Evidence map›Paper›PMID 41832858›Full record

ArticleDrug and alcohol dependence2026

The changing contribution of fentanyl use to non-fatal overdose among a cohort of people who inject drugs in San Diego, California: A longitudinal assessment.

O S Jegede, D Abramovitz, W H Eger, I Artamonova, A R Bazzi, N K Martin, D Werb, C F Vera, S A Strathdee, A Bórquez

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Article in Drug and alcohol dependence, 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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0citing papers in PubMed
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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

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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

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

O S JegedeHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA; School of Public Health Work, San Diego State University, San Diego, CA, USA.
D AbramovitzSchool of Medicine, University of California San Diego, La Jolla, CA, USA.
W H EgerSchool of Medicine, University of California San Diego, La Jolla, CA, USA; School of Social Work, San Diego State University, USA.
I ArtamonovaSchool of Medicine, University of California San Diego, La Jolla, CA, USA.
A R BazziSchool of Public Health Work, San Diego State University, San Diego, CA, USA; Boston University School of Public Health, Boston, MA, USA.
N K MartinSchool of Medicine, University of California San Diego, La Jolla, CA, USA; Population Health Sciences, University of Bristol, Bristol, UK.
D WerbSchool of Medicine, University of California San Diego, La Jolla, CA, USA; Centre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, ON, Canada.
C F VeraSchool of Medicine, University of California San Diego, La Jolla, CA, USA.
S A StrathdeeSchool of Medicine, University of California San Diego, La Jolla, CA, USA.
A BórquezSchool of Medicine, University of California San Diego, La Jolla, CA, USA. Electronic address: aborquez@health.ucsd.edu.

Funding

Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Marketsand Drug TourismR01DA049644 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI STRATHDEE, STEFFANIE A. · 2020 to 2024
$8.2M
A binational cohort of the intersection between substance use, HIV, and associated comorbidities among people who inject drugs in San Diego, CA U01DA063078 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Britt Skaathun, Steffanie A Strathdee · 2025 to 2026
$4.9M
Efficacy and implementation considerations for a peer-led motivational interviewing intervention to promote uptake of drug checking services and safer drug use behaviors to reduce overdoseR33DA061260 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Annick Borquez, Steffanie A Strathdee · 2024 to 2026
$3.1M
Real-time prediction of emerging drug use epidemics in the United StatesDP2DA049295 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BORQUEZ, ANNICK · 2019 to 2019
$2.4M
NIDA NIH HHS DP2 DA049295NIDA NIH HHS R01 DA049644NIDA NIH HHS R33 DA061260NIDA NIH HHS U01 DA063078
6 · The paper itself

Abstract

backgroundFentanyl has driven overdoses across the U.S. in heterogeneous ways, with local variation in non-fatal overdoses remaining under-described. We sought to estimate the contributions of fentanyl to non-fatal overdose among people who inject drugs (PWID) in San Diego, CA, during a period of substantial drug supply evolution.

methodsUsing convenience sampling, we recruited PWID living in San Diego into a longitudinal cohort study involving biannual assessments of opioid use and non-fatal overdose from 10/2020-05/2024. Multivariable Poisson regression assessed longitudinal associations between past six-month fentanyl use and non-fatal overdose risk. We calculated the confounder-adjusted longitudinal population attributable fraction (LPAF) to quantify fentanyl's contribution to non-fatal overdoses over time.

resultsAmong 204 participants, the median age was 40.5 years, 73.0% were male, and 68.1% experienced homelessness. Fentanyl use increased from 51.0%(104/204) at Visit 1(10/2020-10/2021) to 62.4%(68/109) at Visit 6(10/2023-05/2024) while non-fentanyl opioid use decreased from 39.7%(81/204) to 5.5%(6/109). Past six-month non-fatal overdose decreased from 22.5%(46/204) to 15.6%(17/109) overall, and from 38.5%(40/104) to 19.1%(13/68) among those using fentanyl. Significant associations between fentanyl use and non-fatal overdose risk were observed at Visits 1 (Adjusted Relative Risk (ARR) 5.97, 95%CI: 2.37-15.00) and 5 (ARR 4.19, 95%CI: 1.17-15.00). The percentage of non-fatal overdoses contributed by fentanyl use in this cohort (LPAF) was 35%(0.35, 95%CI: 0.17-0.52).

conclusionThe contribution of fentanyl to non-fatal overdoses varied over time in our cohort. Disentangling the role of contextual factors such as opioid tolerance, fentanyl potency, and behavioral changes will support intervention design amid increasingly toxic drug supplies.

Indexed as

Analgesics, OpioidDrug OverdoseFentanylOpioid-Related DisordersSubstance Abuse, IntravenousAdultCaliforniaCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedAnalgesics, OpioidFentanylIllicit drugsOverdosesPeople who inject drugsPopulation attributable fraction

Identifiers

PMID41832858
PMCPMC13041729

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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.