Evidence map›Paper›PMID 34390966›Full record

ArticleThe International journal on drug policy2021

Investigating a bidirectional relationship between overdose and provision of injection initiation assistance among persons who inject drugs in Vancouver, Canada and Tijuana, Mexico.

Jeanette M Bowles, Sonia Jain, Xiaoying Sun, Steffanie A Strathdee, Kora DeBeck, M-J Milloy, Zachary Bouck, Dan Werb

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Jeanette M BowlesCentre on Drug Policy Evaluation, Unity Health Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada.
Sonia JainBiostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
Xiaoying SunBiostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
Steffanie A StrathdeeDivision of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
Kora DeBeckBritish Columbia Centre on Substance Use, 1045 Howe St Suite 400, Vancouver, BC V6Z 2A9, Canada; School of Public Policy, Simon Fraser University, 8888 University Dr, Burnaby, BC V5A 1S6, Canada.
M-J MilloyBritish Columbia Centre on Substance Use, 1045 Howe St Suite 400, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
Zachary BouckCentre on Drug Policy Evaluation, Unity Health Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada.
Dan WerbCentre on Drug Policy Evaluation, Unity Health Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada; Biostatistics Research Center, Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St Room 425, Toronto, ON M5T 3M6, Canada. Electronic address: dwerb@health.ucsd.edu.
University of California San Diego · USUnity Health TorontoSimon Fraser University · CAUniversity of British Columbia · CAUniversity of Toronto · CA

Funding

Vancouver Drug Users Study: The Impacts of Evolving Drug Use Patterns on HIV/AIDSU01DA038886 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI DEBECK, KORA, HAYASHI, KANNA · 2015 to 2024
$12.1M
Impact of Drug Policy Reform on the HIV Risk Environment among IDUs in TijuanaR37DA019829 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI STRATHDEE, STEFFANIE A. · 2010 to 2019
$6.7M
Impacts of universal access to HIV/AIDS care among HIV+ injection drug usersU01DA021525 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI MILLOY, M-J · 2017 to 2024
$4.3M
Preventing HIV by modifying the context for injecting initiationDP2DA040256 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI WERB, DANIEL M · 2015 to 2015
$2.3M
NIDA NIH HHS DP2 DA040256NIDA NIH HHS R37 DA019829NIDA NIH HHS U01 DA021525NIDA NIH HHS U01 DA038886
6 · The paper itself

Abstract

backgroundIndividuals who initiate injection drug use often receive assistance from an injection-knowledgeable peer. Persons who assist peers in injection initiation events often inject frequently, which heightens overdose risk. As such, overdose and injection initiation events may be correlated. To explore a potential relationship, we assessed temporal associations between experiencing a non-fatal overdose and assisting others in initiating injection drug use among persons who inject drugs in two North American cities - Vancouver, Canada and Tijuana, Mexico.

methodsFrom 2014 to 2018, this retrospective cohort study included people who inject drugs from Vancouver (n=1332) and Tijuana (n=666) who completed a baseline and six-month follow-up interview. Within each site, we assessed bidirectional temporal associations using two separate multivariable logistic regression models: for model 1, recent provision of injection initiation assistance (at six months) was the outcome and recent overdose (at baseline) was the exposure; for model 2, recent overdose (at six months) was the outcome and recent provision of injection initiation assistance (at baseline) was the exposure. Both models adjusted for potential confounders.

resultsVancouver-based participants reporting overdose at baseline had 163% greater odds of reporting provision of injection initiation assistance at follow-up (adjusted Odds Ratio [aOR] 2.63; 95% Confidence Interval [CI] 1.41-4.90); while participants reporting provision of injection initiation assistance at baseline had 89% greater odds of reporting a non-fatal overdose at follow-up (aOR 1.89; 95% CI 1.00-3.57). Among Tijuana-based participants, we did not observe a statistically significant association in either direction.

conclusionFindings in Vancouver suggest that injection initiation assistance and overdose are bidirectionally-associated phenomena. The present findings highlight the need for interventions that ensure that persons who provide injection initiation assistance are given overdose prevention support, both for themselves and for those they assist to initiate injection drug use. While our Tijuana-based results did not suggest a bidirectional relationship, preventative approaches should nonetheless be undertaken.

Indexed as

Drug OverdoseDrug UsersPharmaceutical PreparationsSubstance Abuse, IntravenousCanadaCohort StudiesHumansMexicoRetrospective StudiesPharmaceutical PreparationsInjection drug useInjection initiationOpioidsOverdose

Identifiers

PMID34390966
PMCPMC8530890
OpenAlexW3193956190

What OpenQuestion holds

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Registered trials

None linked

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.