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. Author manuscript; available in PMC: 2023 Mar 1.
Published in final edited form as: Drug Alcohol Depend. 2022 Jan 10;232:109269. doi: 10.1016/j.drugalcdep.2022.109269

Table 2.

Hazards of repeat opioid overdose, stratified by drugs involved in index overdose.

Full Sample, no MOUD before Index Overdose (n = 4898) Index Overdose Involved Heroin and/or Synthetic Opioidsa (n = 3541) Index Overdose Involved Prescription Opioids Onlyb (n = 1357)
Covariate HR (95% CI) HR (95% CI) HR (95% CI)
MOUD After Overdose 0.35 (0.24, 0.51)* 0.30 (0.20, 0.46)* 0.71 (0.31, 1.62)
Index Overdose Characteristics
Involved Heroin/Synthetic Opioids 1.44 (1.22, 1.71)* – –
Involved Benzodiazepines 0.97 (0.70, 1.35) 1.06 (0.68, 1.64) 0.95 (0.57, 1.58)
Resulted in Inpatient Hospitalization 0.75 (0.63, 0.9)* 0.78 (0.64, 0.96)* 0.70 (0.49, 1.00)*
Age
12–24 1.26 (0.93, 1.71) 1.25 (0.89, 1.76) 1.08 (0.53, 2.19)
25–39 1.24 (0.97, 1.57) 1.12 (0.85, 1.47) 1.57 (0.95, 2.58)
40–55 1.02 (0.81, 1.27) 0.92 (0.70, 1.19) 1.36 (0.86, 2.12)
56–64 REF REF REF
Racial/Ethnic Group
White REF REF REF
Black 0.88 (0.74, 1.04) 0.81 (0.67, 0.99) 1.14 (0.80, 1.62)
Hispanic 0.87 (0.68, 1.10) 0.77 (0.58, 1.02) 1.22 (0.74, 1.99)
Other/Unknown 0.92 (0.72, 1.17) 0.99 (0.76, 1.28) 0.69 (0.37, 1.30)
Gender
Female REF REF REF
Male 1.25 (1.08, 1.43)* 1.25 (1.07, 1.47) 1.19 (0.87, 1.62)
Year of index overdose
2015 REF REF REF
2016 1.11 (0.9, 1.37) 1.06 (0.84, 1.34) 1.33 (0.83, 2.11)
2017 1.16 (0.95, 1.42) 1.09 (0.87, 1.36) 1.43 (0.91, 2.25)
2018 1.08 (0.88, 1.33) 1.04 (0.82, 1.31) 1.26 (0.77, 2.05)
SUD Comorbiditiesc
Alcohol Use Disorder 1.03 (0.88, 1.21) 0.99 (0.83, 1.19) 1.3 (0.90, 1.90)
Benzodiazepine Use Disorder 1.05 (0.82, 1.35) 1.12 (0.85, 1.46) 0.76 (0.41, 1.43)
Cannabis Use Disorder 0.96 (0.78, 1.18) 1.04 (0.83, 1.29) 0.6 (0.32, 1.12)
Opioid Use Disorder 1.53 (1.32, 1.77)* 1.46 (1.24, 1.73) 1.71 (1.22, 2.39)*
Psychiatric Comorbiditiesc
Bipolar Disorder 0.97 (0.8, 1.17) 0.95 (0.77, 1.17) 1.17 (0.76, 1.80)
Major Depressive Disorder 1.11 (0.94, 1.31) 1.08 (0.90, 1.31) 1.16 (0.81, 1.67)
Anxiety Disorder 1.00 (0.85, 1.19) 1.00 (0.83, 1.21) 1.05 (0.71, 1.54)
Personality Disorder 1.13 (0.84, 1.54) 1.32 (0.95, 1.82) 0.52 (0.20, 1.31)
Schizophrenia 1.04 (0.8, 1.36) 1.02 (0.76, 1.38) 1.09 (0.60, 1.98)
Medical Comorbiditiesc
Chronic Pain 1.09 (0.94, 1.27) 1.07 (0.91, 1.26) 1.26 (0.87, 1.83)
Heart Failure 0.83 (0.56, 1.23) 0.71 (0.42, 1.20) 1.01 (0.53, 1.96)
Hepatitis C 1.16 (0.97, 1.38) 1.09 (0.90, 1.32) 1.58 (1.06, 2.37)*
HIV 1.26 (0.90, 1.77) 1.19 (0.80, 1.77) 1.30 (0.66, 2.58)
Hypertension 1.14 (0.96, 1.34) 1.16 (0.96, 1.41) 1.00 (0.70, 1.44)
Pneumonia 1.22 (0.93, 1.59) 1.24 (0.91, 1.69) 1.16 (0.67, 2.03)
Prescriptions Before Overdose
Benzodiazepines (BZ)
BZ in 6-month baseline 0.96 (0.76, 1.22) 1.04 (0.80, 1.35) 0.73 (0.41, 1.31)
BZ at index overdose 1.10 (0.89, 1.36) 0.93 (0.72, 1.20) 1.57 (1.04, 2.36)*
Prescription Opioids
Opioids in 6-month baseline 0.88 (0.74, 1.04) 0.96 (0.79, 1.15) 0.57 (0.37, 0.89)*
Opioids at index overdose 0.68 (0.54, 0.86)* 0.70 (0.53, 0.93)* 0.59 (0.39, 0.90)*
Health Service Utilization
ED visit in 6-month baseline 1.31 (1.13, 1.52)* 1.33 (1.13, 1.57)* 1.20 (0.85, 1.68)
Any psychosocial service in 6-month baseline 0.84 (0.71, 0.99)* 0.87 (0.73, 1.05) 0.66 (0.45, 0.97)*

Note. CI = confidence interval; SUD = substance use disorder.

*

Statistically significant at p < 0.05.

a

Includes opioid poisonings with ICD-9 or ICD-10 codes for heroin or synthetic opioid poisoning, even if codes for methadone or other natural/semi-synthetic opioid poisoning were also present.

b

Includes opioid poisonings without ICD-9 or ICD-10 codes for heroin or synthetic opioid poisoning.

c

Reference for each comorbid condition is the absence of the condition.