A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City

PLoS One. 2017 Jun 8;12(6):e0179054. doi: 10.1371/journal.pone.0179054. eCollection 2017.


Objective: To identify meaningful classes of opioid-using military veterans in terms of self-reported opioid overdose risk behaviors.

Method: The study recruited a sample of 218 military veterans in the NYC area who were discharged from active duty service after September 11, 2001 and reported past-month opioid use. Survey data including measures of mental health, social stressors, substance use, and opioid-related overdose risk behaviors were analyzed using Latent Class Analysis (LCA).

Results: A five group solution had excellent fit scores and interpretability. Factor analysis confirmed the existence of two major dimensions of variation: non-adherence and heroin use. The five groups included lower-risk prescription opioid users, non-adherent prescription opioid users and heroin users. The non-adherent prescription opioid users and heroin user classes were both further subdivided into "occasional" and "regular" use categories. In addition to endorsing a greater number of overdose risk behaviors, users in the regular use classes were more likely to screen positive for alcohol and substance use disorders, reported greater self-medicating opioid use to relieve anxiety, reported greater problems with physical pain, were more likely to have had mental health, alcohol and drug treatment, and were less likely to be employed or in school. Heroin users also were less likely to report stable housing.

Conclusions: Findings indicate that opioid overdose risk classes are grounded in contextual factors related to experiences of psychological, physiological, and social adjustment pain and distress which should be addressed in tailored interventions targeting opioid users' unique constellations of risk behaviors and comorbid conditions.

MeSH terms

  • Adult
  • Drug Overdose / epidemiology*
  • Female
  • Humans
  • Male
  • New York City / epidemiology
  • Opioid-Related Disorders / epidemiology*
  • Risk-Taking*
  • Veterans / statistics & numerical data*

Grant support

Dr. Bennett's current project is a 4-year study of Opioid Use/Misuse and Overdose Risk among veterans (R01DA036754) that will help determine ecological, structural, and psychosocial aspects of opioid use and overdose risk. Funding for this project is provided by the National Institutes of Health, National Institute on Drug Abuse, awarded to Dr. Alex S. Bennett -- (NIH RO1 DA 036754). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.