Reported history and correlates of drug overdose among people who inject drugs in lebanon

Abstract

Background: Opioid overdose is an issue of increasing concern, and better epidemiologic data are needed to implement effective treatment programmes. Few published reports address the frequency of fatal or non-fatal opioid overdose in countries in the Middle East and North Africa region. Aims: We provide the first-ever study of the reported history and correlates of drug overdose among a broad sample of out-of-treatment people who inject drugs (PWID) in Lebanon. Methods: This was a respondent-driven sampling, cross-sectional, biobehavioural study carried out in Beirut, Lebanon, between October 2014 and February 2015. Data were collected on sociodemographics, risk profiles, drug use histories, drug and sexual risk behaviours, history of substance use treatment and incarceration, and pertinent infectious disease test results. Results: We recruited 382 eligible PWID. The majority were Lebanese (95.3%) men (95.5%), with an average age of 30.3 (standard deviation 9.9) years. A history of drug overdose was reported in 171 (44.8%) PWID. Around 86% reported heroin as the first drug they had ever injected. Approximately half (53.0%) reported a history of substance use treatment, and 80.1% reported a history of arrest for the injection or possession of drugs. Our analysis demonstrates that, after adjusting for relevant covariates, drug overdose is associated with a history of incarceration, drug treatment, and an increased number of arrests in one’s lifetime for drug injection or possession. Conclusions: The observed associations suggest overdose prevention programmes may be effective if targeted to recently incarcerated people and to those receiving drug treatment.