Mental health status, health service utilization, drug use behaviors associated with non-fatal overdose among people who use illicit drugs: A meta-analysis

ABSTRACT

Background

The present study aims to determine mental health conditions, service use determinants, and drug use behaviors associated with non-fatal overdose among people who use illicit drugs (PWUIDs).

Methods

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 PWUIDs. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, and Outcomes (PICO) criteria. The present study applied OR to measure the effect size with 95% CI. For data analysis, R 3.5.1 with the “meta” package was used to conduct the meta-analysis.

Results

After a detailed assessment of more than 13,845 articles, a total of 60 studies met the eligibility criteria. We found that non-fatal overdose was independently and positively associated with various factors considered and was, as expected, most strongly associated with being male, needs help injecting, needle sharing, overdose experience in past 12 months, alcohol abuse, had mental health diagnosis, depression, and anxiety disorders, suicide (ideation or attempt), inpatient detoxification, benzodiazepine use, and emergency department visit or hospitalization.

Conclusion

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.

Abbreviations: PWUIDs: People who use illicit drugs; WHO: World Health Organization; CI: Confidence intervals; NOS: Newcastle-Ottawa Scale; OR: Odds ratio; PICO: Population, Intervention, Comparator, Outcomes; PRISMA: Protocols of Systematic Reviews and Meta-Analyses; PWIDs: people who inject drugs; WHO: World Health Organization; SIF: Safer Injection Facility

KEYWORDS:

• Non-fatal overdose
• depression and anxiety disorders
• suicide (ideation or attempt)
• alcohol abuse

Acknowledgments

This study was sponsored by Social Deter minants of Health Re search Center, Saveh Univer sity of Medical Sciences, Saveh, Iran

Ethics approval and consent to participate

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

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

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

Author contributions

BA. Conceived the study. BA. collected all the data. RM analyzed and interpreted the data. PH and BA. drafted the manuscript. All authors commented on the drafts of the manuscript and approved the final copy of the paper for submission.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or non-for-profit sectors.