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Research Summary

Risk Factors for Nonfatal Drug Overdose

Fatal overdose is the leading cause of death among drug users, and nonfatal overdose causes medical complications. To identify risk factors for nonfatal overdose, researchers surveyed 772 street-recruited drug users in New York City who had been injecting drugs for at least 1 year and injected heroin in the last 2 months.

  • One of 6 subjects had a nonfatal overdose in the 6 months before study entry.
  • In analyses adjusted for potential confounders, the following were significantly associated with an increased risk of nonfatal overdose in the last 6 months:
    • an overdose more than 6 months before study entry (odds ratio [OR], 28.6)
    • younger age (e.g., OR, 7.2 for subjects 18–24 versus those 45 and older)
    • cocaine use in the last 6 months (OR, 2.1)
    • serious withdrawal symptoms in the last 2 months (OR, 2.7)
    • alcohol use in the last  6 months (OR, 1.9)


This cross-sectional study confirms findings from previous studies reporting that nonfatal overdoses often recur in drug users and are positively associated with alcohol use, cocaine use, and periods of abstinence. Clinicians should target both drug users with previous overdoses and polysubstance users for overdose prevention efforts.

Alexander Y. Walley, MD


Coffin PO, Tracy M, Bucciarelli A, et al. Identifying injection drug users at risk of nonfatal overdose. Acad Emerg Med. 2007;14(7):616–623.