Encountering Overdose: Examining the Contexts and Correlates of US College Students’ Overdose Experiences

Abstract

Background

As overdose rates increase, it is critical to better understand the causes and contexts of overdose, particularly for college students who exhibit high rates of alcohol and drug use. The purpose of this study was to examine the social contexts of U.S. college students’ overdose experiences (their own, witnessed, and family’/friends’), and to assess the correlates of personal overdose.

Methods

A cross-sectional survey containing open- and closed-ended questions about overdose encounters was completed by undergraduate students at a southeastern American university (n = 1,236). Descriptive frequencies assessed prevalence, substance involvement, and fatalities associated with different encounter types. A content analysis of open-ended responses examined the social contexts of encounters. Multivariate logistic regression was used to assess the correlates of personal overdose.

Results

Forty-one percent of respondents reported at least one type of overdose encounter and witnessed overdose was most common. Substances involved varied across encounter type and 20-40% of respondents reported overdose-related fatalities. Students who encountered overdose often reported multiple experiences and many attributed overdoses to mixing substances. Respondents commonly encountered overdose as intervening bystanders and overdose events were often perceived to be intentional or the result of using substances to cope with stress/mental health concerns. Personal overdose was significantly associated with having ever mixed alcohol with prescription drugs, been diagnosed with a mental disorder, witnessed an overdose, and had a family member/friend overdose.

Conclusion

Findings suggest a need for future research into the contexts and consequences of students’ overdose encounters to more effectively tailor overdose prevention/response initiatives within college communities.

Keywords:

• Overdose
• college students
• bystander intervention
• polysubstance use
• stress

Acknowledgements

The authors would like to thank Samantha Petillo, Sammy Stocking, Kennedy Toole, Heath Hoffmann, Julia McReynolds-Pérez, Crystal Matthews, Christine Workman, Shiri Noy, and Laura Simon for helpful conversations and their feedback on and support of this study. We also thank anonymous survey participants and funding sources including the College of Charleston School of Humanities and Social Sciences, the College of Charleston Division of Student Affairs, and the College of Charleston Office of Undergraduate Research and Creative Activities (Grant Number SU2020-27), for helping to make this research possible.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This work was supported by the College of Charleston School of Humanities and Social Sciences, the College of Charleston Division of Student Affairs, and the College of Charleston Office of Undergraduate Research and Creative Activities (Grant Number SU2020-27). Funding organizations were not involved in study design, the collection or analysis of data, or the writing of this manuscript.