Density of Low-Barrier Opioid Agonist Clinics and Risk of Non-Fatal Overdose During a Community-wide Overdose Crisis: A Spatial Analysis

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Abstract

Objectives:

In recent years, North America has witnessed a spike in the number of overdoses (OD) and OD-related deaths. The aim of this study was to assess spatial correlates of OD risk in Vancouver, Canada.

Methods:

Data utilized for this study was from three open and ongoing prospective cohorts of people who use drugs (PWUDs) in Vancouver, Canada. Logistic regression analyses with generalized linear mixed-effects models (GLMM) was used to examine correlates of residing in areas characterized by high OD rates. Mapping was used to examine areas showing OD clusters.

Results:

We included 1,336 PWUDs who resided in the downtown area. In multivariable analysis, higher availability of methadone clinics within walking distance, daily cocaine injectors and daily crack users had independent decreased odds of living within an OD cluster.

Conclusion:

This study found that higher availability of methadone clinics was associated with decreased odds of living within OD clusters.

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Author and article information

Journal

Journal ID (nlm-journal-id): 101516571

Journal ID (pubmed-jr-id): 36766

Journal ID (nlm-ta): Spat Spatiotemporal Epidemiol

Journal ID (iso-abbrev): Spat Spatiotemporal Epidemiol

Title: Spatial and spatio-temporal epidemiology

ISSN (Print): 1877-5845

ISSN (Electronic): 1877-5853

Publication date Nihms-submitted: 13 February 2020

Publication date (Electronic): 04 July 2019

Publication date (Print): August 2019

Publication date PMC-release: 01 August 2020

Volume: 30

Page: 100288

Affiliations

[a ]British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada

[b ]School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC V6T 1Z3, Canada

[c ]Department of Medicine, BC Centre on Substance Use, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada

[d ]Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, United States

Author notes

Author Contribution

Study concept and design: OA, MES, MJM; acquisition of data: EN; Cohort study design: TK, KD, KH, MJM, EW; analysis and interpretation of data: EN, OA, MES, MJM. Data preparation: EN; drafting of the manuscript: OA, MES; critical revision of the manuscript for important intellectual content and for final approval: all authors; statistical analysis: EN. All authors have read and approved the final version.

[* ]Corresponding author Address: British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, Tel: +1(604)806-9142, Fax: +1(604)806-9044, bccsu-mjsm@ 123456bccsu.ubc.ca

Article

Accession ID: PMC7067060 Pmcid ID: PMC7067060 Pmc-uid ID: 7067060 Manuscript ID: nihpa1555274

DOI: 10.1016/j.sste.2019.100288

PMC ID: 7067060

PubMed ID: 31421798

SO-VID: 4a82574b-d1e0-4811-9951-8a6bcfcc1b73

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