ArticleDrug and alcohol dependence2021
Trends in unintentional polysubstance overdose deaths and individual and community correlates of polysubstance overdose, North Carolina, 2009-2018.
Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Higher prevalence of non-fatal overdose with opioid and stimulant use compared to use of opioids alone.Drug and alcohol dependence · 2026Article
- Questions on Medicines, Alcohol, and Illicit Drug Interactions in the Finnish AddictionLink Online Service: A Descriptive Analysis.Nordisk alkohol- & narkotikatidskrift : NAT · 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
- "No judgment, no preaching": approaches to harm reduction service provision for people who use drugs in North Carolina.Harm reduction journal · 2026Article
- A prospective longitudinal analysis of opioid and stimulant use in American Indian and First Nations communities.Addictive behaviors · 2025Article
- Cross sectional multi-sample study of nonfatal overdose in adolescents and young adults in the fentanyl era.Drug and alcohol dependence · 2025Article
- Use of reagent test kits and fentanyl test strips among electronic music festival attendees in Colorado: prevalence, barriers, and behavior in response to drug checking.Harm reduction journal · 2025Article
- Trends in emergency department visits for acute intoxication: a 3-year retrospective study in Hangzhou, East China.Frontiers in public health · 2025Article
- Estimating the ratio of fatal to non-fatal overdoses involving all drugs, all opioids, synthetic opioids, heroin or stimulants, USA, 2010-2020.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024Article
- "They don't go by the law around here": law enforcement interactions after the legalization of syringe services programs in North Carolina.Harm reduction journal · 2022Article
- National polydrug use patterns among people who misuse prescription opioids and people who use heroin. Results from the National Household Survey on Drug Use and Health.Drug and alcohol dependence · 2022Article
- Long-term Psychoactive Medications, Polypharmacy, and Risk of Suicide and Unintended Overdose Death Among Midlife and Older Women Veterans.Journal of general internal medicine · 2022Article
- Literal text analysis of poly-class and polydrug overdose deaths in North Carolina, 2015-2019.Drug and alcohol dependence · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPolysubstance involvement is increasing among fatal drug overdoses. However, little is known about the epidemiology of polysubstance drug overdoses. This paper describes emerging trends in unintentional polysubstance overdose deaths in North Carolina (NC) and examines associations with individual and community factors.
methodsUsing 2009-2018 NC death certificate data, we identified unintentional drug overdose deaths and commonly involved substances (opioids, stimulants, benzodiazepines, alcohol, and antiepileptics). We examined polysubstance combinations, comparing opioid and non-opioid involved deaths. We examined individual level correlates from death certificate data and community level correlates from the American Community Survey and Robert Wood Johnson Foundation County Health Rankings to quantify associations.
resultsFrom 2009-2018, 53 % of opioid and 19 % of non-opioid overdose deaths involved multiple substances. During this period, polysubstance overdose death increased dramatically, from 2.9 to 12.1 per 100,000 persons, with the greatest increases among drug combinations involving stimulants. The most common polysubstance combinations were: opioids and stimulants (12.1 % of overdose deaths); opioids and benzodiazepines (9.0 %); opioids and alcohol (5.1 %); opioids, stimulants, and benzodiazepines (3.1 %); and opioids, benzodiazepines, and antiepileptics (2.2 %). Compared to overdoses involving opioids alone, overdoses involving combinations of opioids, stimulants, and benzodiazepines involved younger individuals (53.7 % in 15-34 years of age vs. 40.7 %). Men comprised two-thirds of overdoses involving opioids alone, however, overdoses involving opioids, benzodiazepines, and antiepileptics were predominantly among women (60.6 %).
conclusionsPolysubstance involvement has increased among overdose deaths in NC. These findings can be used to inform public health interventions addressing polysubstance deaths and associated individual and community level factors.
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