ArticleDrug and alcohol dependence2023
Increasing trends and incidence of nonfatal overdose among women sex workers who use drugs in British Columbia: The role of criminalization-related barriers to harm reduction.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- Health inequities faced by sex workers.The Lancet. Public health · 2026Review
- Take-home naloxone (THN) ownership among a community-based cohort of sex workers who use drugs in metro vancouver: longitudinal trends and structural determinants (2017-2024).Harm reduction journal · 2026Article
- Access to health and harm reduction services during drug decriminalization in British Columbia, Canada: a mixed-method study.BMC public health · 2026Article
- Use of clinic- and community-based overdose prevention services by sex workers who use drugs: findings from a community-based cohort in Vancouver, Canada (2017-2024).Harm reduction journal · 2026Article
- Article
- Community-administered naloxone for overdose reversal: The role of sex worker-led programming and occupational violence in a community-based cohort (2018-2024).The International journal on drug policy · 2025Article
- A scoping review on barriers and facilitators to harm reduction care among youth in British Columbia, Canada.Harm reduction journal · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundStructurally marginalized women who use drugs experience disproportionately elevated health and social inequities that require specialized responses to mitigate risk of overdose. This study aimed to longitudinally investigate incidence and predictors of first nonfatal overdose among women sex workers who use drugs.
methodsData (2010-2019) were drawn from AESHA (An Evaluation of Sex Workers Health Access), a community-based, prospective, open cohort of > 900 women sex workers in Metro Vancouver, Canada. Incidence was examined and Cox regression modelled time-updated predictors of first nonfatal overdose. Time series analysis examined annual trends.
resultsAmong 273 eligible participants, 23% (n = 63) reported a first nonfatal overdose over follow-up with an incidence density of 5.87/100 person-years. In multivariable analysis, independent predictors of time to nonfatal overdose were police-related barriers to harm reduction (Adjusted Hazard Ratio [AHR]=2.62; 95% confidence interval [CI] 1.51-4.54), binge alcohol use (AHR=2.28; 95%CI 1.16-4.45), opioid use (AHR=2.23; 95%CI 1.15-4.33), and crystal methamphetamine use (AHR=2.07; 95%CI 1.27-3.39). Time series analysis demonstrated a significantly increasing trend in first nonfatal overdose, with annual proportions increasing 0.59% (95%CI 0.39-0.78%) every year, on average.
conclusionsThis study provides strong longitudinal evidence from the longest-standing cohort of sex workers in North America. Nonfatal overdose in this setting is a critical public health concern. Criminalization-related barriers to harm reduction strongly predicted nonfatal overdose. Structural changes to legal and policing practices alongside gender-sensitive addiction services are urgently needed.
Indexed as
Identifiers
What OpenQuestion holds
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.