Fentanyl Overdose Concerns Among People Who Inject Drugs: The Role of Sex, Racial Minority Status, and Overdose Prevention Efforts

Abenaa Acheampong Jones, Kristin E. Schneider, Christa T. Mahlobo, Jennifer L. Maggs, Lauren Dayton, Karin E. Tobin, Carl A. Latkin

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective: People who inject drugs (PWID) have an elevated risk of fentanyl-related overdoses. This study explores fentanyl overdose concerns among PWID and the role of sex, racial minority status, and overdose prevention efforts in these concerns. Method: Data were from 498 PWID from Baltimore City, MD, recruited using street-based outreach between 2016 and 2019. Multinomial logistic regressions assessed correlates of participants’ level of concern for themselves and their peers overdosing from fentanyl. Results: A third of participants were female, half were Black, over two-thirds perceived fentanyl to be in all/most of heroin, 40% expressed low fentanyl overdose concern, and a third overdosed in the past 6 months. After controlling for sociodemographic characteristics, female sex was associated with being very concerned about fentanyl overdoses for oneself (adjusted relative risk [aRR]: 2.13; 95% CI: 1.22, 3.72) and peers (aRR: 1.98; 95% CI: 1.14, 3.45). Compared to Black participants, White participants were less likely to be very concerned about fentanyl overdoses for themselves (aRR: 0.35; 95% CI: 0.19, 0.65). Participants who often/always carried naloxone (aRR: 2.91; 95%CI: 1.42, 5.95) perceived fentanyl in most heroin (aRR: 2.78; 95% CI: 1.29, 5.97) or were on medications for opioid use disorder (MOUD) (quite a bit concerned aRR: 2.18; 95% CI: 1.28, 3.69; very concerned: aRR: 1.96; 95% CI: 1.19, 3.22) were more likely than their counterparts to report being concerned for their peers, but not for themselves. Conclusion: Female sex and racial minority status were associated with greater concern regarding fentanyl overdoses for oneself. Increasing overdose deaths in these populations suggests disparate access to harm-reduction initiatives rather than interest or concern. Furthermore, findings on naloxone,MOUD, and concerns for peers support social network-based interventions among PWID.

Original languageEnglish (US)
Pages (from-to)191-198
Number of pages8
JournalPsychology of Addictive Behaviors
Volume37
Issue number2
DOIs
StatePublished - May 5 2022

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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