Submission Type

Original Research


Introduction: The overdose crisis continues to be a significant problem, particularly in rural states such as Maine. The objectives of this study were to: 1) describe demographic and health characteristics and 2) identify overdose risk factors among people in Maine hospitalized with injection drug use (IDU)-associated infections.

Methods: We performed descriptive analysis of demographics, health characteristics, and injection practices, stratified by lifetime history of overdose. We conducted an exploratory logistic regression analysis, controlling for gender, homelessness, having experienced an emergency department (ED) visit in the past 3-months, and endorsement of injecting alone in the past 30 days to examine predictors of lifetime overdose risk.

Results: Of the 101 participants in the study, 54 (53%) had a lifetime history of overdose. A significantly greater proportion of participants with a history of overdose reported experiencing homelessness (n=31 (57%) versus n=15 (32%), p = 0.010) and an ED visit in the past 3-months (n=32 (59%) versus n=15 (32%), p = 0.006) compared to participants without a history of overdose. In multivariable analysis, having an ED visit in the past 3 months was associated with an increased risk of overdose (aOR 3.55, 95% CI: 1.45-8.66).

Discussion: In this study, a greater proportion of participants with a history of overdose were experiencing homelessness as compared to those without a history of overdose. We found that a having visited an ED in the past 3-months was an important risk factor for drug overdose.

Conclusions: The ED may be an important setting to identify people, particularly unhoused individuals, at risk for overdose and to offer harm reduction and other supportive resources.



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