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The relationship between depressive symptoms and nonfatal overdose among a sample of drug users in Baltimore, Maryland

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Abstract

Nonfatal drug overdoses are common among heroin users. While several factors that increase risk of overdose have been identified, there is little research on the role of mental health status. The purpose of this study was to examine the association between depressive symptoms and history of overdose. A sample of 729 opiate and cocaine users completed a cross-sectional survey. Of the sample, 65% reported never having overdosed, 31% had overdosed longer than 12 months before the interview, and 4% had overdosed within the past 12 months. Results indicate that a high score on the Center for Epidemiological Studies Depression Scale (CES-D), a measure of depressive symptoms, was associated with having overdosed within the past 12 months (relative risk ratio [RRR]=3.06; 95% confidence interval [CI], 1.33 to 7.05) after adjusting for age, gender, injection frequency, and physical health impairment. These results suggest that drug users with depressive symptoms should be targeted for overdose prevention programs.

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References

  1. Sporer KA, Acute heroin overdose. Ann Intern Med. 1999;130:584–590.

    CAS  PubMed  Google Scholar 

  2. Darke S, Ross J, Hall W. Overdose among heroin users in Sydney, Australia: II. responses to overdose. Addiction. 1996;91:413–417.

    Article  CAS  PubMed  Google Scholar 

  3. White JM, Irvine RJ. Mechanisms of fatal opioid overdose. Addiction. 1999;94:961–972.

    Article  CAS  PubMed  Google Scholar 

  4. Warner-Smith M, Darke S, Day C. Morbidity associated with non-fatal heroin overdose. Addiction. 2002;97:963–967.

    Article  PubMed  Google Scholar 

  5. Olfson M, Shea S, Feder A, et al.. Prevalence of anxiety, depression, and substance use disorders in an urban general medicine practice. Arch Fam Med. 2000;9:876–883.

    Article  CAS  PubMed  Google Scholar 

  6. Borges G, Walters EE, Kessler RC. Associations of substance use, abuse, and dependence with subsequent suicidal behavior. Am J Epidemiol. 2000;151:781–789.

    CAS  PubMed  Google Scholar 

  7. Bronisch T, Wittchen HU, Suicidal ideation and suicide attempts: comorbidity with depression, anxiety disorders, and substance abuse disorder. Eur Arch Psychiatry Clin Neurosci. 1994;244:93–98.

    Article  CAS  PubMed  Google Scholar 

  8. Oppenheimer E, Tobutt C, Taylor C, Andrew T. Death and survival in a cohort of heroin addicts from London clinics: a 22-year follow-up study. Addiction. 1994;89: 1299–1308.

    Article  CAS  PubMed  Google Scholar 

  9. Hser YI, Hoffman V, Grella CE, Anglin MD. A 33-year follow-up of narcotics addicts. Arch Gen Psychiatry. 2001;58:503–508.

    Article  CAS  PubMed  Google Scholar 

  10. Darke S, Ross J. The relationship between suicide and heroin overdose among methadone maintenance patients in Sydney, Australia. Addiction. 2001;96:1443–1453.

    Article  CAS  PubMed  Google Scholar 

  11. Khantzian EJ. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatry 1985;142:1259–1264.

    CAS  PubMed  Google Scholar 

  12. Weiss, RD, Griffin ML, Mirin SM. Drug abuse as self-medication for depression: an empirical study. Am J Drug Alcohol Abuse. 1992;18:121–129.

    CAS  PubMed  Google Scholar 

  13. Zador D, Sunjic S, McLennan J. Circumstances and users’ perceptions of heroin overdose at the time of the event and at 1-week follow-up in Sydney, Australia: implications for prevention. Addict Res Theory. 2001:9:407–423.

    Google Scholar 

  14. Latkin CA, Forman VL. Patterns of needle acquisition and sociobehavioral correlates of needle exchange program attendance in Baltimore, Maryland, USA. J Acquir Immune Defic Syndr. 2001;27:398–404.

    CAS  PubMed  Google Scholar 

  15. Radloff L. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.

    Google Scholar 

  16. Radloff L, Locke B. The community mental health assessment survey and the CES-D Scale. In: Weissman M, Myers J, Roass C, eds. Community Surveys of Psychiatric Disorder. New Brunswick, NJ: Rutgers University Press; 1986;177–189.

    Google Scholar 

  17. Zimmerman M, Coryell W. The validity of a self-report questionnaire for diagnosing major depressive disorder. Arch Gen Psychiatry. 1988;45:738–740.

    CAS  PubMed  Google Scholar 

  18. Knowlton AR, Latkin CA, Schroeder JR, Hoover DR, Ensminger M, Celentano DD. Longitudinal predictors of depressive symptoms among low income injection drug users. AIDS Care. 2001;13:549–559.

    Article  CAS  PubMed  Google Scholar 

  19. Boyd JH, Weissman MM, Thompson, WD, Myers JK. Screening for depression in a community sample. Understanding the discrepancies between depression symptom and diagnostic sales. Arch Gen Psychiatry. 1982;39:1195–1200.

    CAS  PubMed  Google Scholar 

  20. Ware J. The status of health assessment. Annu Rev Public Health. 1995;16:327–354.

    Article  PubMed  Google Scholar 

  21. Akaike H. A new look at statistical model identification. IEEE Trans Automatic Control. 1974;19:716–722.

    Article  Google Scholar 

  22. Stata Corporation. Stata [computer software]. Version 6. College Station, TX: Stata;1999.

    Google Scholar 

  23. Darke S, Ross J, Hall W. Overdose among heroin users in Sydney, Australia: I. prevalence and correlates of non-fatal overdose. Addiction. 1996;91:405–411.

    Article  CAS  PubMed  Google Scholar 

  24. Darke S, Zador D. Fatal heroin “overdose”,: a review. Addiction. 1996;91:1765–1772.

    Article  CAS  PubMed  Google Scholar 

  25. Davoli M, Perucci CA, Forastiere F, et al.. Risk factors for overdose mortality: a casecontrol study within a cohort of intravenous drug users. Int J Epidemiol. 1993;22:273–277.

    CAS  PubMed  Google Scholar 

  26. Khantzian EJ. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatry. 1985;142:1259–1264.

    CAS  PubMed  Google Scholar 

  27. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry, 1994;51:8–19.

    CAS  PubMed  Google Scholar 

  28. Grant BF, Comorbidity between DSM-IV drug use disorders and major depression: results of a national survey of adults. J Subst Abuse. 1995;74:481–497.

    Article  Google Scholar 

  29. Kandel DB, Huang FY, Davies M. Comorbidity between patterns of substance use dependence and psychiatric syndromes. Drug Alcohol Depend, 2001;64:233–241.

    Article  CAS  PubMed  Google Scholar 

  30. Brooner RK, King VL, Kidorf M, Schmidt CW Jr, Bigelow GE. Psychiatric and substance use comorbidity among treatment-seeking opioid abusers. Arch Gen Psychiatry. 1997;54:71–80.

    CAS  PubMed  Google Scholar 

  31. Rounsaville BJ, Weissman MM, Crits-Christoph K, Wilber C, Kleber H. Diagnosis and symptoms of depression in opiate addicts. Course and relationship to treatment outcome. Arch Gen Psychiatry. 1982;39:151–156.

    CAS  PubMed  Google Scholar 

  32. Dinwiddie SH, Cottler L, Compton W, Abdallah AB. Psychopathology and HIV risk behaviors among injection drug users in and out of treatment. Drug Alcohol Depend. 1996;43:1–11.

    Article  CAS  PubMed  Google Scholar 

  33. Jones R, Gruer L, Gilchrist G, Seymour A, Black M, Oliver J. Recent contact with health and social services by drug misusers in Glasgow’who died of a fatal overdose in 1999. Addiction. 2002;97:1517–1522.

    Article  PubMed  Google Scholar 

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Correspondence to Karin E. Tobin.

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Tobin, K.E., Latkin, C.A. The relationship between depressive symptoms and nonfatal overdose among a sample of drug users in Baltimore, Maryland. J Urban Health 80, 220–229 (2003). https://doi.org/10.1093/jurban/jtg025

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