ArticleThe International journal on drug policy2020
Polysubstance use in rural West Virginia: Associations between latent classes of drug use, overdose, and take-home naloxone.
Article in The International journal on drug policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- The Evolving Overdose Epidemic: Synthetic Opioids and Rising Stimulant-Related Harms.Epidemiologic reviews · 2020Pooled it
- Implementation of contingency management with women engaging in polysubstance use.Addiction science & clinical practice · 2025Trial
- Community coalition and key stakeholder perceptions of the community opioid epidemic before an intensive community-level intervention.Journal of substance abuse treatment · 2022Trial
- Daily polysubstance use associated with HIV, HCV, and non-fatal overdose among people who inject drugs: A latent class analysis using nationwide data.Drug and alcohol dependence · 2026Article
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Correlates of Rural Naloxone Possession Among People Who Use Drugs: A Multi-State Cross-Sectional Analysis.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Patterns of polysubstance use among people who use drugs on an American Indian reservation of a southern plains Tribal Nation.Harm reduction journal · 2026Article
- Drug Use After Emergency Department-Initiated Injectable Buprenorphine: A Secondary Analysis of the ED-INNOVATION Ancillary Safety and Feasibility Trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Article
- Association of route of drug administration with self-reported non-fatal overdose: A cohort study of Baltimore City adults who have injected drugs.Drug and alcohol dependence · 2025Article
- Patterns of Drugs Involved in Fatal Overdose and Demographic Correlates: A Latent Class Analysis of Polysubstance-Involved Deaths in the Urban Midwest.Substance use & addiction journal · 2025Article
- Polysubstance use patterns among individuals applying for opioid use disorder treatment in the U.S.Journal of substance use · 2025Article
- Quantifying the size and characteristics of a population of people who use drugs on the reservation lands of a tribal nation in the southern plains (USA).Harm reduction journal · 2025Article
- Grade-Level Differences in the Profiles of Substance Use and Behavioral Health Problems: A Multi-Group Latent Class Analysis.International journal of environmental research and public health · 2024Article
- Patients presenting to the ED with nonfatal drug overdose: Self-reported history of overdose and naloxone use.The American journal of emergency medicine · 2024Article
- Harm Reduction and Treatment Among People at High Risk of Overdose.JAMA network open · 2024Article
- Latent class analysis of emergency department patients engaged in telehealth peer recovery support services and associations of identified classes with post-discharge outcomes.Journal of substance use and addiction treatment · 2024Article
- Differential risks of syringe service program participants in Central Ohio: a latent class analysis.Harm reduction journal · 2023Article
- Factors Associated with HIV Testing Among People Who Inject Drugs: Findings from a Multistate Study at the Start of the COVID-19 Pandemic.AIDS and behavior · 2023Article
- Patterns of opioid use behaviors among patients seen in the emergency department: Latent class analysis of baseline data from the POINT pragmatic trial.Journal of substance use and addiction treatment · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRural communities in the United States have been disproportionately affected by the opioid crisis. Little research has explored the relationship between polysubstance use and overdose experiences among people who inject drugs (PWID) in rural communities. We sought to identify classes of polysubstance drug use among rural PWID and evaluate the associations between polysubstance drug use classes, recent overdose experiences, and receipt of take-home naloxone (THN).
methodsWe surveyed 420 PWID (June-July 2018) who had injected drugs in the previous 6 months in Cabell County, West Virginia. Participants were recruited from the local syringe services program and through street-based recruitment. We conducted a latent class analysis using 9 measures of injection and non-injection drug use and tested for associations with having experienced an overdose in the past 6 months and having received THN in the past 6 months.
resultsWe identified four substance use classes in our sample: polydrug/polyroute use (35.0% of the sample), polyroute stimulant/injection opioid use (33.3%), polyroute stimulant use (20.3%), and injection opioid use (11.3%). Overall, 42.6% of the sample had experienced an overdose in the past 6 months. The classes differed in terms of overdose (χ=91.53, p<0.001), with the polydrug/polyroute use class having the highest probability of overdose and the polyroute stimulants class having the lowest. Only 46.5% of participants had received THN, and probabilities differed between classes (χ=21.93, p<0.001). The polyroute stimulants/injection opioid use and polydrug/polyroute use classes had the highest levels of THN receipt while the polyroute stimulants use class had the least.
conclusionAmong rural PWID in West Virginia, polysubstance use was prevalent and associated with overdose and THN acquisition. These analyses demonstrate the importance of scaling up naloxone distribution in rural settings. Overdose prevention initiatives are reaching persons at high risk of overdose, but expansion of services is needed.
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Registered trials
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