Evidence map›Paper›PMID 40997404›Full record

ArticleDrug and alcohol dependence2025

Opioid withdrawal as a barrier to harm reduction: Examining how overdose prevention behaviors are affected by withdrawal.

Grace Yi, Lauren Dayton, Anya Scott-Wallace, Melissa Davey-Rothwell, Seun Falade-Nwulia, Carl Latkin

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In one paragraph

Article in Drug and alcohol dependence, 2025. 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
–field-weighted citation impact
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.

  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

6 authors.

Grace YiHealth, Behavior, and Society Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States. Electronic address: gyi@mednet.ucla.edu.
Lauren DaytonHealth, Behavior, and Society Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States.
Anya Scott-WallaceHealth, Behavior, and Society Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States.
Melissa Davey-RothwellHealth, Behavior, and Society Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States.
Seun Falade-NwuliaJohns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD, United States.
Carl LatkinHealth, Behavior, and Society Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States.

Funding

A geospatial analysis of hotspots and targeted injection settings pilot intervention for HIV prevention among people who inject drugs in Baltimore, MarylandR01DA050470 · NIDA · JOHNS HOPKINS UNIVERSITY · PI LATKIN, CARL A · 2020 to 2025
$4.1M
NIDA NIH HHS R01 DA050470
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn the past decade, the increasing availability and prevalence of fentanyl in the drug supply have heightened the risk of fatal overdose and increased the frequency and severity of opioid withdrawal symptoms. We aimed to examine how opioid withdrawal impacts engagement in harm reduction behaviors among people who use drugs.

methodsData came from a community-based research study in Baltimore, Maryland, conducted from 2022 to 2024. Participants were adults who used heroin, fentanyl, or prescription opiates to get high in the past month (N = 676). Structured surveys assessed withdrawal as a barrier to testing drugs for potency and overdose prevention. Logistic regression models were used to identify correlates of engagement in harm reduction during periods of withdrawal.

resultsHalf the sample (46.6 %) reported that withdrawal "always" or "often" prevented them from testing drugs, and 66.6 % agreed that withdrawal was a barrier to overdose prevention. Depression symptoms (adjusted odds ratio (aOR): 1.56, 95 % CI 1.09-2.25), increased opioid use per week (aOR: 1.12, 95 % CI 1.03-1.22), and White race (aOR: 1.75, 95 % CI 1.16-2.62) were independently associated with lower engagement in drug testing and overdose prevention during withdrawal.

conclusionsWithdrawal significantly impacts engagement in harm reduction behaviors, even among those with high awareness and receptivity to drug testing and overdose prevention strategies. Withdrawal management and mental health support are emergent and critical components for harm reduction interventions to prevent overdose morbidity and mortality among people who use drugs.

Indexed as

Drug testingOpioid useOverdose preventionWithdrawal

Identifiers

PMID40997404
PMCPMC12672015

What OpenQuestion holds

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Registered trials

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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.