. The findings of the current meta-analysis support the requirement to improve suitable harm reduction strategies for drug users, such as peer-based overdose management, and further focusing on the need to balance the current emphasis on enforcement-based responses to illegal drug use with health-related interventions.

Keywords:

• Non-fatal overdose
• crystal methamphetamine use
• heroin injection
• cocaine use

Acknowledgments

This study was sponsored by Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.

Author contributions

AB and BA. Conceived the study EA and BA collected all data. AB, AHB, LFM and EA analyzed and interpreted the data. RM, PH, NSA, MR and BA drafted the manuscript. All authors commented on the drafts of the manuscript and approved the final copy of the paper for submission.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declaration of interest statement

The authors declare that there are no conflicts of interest.

Ethics approval and consent to participate

This study was an analysis of preexisting literature and did not use human subjects.