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High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users.

Abstract

BACKGROUND

Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Yet few studies have examined the overdose knowledge and experience of nonmedical PO users.

METHODS

In depth, semi-structured, audio-recorded interviews were conducted with 46 New York City young adults (ages 18-32) who reported using POs nonmedically within the past 30 days. Verbatim interview transcripts were coded for key themes in an analytic process informed by grounded theory.

RESULTS

Despite significant experience with overdose (including overdose deaths), either personally or within opioid-using networks, participants were relatively uninformed about overdose awareness, avoidance and response strategies, in particular the use of naloxone. Overdose experiences typically occurred when multiple pharmaceuticals were used (often in combination with alcohol) or after participants had transitioned to heroin injection. Participants tended to see themselves as distinct from traditional heroin users, and were often outside of the networks reached by traditional opioid safety/overdose prevention services. Consequently, they were unlikely to utilize harm reduction services, such as syringe exchange programs (SEPs), that address drug users' health and safety.

CONCLUSIONS

These findings suggest that many young adult nonmedical PO users are at high risk of both fatal and non-fatal overdose. There is a pressing need to develop innovative outreach strategies and overdose prevention programs to better reach and serve young PO users and their network contacts. Prevention efforts addressing risk for accidental overdose, including opioid safety/overdose reversal education and naloxone distribution, should be tailored for and targeted to this vulnerable group.

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  • Authors+Show Affiliations

    ,

    The Graduate Center, City University of New York, Dept. of Sociology, 365 Fifth Avenue, Room 6112.04, New York, NY 10016, United States; National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States. Electronic address: dfrank40@gmail.com.

    ,

    National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States.

    ,

    National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States.

    ,

    National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States.

    ,

    St. Ann's Corner of Harm Reduction, 886 Westchester Avenue, Bronx, NY 10459, United States.

    ,

    National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States.

    National Development and Research Institutes, Inc., 71 W. 23rd Street, 4th Floor, New York, NY 10010, United States. Electronic address: teper@ndri.org.

    Source

    MeSH

    Adolescent
    Adult
    Analgesics, Opioid
    Drug Overdose
    Female
    Grounded Theory
    Health Knowledge, Attitudes, Practice
    Humans
    Interviews as Topic
    Male
    Naloxone
    Narcotic Antagonists
    Needle-Exchange Programs
    New York City
    Opioid-Related Disorders
    Prescription Drug Misuse
    Risk
    Substance Abuse, Intravenous
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    25151334

    Citation

    TY - JOUR T1 - High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users. AU - Frank,David, AU - Mateu-Gelabert,Pedro, AU - Guarino,Honoria, AU - Bennett,Alex, AU - Wendel,Travis, AU - Jessell,Lauren, AU - Teper,Anastasia, Y1 - 2014/07/31/ PY - 2014/4/22/received PY - 2014/7/4/revised PY - 2014/7/22/accepted PY - 2014/7/31/aheadofprint PY - 2014/8/25/entrez PY - 2014/8/26/pubmed PY - 2015/9/4/medline KW - Harm reduction KW - Naloxone KW - Nonmedical prescription opioid use KW - Overdose KW - Transition to heroin SP - 84 EP - 91 JF - The International journal on drug policy JO - Int. J. Drug Policy VL - 26 IS - 1 N2 - BACKGROUND: Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Yet few studies have examined the overdose knowledge and experience of nonmedical PO users. METHODS: In depth, semi-structured, audio-recorded interviews were conducted with 46 New York City young adults (ages 18-32) who reported using POs nonmedically within the past 30 days. Verbatim interview transcripts were coded for key themes in an analytic process informed by grounded theory. RESULTS: Despite significant experience with overdose (including overdose deaths), either personally or within opioid-using networks, participants were relatively uninformed about overdose awareness, avoidance and response strategies, in particular the use of naloxone. Overdose experiences typically occurred when multiple pharmaceuticals were used (often in combination with alcohol) or after participants had transitioned to heroin injection. Participants tended to see themselves as distinct from traditional heroin users, and were often outside of the networks reached by traditional opioid safety/overdose prevention services. Consequently, they were unlikely to utilize harm reduction services, such as syringe exchange programs (SEPs), that address drug users' health and safety. CONCLUSIONS: These findings suggest that many young adult nonmedical PO users are at high risk of both fatal and non-fatal overdose. There is a pressing need to develop innovative outreach strategies and overdose prevention programs to better reach and serve young PO users and their network contacts. Prevention efforts addressing risk for accidental overdose, including opioid safety/overdose reversal education and naloxone distribution, should be tailored for and targeted to this vulnerable group. SN - 1873-4758 UR - https://www.unboundmedicine.com/medline/citation/25151334/High_risk_and_little_knowledge:_Overdose_experiences_and_knowledge_among_young_adult_nonmedical_prescription_opioid_users_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S0955-3959(14)00206-0 ER -