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. 2018 Jul 5;15(1):34.
doi: 10.1186/s12954-018-0240-z.

Fentanyl-contaminated drugs and non-fatal overdose among people who inject drugs in Baltimore, MD

Ju Nyeong Park  1   2 , Brian W Weir  3 , Sean T Allen  3 , Patrick Chaulk  4   5   6 , Susan G Sherman  3   7
Affiliations

Fentanyl-contaminated drugs and non-fatal overdose among people who inject drugs in Baltimore, MD

Ju Nyeong Park et al. Harm Reduct J. .

Abstract

Background: The opioid crisis remains a major public health issue in the US and beyond. Despite rapid rises in fentanyl-related mortality nationally, little is known about the role of fentanyl in the occurrence of non-fatal overdose among people who use drugs. We examined the prevalence of non-fatal overdose and perceived fentanyl exposure among syringe services program (SSP) clients and modeled the correlates of non-fatal overdose.

Methods: Data were drawn from a cross-sectional survey of 203 SSP clients in Baltimore, MD recruited in 2016. Logistic regression models were used to identify the correlates of experiencing non-fatal overdose in the past 12 months.

Results: The majority (65%) was male, 52% were black, 41% were white, and 37% were homeless. Almost all (97%) used heroin, 64% injected heroin with cocaine (i.e., speedball), and many used other types of drugs. Half (53%) perceived fentanyl presence in their drugs either half, most or all of the time. Lifetime and past 12 month prevalence of non-fatal overdose were 58 and 31%, respectively. Independent correlates of non-fatal overdose in the past 12 months were perceiving fentanyl in drugs more than half the time (aOR = 2.79; 95% CI = 1.00-4.68), speedball injection (aOR = 2.80, 95% CI = 1.26-6.23), non-prescription buprenorphine use (aOR = 6.37; 95% CI = 2.86-14.17), and homelessness (aOR = 3.07; 95% CI = 1.28-7.39).

Conclusions: These data demonstrate that SSP clients are at high-risk of overdose, some of which is likely attributable to fentanyl exposure. Addressing the rising fentanyl epidemic will require comprehensive and innovative strategies that attend to drug use patterns and structural factors such as homelessness.

Keywords: Epidemiology; Heroin; Opioids; Overdose; Substance use.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for the study was obtained from the Johns Hopkins Bloomberg School of Public Health Institutional Review Board. Informed consent was obtained from each study participant at time of survey.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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