ArticleThe International journal on drug policy2018
Quantity fluctuations of illicitly used opioids and overdose risk.
Article in The International journal on drug policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Non-fatal Overdose and Associated Factors Among People Who Use Opioids: Findings From a Cross-sectional Study.Journal of community health · 2025Article
- Overdose risk profiles in pregnancy: Latent class analysis of pregnant individuals with opioid use disorder.Journal of substance use and addiction treatment · 2025Article
- Predictors of opioid overdose during the COVID-19 pandemic: The role of relapse, treatment access and nonprescribed buprenorphine/naloxone.Journal of substance use and addiction treatment · 2023Article
- Income generation and the patterning of substance use: A gender-based analysis.Drug and alcohol dependence · 2021Article
- Unintentional drug overdose: Is more frequent use of non-prescribed buprenorphine associated with lower risk of overdose?The International journal on drug policy · 2020Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundReduced opioid tolerance is believed to be associated with overdose risk, although this relationship has primarily been examined in the context of gaps and frequency of opioid use. We sought to assess how changes in the quantity of opioids used, as opposed to periods of abstinence or overall frequency of use, relate to overdose risk.
methodsAmong repeated visits of participants of a behavioral intervention trial from 2014 to 2016, we used multivariable logistic regression models fit with generalized estimating equations to examine the relationship between the percentage of opioid use days on which individuals used more or less than the quantity they used on average (i.e., quantity volatility) and the occurrence of opioid overdose.
resultsOur sample included 290 four-month reporting periods among 63 participants (67% male). Opioid overdose events were reported by 28 (44%) participants during 48 (17%) reporting periods. Our measure of quantity volatility had a median of 20% (IQR 0.0-50.0). In multivariable analysis, using a quantity different than the quantity used on average on more than 20% of all opioid use days in the reporting period was significantly associated with odds of any opioid overdose (Adjusted OR = 3.55, 95%CI = 1.55-8.13, p = 0.003), controlling for confounders.
conclusionQuantity volatility of illicitly used opioids was positively associated with overdose risk and may contribute to the complex system of overlapping factors that influence overdose risk. Future observational research among opioid users should collect detailed opioid use data, including quantity used over time, to clarify the patterns that most elevate overdose risk.
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