ArticleThe International journal on drug policy2026
Characterizing non-fatal overdose among people who inject drugs in India: prevalence and risk factor analysis, 2022-2024.
Article in The International journal on drug policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNon-fatal overdose strongly predicts future fatal overdose, yet limited prior work describes the burden among people who inject drugs (PWID) in India. We estimated prevalence and identified correlates of non-fatal overdose among PWID from India.
methodsWe conducted respondent-driven sampling (RDS) surveys among PWID across 6 Indian cities (n∼750/site; Amritsar, Bilaspur, Churchandpur, Delhi, Kanpur, and Ludhiana) during 2022-2024. Prevalence of non-fatal overdose in the prior 6 months and non-mutually exclusive events following the overdose were estimated using RDS-weighted descriptive statistics. Correlates (i.e., sociodemographics, HIV and hepatitis C status, substance use in the prior 6 months, and psychosocial symptoms) were assessed using multilevel logistic regression.
resultsPrevalence of non-fatal overdose was 8.8% among 4495 PWID. Factors significantly associated with overdose included daily or seasonal employment (vs. monthly or weekly wages), hepatitis C antibody positive status, witnessing a fatal overdose, injecting 3 or more times per day (vs. 1-2 times per day), concurrent use of heroin and stimulants (vs. buprenorphine or other prescription opioids only), hazardous alcohol use, attending a medical facility for addiction or detoxification, and experiencing mild or depressive symptoms (vs. none). Following the overdose, 44.7% reported help from a friend or family member, 25.5% reported nothing happened, 12.9% went to a hospital, and 5.6% were referred to drug treatment or detoxification.
conclusionsWe observed a variable burden of non-fatal overdose associated with high injection frequency, combination drug use, alcohol use, attending medical detoxification, and depressive symptoms. Low levels of subsequent linkage to treatment services suggest opportunities to improve overdose prevention and management.
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