ArticleDrug and alcohol dependence2020
Risk and protective factors for repeated overdose after opioid overdose survival.
Article in Drug and alcohol dependence, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies.Pain medicine (Malden, Mass.) · 2022Pooled it
- Mental disorder and opioid overdose: a systematic review.Social psychiatry and psychiatric epidemiology · 2022Pooled it
- Recruiting a National Sample of First Response Agencies to Participate in an Overdose Prevention Research Project: Randomized Controlled Trial and Feasibility Study.JMIR formative research · 2026Trial
- Opioid agonist treatment outcomes among individuals with a history of nonfatal overdose: Findings from a pragmatic, pan-Canadian, randomized control trial.The American journal on addictions · 2025Trial
- Evaluating risk factors and protective clinical interventions for opioid use disorder and overdose in American Indian/Alaska Native populations.Journal of ethnicity in substance abuse · 2026Article
- Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study.BMC public health · 2026Article
- Pharmacotherapy and overdose risk following new opioid use disorder diagnosis among Medicaid beneficiaries.The American journal of drug and alcohol abuse · 2026Article
- Predicting drug overdose and death after "before medically advised" hospital discharge.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Factors associated with emergency room visits among patients with opioid use disorder: A study of buprenorphine-treated and untreated patients.Drug and alcohol dependence reports · 2025Article
- The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis.Addiction (Abingdon, England) · 2025Article
- Development and Validation of Natural Language Processing Algorithms in the ENACT National Electronic Health Record Research Network.medRxiv : the preprint server for health sciences · 2025Article
- Development and validation of natural language processing algorithms in the national ENACT network.Journal of clinical and translational science · 2025Article
- Trends in recurrent overdose and treatment initiation following emergency department visits for opioid overdose between 2016 and 2021.Drug and alcohol dependence · 2024Article
- Implementation and evaluation of interprofessional overdose review team recommendations following intentional or accidental overdose events.The mental health clinician · 2024Article
- Loneliness and fearfulness are associated with non-fatal drug overdose among people who inject drugs.PloS one · 2024Article
- County-level social vulnerability and nonfatal drug overdose emergency department visits and hospitalizations, January 2018-December 2020.Drug and alcohol dependence · 2023Article
- Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022.Drug and alcohol dependence · 2023Article
- Non-fatal overdose risk during and after opioid agonist treatment: A primary care cohort study with linked hospitalisation and mortality records.The Lancet regional health. Europe · 2022Article
- Enhancing research data infrastructure to address the opioid epidemic: the Opioid Overdose Network (O2-Net).JAMIA open · 2022Article
- Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study.BMC public health · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundNonfatal opioid overdose (OD) is an opportunity to identify patients who may benefit from interventions to reduce repeated overdose (rOD). In this study, we sought to determine risk and protective factors associated with rOD.
methodsIn this retrospective cohort study of 4,155 patients aged 18-64 who presented to one of 16 emergency departments in a single Western Pennsylvania health system between July 2015 and January 2018 for index opioid overdose (iOD) and survived to discharge, we identified demographic and clinical factors association with rOD within one-year. Relative risk of repeated opioid overdose was estimated using adjusted Cox proportional hazard ratios (aHRs).
results14.9 % of patients (95 % CI 13.9-16.1) had a rOD, with 29 % occurring within 30 days from iOD. The adjusted hazard of opioid overdose was increased for male patients (aHR = 1.19; 95 % CI 1.01, 1.41), those with pre-iOD diagnoses of anxiety (aHR = 1.41; 95 % CI1.13, 1.77), depression (aHR = 1.44; 95 % CI 1.17, 1.78), substance use disorders (aHR = 1.30; 95 % CI 1.09, 1.55), and alcohol use disorder (aHR = 1.52; 95 % CI 1.02, 2.25). The hazard was lower for individuals prescribed an opioid in the 90 days prior to iOD (aHR = 0.59; 95 % CI 0.37, 0.97) and those admitted to the hospital for iOD (aHR = 0.56; 95 % CI 0.37, 0.86).
conclusionWe found that, among ED patients who survive an initial OD, mental health and substance use diagnoses are associated with a higher hazard of repeated overdoses whereas opioids prescriptions and admission are associated with lower hazards.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.