Non-fatal overdose (NFOD) is a major cause of morbidity among people who inject drugs (PWID)
and multiple NFOD is associated with increased risk of fatal overdose. Despite this, few studies have examined the
prevalence and correlates of drug-specific multiple NFOD. The current study aimed to determine the prevalence
and correlates of recent multiple non-fatal opioid overdose (NFOOD) among PWID who access needle syringe
programs (NSPs) in Australia.
The Australian Needle and Syringe Program Survey is conducted annually and was conducted at 46 sites
across Australia in 2019. Participation involves completion of a self-administered questionnaire and a capillary
dried blood spot for HIV and hepatitis C virus testing. In 2019, respondents who reported a minimum of one
NFOOD in the previous 12 months (recent NFOOD) were asked to complete supplementary questions regarding
their last NFOOD. Bivariate and multivariate logistic regression were used to determine factors independently
associated with multiple recent NFOOD.
A total of 222 respondents reported recent NFOOD. Respondents were predominantly male (59%), one
third (39%) were aged less than 39 years and 73% reported last injecting heroin at their last NFOOD. One in two
respondents (48%, n = 107) reported multiple opioid overdoses (median 3, interquartile range 2–5). The odds of
reporting multiple NFOOD were higher among respondents who reported injecting in a public location at their
last NFOOD (adjusted odds ratio [AOR] 2.10, 95% CI 1.14–3.90, p = 0.018) and benzodiazepine use in the 12 h
prior to NFOOD (AOR 2.74, 95% CI 1.50–4.99, p = 0.001).
Multiple NFOOD was prevalent among PWID who utilised NSPs who reported recent NFOOD. Public
injecting and benzodiazepine use were associated with increased risk of multiple NFOOD, and there is a need for
interventions specifically targeting PWID who report these high risk injecting practices.
Link to publisher’s web site