Examining Factors Associated with Non-Fatal Overdose among People Who Inject Drugs in Rural Appalachia

Janet K. Otachi, Nikita Vundi, Hilary L. Surratt

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Overdose (OD) deaths have continued to rise in the United States posing a critical public health challenge. Various factors have been associated with increased likelihood of OD, including history of injection drug use. Purpose: This study examined multi-level factors associated with non-fatal OD among current people who inject drugs (PWID) in Appalachian Kentucky. Methods: This cross-sectional study utilized data from 324 PWID recruited via Respondent-Driven Sampling techniques in three Appalachian counties. The analysis focused on correlates of overdose history among people who inject drugs (PWID). Findings: Approximately 36.7% of our sample reported having overdosed in their lifetime, with only 21.4% currently having access to a naloxone kit for OD reversal. Respondents who had injected fentanyl alone or in combination with another drug (OR = 4.26, 95% CI= 2.31,7.86) had 4 times higher odds of an OD than those who did not. Our study found those who injected buprenorphine as primary drug (OR = 0.29, 95% CI = 0.10,0.81) had lower odds of OD compared to those who injected heroin. Conclusions/Importance: Given an increase in OD prevalence among PWID in the U.S, and especially among people living in the Appalachian region of Kentucky, assessing factors associated with OD is critical in development of tailored public health interventions to address the disparate rates of non-fatal OD in this vulnerable population.

Original languageEnglish
Pages (from-to)1935-1942
Number of pages8
JournalSubstance Use and Misuse
Issue number12
StatePublished - Sep 1 2020

Bibliographical note

Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.


  • Drug overdose
  • PWID
  • naloxone
  • non-fatal overdose
  • unintentional overdose

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


Dive into the research topics of 'Examining Factors Associated with Non-Fatal Overdose among People Who Inject Drugs in Rural Appalachia'. Together they form a unique fingerprint.

Cite this