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Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder

Dahlman, Disa LU ; Ohlsson, Henrik LU ; Edwards, Alexis C. LU ; Sundquist, Jan LU ; Håkansson, Anders LU and Sundquist, Kristina LU (2021) In Substance Abuse: Treatment, Prevention, and Policy 16(1).
Abstract

Background: Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD. Methods: We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005–December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates. Results: Univariate analysis showed that several covariates were... (More)

Background: Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD. Methods: We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005–December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates. Results: Univariate analysis showed that several covariates were associated with incident and fatal opioid OD. In the multivariate analysis, incident opioid OD was associated with educational attainment (Hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94–0.97), having received social welfare (HR 1.31; 95% CI 1.22–1.39), and criminal conviction (HR 1.53; 95% CI 1.42–1.65). Fatal opioid OD was also associated with criminal conviction (HR 1.93; 95% CI 1.61–2.32). Conclusion: Individuals with low education and receipt of social welfare had higher risks of incident opioid OD and individuals with criminal conviction were identified as a risk group for both incident and fatal opioid OD. Our findings should raise attention among health prevention policy makers in general, and among decision-makers within the criminal justice system and social services in particular.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Drug abuse, Drug-related death, Opioids, Poisoning, Socioeconomic status, Sweden
in
Substance Abuse: Treatment, Prevention, and Policy
volume
16
issue
1
article number
73
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85115720276
  • pmid:34565405
ISSN
1747-597X
DOI
10.1186/s13011-021-00409-3
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021, The Author(s).
id
3a6b81b0-c94d-40ad-adc2-664550d955c6
date added to LUP
2021-11-19 11:03:21
date last changed
2024-06-16 23:20:53
@article{3a6b81b0-c94d-40ad-adc2-664550d955c6,
  abstract     = {{<p>Background: Opioid overdose (OD) and opioid OD death are major health threats to people with opioid use disorder (OUD). Socioeconomic factors are underexplored potential determinants of opioid OD. In this study, we assessed socioeconomic and other factors and their associations with incident and fatal opioid OD, in a cohort consisting of 22,079 individuals with OUD. Methods: We performed a retrospective, longitudinal study based on Swedish national register data for the period January 2005–December 2017. We used Cox proportional hazard models to investigate the risk of incident and fatal opioid OD as a function of several individual, parental and neighborhood covariates. Results: Univariate analysis showed that several covariates were associated with incident and fatal opioid OD. In the multivariate analysis, incident opioid OD was associated with educational attainment (Hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94–0.97), having received social welfare (HR 1.31; 95% CI 1.22–1.39), and criminal conviction (HR 1.53; 95% CI 1.42–1.65). Fatal opioid OD was also associated with criminal conviction (HR 1.93; 95% CI 1.61–2.32). Conclusion: Individuals with low education and receipt of social welfare had higher risks of incident opioid OD and individuals with criminal conviction were identified as a risk group for both incident and fatal opioid OD. Our findings should raise attention among health prevention policy makers in general, and among decision-makers within the criminal justice system and social services in particular.</p>}},
  author       = {{Dahlman, Disa and Ohlsson, Henrik and Edwards, Alexis C. and Sundquist, Jan and Håkansson, Anders and Sundquist, Kristina}},
  issn         = {{1747-597X}},
  keywords     = {{Drug abuse; Drug-related death; Opioids; Poisoning; Socioeconomic status; Sweden}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Substance Abuse: Treatment, Prevention, and Policy}},
  title        = {{Socioeconomic correlates of incident and fatal opioid overdose among Swedish people with opioid use disorder}},
  url          = {{http://dx.doi.org/10.1186/s13011-021-00409-3}},
  doi          = {{10.1186/s13011-021-00409-3}},
  volume       = {{16}},
  year         = {{2021}},
}