ArticleThe International journal on drug policy2021
Conceptualizing overdose trauma: The relationships between experiencing and witnessing overdoses with PTSD symptoms among street-recruited female sex workers in Baltimore, Maryland.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- Factors Associated With Opioid-Involved Overdose: Descriptive Data From a Randomized Controlled Trial Evaluating Extended-Release Buprenorphine for Perinatal Opioid Use Disorder.Substance use & addiction journal · 2026Trial
- Study protocol for a randomized trial examining a peer grief support approach for people grieving drug overdose deaths.Addiction science & clinical practice · 2026Trial
- Baseline characteristics of people experiencing homelessness with a recent drug overdose in the PHOENIx pilot randomised controlled trial.Harm reduction journal · 2023Trial
- Perceptions surrounding intranasal naloxone use and access among a population experiencing homelessness.Exploratory research in clinical and social pharmacy · 2026Article
- Article
- Xenon gas as a potential treatment for opioid use disorder, alcohol use disorder, and related disorders.Medical gas research · 2025Review
- Severity of post-traumatic stress and non-medical, concomitant opioid and benzodiazepine use in a sample of women at high risk of overdose.International journal of mental health and addiction · 2025Article
- Article
- Impact of jail-based methadone or buprenorphine treatment on non-fatal opioid overdose after incarceration.Drug and alcohol dependence · 2024Observational
- The relationship between felt stigma and non-fatal overdose among rural people who use drugs.Harm reduction journal · 2024Article
- Violence Exposure, Mental Distress, Substance Use Behaviors, and Overdose Experiences Among People who Inject Drugs.Journal of social work practice in the addictions · 2024Article
- Early vs. Later Experiences of Violence and Polysubstance Use Among Adults Who Inject Drugs.Substance use & misuse · 2024Article
- Associations with experience of non-fatal opioid overdose in British Columbia, Canada: a repeated cross sectional survey study.Harm reduction journal · 2023Article
- Exploring trauma and wellbeing of people who use drugs after witnessing overdose: A qualitative study.The International journal on drug policy · 2023Article
- "I've been to more of my friends' funerals than I've been to my friends' weddings": Witnessing and responding to overdose in rural Northern New England.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Overdose Experiences among People Who Inject Drugs in West Virginia: Personal Loss, Psychological Distress, Naloxone, and Fentanyl.Substance use & misuse · 2023Article
- Examining associations between suicidal desire, implicit fearlessness about death, and lifetime frequency of suicide attempts.Suicide & life-threatening behavior · 2022Article
- Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation.The International journal on drug policy · 2022Article
- Identifying pathways to recent non-fatal overdose among people who use opioids non-medically: How do psychological pain and unmet mental health need contribute to overdose risk?Addictive behaviors · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe opioid crisis has rendered witnessing and experiencing overdoses a common occurrence, especially among marginalized and drug using populations, including female sex workers (FSW). Such exposures may confer psychological trauma that has gone unrecognized. We explored relationships between experiencing and witnessing overdoses and PTSD symptomology to understand the traumatic nature of these experiences.
methodsData were from FSW (N = 380) in Baltimore City, Maryland, who reported whether they had witnessed/experienced any overdoses in the past 6 months ("overdose traumas") and PTSD symptoms (PCL-5). We tested for associations between overdose traumas and PTSD diagnoses/symptomology in bivariate logistic regression models and multivariate models, adjusting for sociodemographic, experiences of violence, and drug use characteristics.
resultsIn our sample, 35.3% witnessed a fatal overdose, 51.9% witnessed a non-fatal overdose, and 28.3% experienced an overdose in the past 6 months. More than half (52.4%) met criteria for PTSD. Most endorsed symptoms within each PTSD domain: 63.2% for intrusive, 58.4% for avoidance, 66.1% for cognition/mood, and 64.7% for arousal/reactivity symptoms. Experiencing an overdose was associated with meeting PTSD criteria and symptoms in all domains in bivariate models. Witnessing an overdose was associated with PTSD diagnoses and intrusive and arousal/reactivity symptoms in bivariate models. Adjusting for sociodemographic characteristics and drug use, experiencing an overdose was associated with intrusive and cognition/mood symptoms, while neither trauma remained associated with PTSD diagnoses.
conclusionsTraumas related to overdose, coined "overdose traumas" appear to be extremely psychologically traumatic, though the relationships vary by type and symptom. Programs should be cognizant of psychological trauma to address the full spectrum of overdose harms. Existing measures of PTSD do not accurately represent the effects of overdose traumas in populations like FSW due to the structural barriers to avoiding locations/situations where overdoses may occur and the overlap between symptoms, drug effects, and adaptive responses to homelessness.
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