ArticleAddiction (Abingdon, England)2024
Opioid-related overdose deaths among people experiencing homelessness, 2017 to 2021: A population-based analysis using coroner and health administrative data from Ontario, Canada.
Article in Addiction (Abingdon, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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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
24 citing papers in PubMed, 21 citations in OpenAlex.
- Peer Navigator Intervention and Opioid-Related Adverse Events for Emergency Department Patients: A Randomized Clinical Trial.JAMA network open · 2026Trial
- The association between cold weather and mortality among populations ever and never experiencing homelessness in British Columbia, Canada.BMC public health · 2026Article
- Perspectives on peer recovery support for people experiencing homelessness: A qualitative study of key informants from national health care for the homeless programs.Journal of substance use and addiction treatment · 2026Article
- Dying younger, dying of overdose: gendered and age dimensions of mortality and shelter service access among individuals experiencing homelessness in Toronto, Canada.BMC public health · 2026Article
- Community-level perceptions of housing services for people with opioid use disorder: a qualitative analysis of community stakeholders in the HEALing communities study.Substance abuse treatment, prevention, and policy · 2026Article
- The Contribution of Homelessness to Opioid Overdose Mortality and Associated Racial Disparities.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- Socioeconomic inequities in drug poisoning deaths in Canada.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Mortality among individuals living in permanent supportive housing: A retrospective cohort study.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Challenges and opportunities in embedding core components of substance use health care into Housing First programs.Frontiers in public health · 2026Article
- "Street sweeps": The municipal government-enforced confiscation of personal belongings among unstably housed people who use drugs in Vancouver, Canada.Public health · 2025Article
- Interventions for stimulant use in people who are homeless or vulnerably housed: a scoping review of the evidence including trauma-informed approaches.Harm reduction journal · 2025Article
- Innovations at the intersection of homelessness and substance use during the COVID-19 pandemic: a scoping review.Harm reduction journal · 2025Article
- Modeling Health and Economic Outcomes of Providing Stable Housing to Homeless Adults With OUD.JAMA network open · 2025Article
- Health and Economic Outcomes of Addressing Encampments of Individuals Using Opioids.JAMA network open · 2025Article
- Programmatic, Environmental, and Temporal Predictors of Violence, Overdose, and Self-Injury in Homeless Shelters in Toronto, Canada, 2012-2021.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Buprenorphine adherence among a prospective cohort of homeless-experienced adults with opioid use disorder.Drug and alcohol dependence · 2025Article
- Perspectives on a transitional housing program for people who use substances who experience homelessness and live with a mental health issue: a pilot study in an urban northern city in Canada.Substance abuse treatment, prevention, and policy · 2025Article
- Initiation of opioid agonist treatment following hospital-treated opioid toxicities and the risk of repeat events in Ontario, Canada: a cohort study using inverse probability of treatment weights.BMJ public health · 2025Article
- Circumstances surrounding opioid toxicity deaths within shelters in Ontario, Canada, before and during the COVID-19 pandemic: a population-based descriptive cross-sectional study.BMJ public health · 2025Article
- Observational
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
aimsTo measure the change in proportion of opioid-related overdose deaths attributed to people experiencing homelessness and to compare the opioid-related fatalities between individuals experiencing homelessness and not experiencing homelessness at time of death. DESIGN, SETTING AND
participantsPopulation-based, time-trend analysis using coroner and health administrative databases from Ontario, Canada from 1 July 2017 and 30 June 2021. MEASUREMENTS: Quarterly proportion of opioid-related overdose deaths attributed to people experiencing homelessness. We also obtained socio-demographic and health characteristics of decedents, health-care encounters preceding death, substances directly contributing to death and circumstances surrounding deaths.
findingsA total of 6644 individuals (median age = 40 years, interquartile range = 31-51; 74.1% male) experienced an accidental opioid-related overdose death, among whom 884 (13.3%) were identified as experiencing homelessness at the time of death. The quarterly proportion of opioid-related overdose deaths attributed to people experiencing homelessness increased from 7.2% (26/359) in July-September 2017 to 16.8% (97/578) by April-June 2021 (trend test P < 0.01). Compared with housed decedents, those experiencing homelessness were younger (61.3 versus 53.1% aged 25-44), had higher prevalence of mental health or substance use disorders (77.1 versus 67.1%) and more often visited hospitals (32.1 versus 24.5%) and emergency departments (82.6 versus 68.5%) in the year prior to death. Fentanyl and its analogues more often directly contributed to death among people experiencing homelessness (94.0 versus 81.4%), as did stimulants (67.4 versus 51.6%); in contrast, methadone was less often present (7.8 versus 12.4%). Individuals experiencing homelessness were more often in the presence of a bystander during the acute toxicity event that led to death (55.8 versus 49.7%); and where another individual was present, more often had a resuscitation attempted (61.7 versus 55.1%) or naloxone administered (41.2 versus 28.9%).
conclusionsPeople experiencing homelessness account for an increasing proportion of fatal opioid-related overdoses in Ontario, Canada, reaching nearly one in six such deaths in 2021.
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