Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder.
Drug abuse
Drug-related death
Opioids
Poisoning
Socioeconomic status
Sweden
Journal
Substance abuse treatment, prevention, and policy
ISSN: 1747-597X
Titre abrégé: Subst Abuse Treat Prev Policy
Pays: England
ID NLM: 101258060
Informations de publication
Date de publication:
26 09 2021
26 09 2021
Historique:
accepted:
09
09
2021
entrez:
27
9
2021
pubmed:
28
9
2021
medline:
23
11
2021
Statut:
epublish
Résumé
Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD. We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005-December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates. Univariate analysis showed that several covariates were associated with incident and fatal opioid OD. In the multivariate analysis, incident opioid OD was associated with educational attainment (Hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94-0.97), having received social welfare (HR 1.31; 95% CI 1.22-1.39), and criminal conviction (HR 1.53; 95% CI 1.42-1.65). Fatal opioid OD was also associated with criminal conviction (HR 1.93; 95% CI 1.61-2.32). Individuals with low education and receipt of social welfare had higher risks of incident opioid OD and individuals with criminal conviction were identified as a risk group for both incident and fatal opioid OD. Our findings should raise attention among health prevention policy makers in general, and among decision-makers within the criminal justice system and social services in particular.
Sections du résumé
BACKGROUND
Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD.
METHODS
We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005-December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates.
RESULTS
Univariate analysis showed that several covariates were associated with incident and fatal opioid OD. In the multivariate analysis, incident opioid OD was associated with educational attainment (Hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94-0.97), having received social welfare (HR 1.31; 95% CI 1.22-1.39), and criminal conviction (HR 1.53; 95% CI 1.42-1.65). Fatal opioid OD was also associated with criminal conviction (HR 1.93; 95% CI 1.61-2.32).
CONCLUSION
Individuals with low education and receipt of social welfare had higher risks of incident opioid OD and individuals with criminal conviction were identified as a risk group for both incident and fatal opioid OD. Our findings should raise attention among health prevention policy makers in general, and among decision-makers within the criminal justice system and social services in particular.
Identifiants
pubmed: 34565405
doi: 10.1186/s13011-021-00409-3
pii: 10.1186/s13011-021-00409-3
pmc: PMC8474855
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
73Subventions
Organisme : NIDA NIH HHS
ID : R01DA030005
Pays : United States
Organisme : NIDA NIH HHS
ID : AA027522
Pays : United States
Organisme : vetenskapsrådet
ID : 2020-01175
Organisme : vetenskapsrådet
ID : 2018-02400
Organisme : medicinska fakulteten, lunds universitet
ID : ALF project grant
Organisme : medicinska fakulteten, lunds universitet
ID : Yngre ALF
Organisme : region skåne
ID : Primary Healthcare Management
Informations de copyright
© 2021. The Author(s).
Références
Drug Alcohol Depend. 2013 Oct 1;132(3):499-504
pubmed: 23623042
Drug Alcohol Depend. 2020 Sep 1;214:108127
pubmed: 32650191
Drug Alcohol Depend. 2018 Apr 1;185:189-191
pubmed: 29459328
PLoS One. 2015 Nov 05;10(11):e0141073
pubmed: 26539701
Forensic Sci Int. 2015 Mar;248:172-80
pubmed: 25645132
Health Syst Transit. 2012;14(5):1-159
pubmed: 22894859
Pain Med. 2018 Jan 1;19(1):79-96
pubmed: 28419384
Am J Public Health. 2013 Dec;103(12):2252-60
pubmed: 24134362
Drug Alcohol Depend. 2019 Aug 1;201:253-259
pubmed: 31260826
Am J Prev Med. 2020 Jul;59(1):59-67
pubmed: 32389530
Med Care. 2017 Jul;55(7):661-668
pubmed: 28614178
Inj Epidemiol. 2017 Dec;4(1):24
pubmed: 28762157
J Addict. 2018 Dec 19;2018:3025683
pubmed: 30662785
Addiction. 2016 Sep;111(9):1607-13
pubmed: 27082514
PLoS One. 2020 Jan 17;15(1):e0227966
pubmed: 31951640
Subst Use Misuse. 2017 Mar 21;52(4):451-458
pubmed: 27849429
Pain Med. 2012 Dec;13(12):1580-9
pubmed: 23137228
J Gen Intern Med. 2013 Apr;28(4):522-9
pubmed: 23070654
Drug Alcohol Depend. 2015 Jul 1;152:177-84
pubmed: 25935735
Addiction. 2010 Sep;105(9):1545-54
pubmed: 20579009
Drug Alcohol Depend. 2016 May 1;162:51-5
pubmed: 26993373
BMC Psychiatry. 2020 Feb 7;20(1):49
pubmed: 32028921
J Urban Health. 2015 Aug;92(4):758-72
pubmed: 26077643
Int J Drug Policy. 2017 Aug;46:54-60
pubmed: 28609749
Addiction. 2013 Feb;108(2):377-84
pubmed: 22925008
BMJ. 2017 Apr 26;357:j1550
pubmed: 28446428
Am J Public Health. 2015 Nov;105(11):e29-49
pubmed: 26451760
BMC Health Serv Res. 2016 Aug 24;16:438
pubmed: 27557947
Drug Alcohol Depend. 2015 Aug 1;153:215-20
pubmed: 26091751
Subst Abus. 2019;40(1):80-86
pubmed: 29465301
BMC Public Health. 2011 Jun 09;11:450
pubmed: 21658213
Drug Alcohol Depend. 2019 Feb 1;195:66-73
pubmed: 30592998
Addiction. 2017 Aug;112(8):1432-1439
pubmed: 28319291