Presenting Author: Janna Ataiants, MPA, MA, DrPH(c), Drexel University Dornsife School of Public Health

ABSTRACT

Background: Research on gender-specific overdose risks is scarce, and limited evidence is available on the social context of women's overdose in urban settings. While women drug users experience overdose at rates compatible to men, they face the elevated levels of sexual violence and frequently become victims of severe physical violence perpetrated by their intimate partners.

Objectives: To examine associations between violence and women's overdose.

Methods: Venue-based sampling was used to recruit adult female participants (N=220) from a Philadelphia-based harm reduction program in 2016-2017. Multinomial logistic regression estimated associations between lifetime sexual or severe physical violence and a three-category overdose outcome: never, low (1-2), and high (> 2) number of lifetime overdoses.

Results: Participants were predominantly White (64%) and in their 30-40s (median age=38.3). The majority reported recent unstable housing (71%) and involvement in survival sex (58%); 35% were incarcerated during past 12 months. The lifetime prevalence of sexual and severe physical violence was 58% and 77% respectively. Overall, 69% experienced at least one lifetime overdose (median=2). Among 122 women who ever overdosed, 27% reported some violence in 24-48 hours prior to one of their overdoses. Victims of lifetime sexual violence had increased odds of having a high number of overdoses (OR=4.5, 95%CI=1.9, 10.7) compared to never having an overdose. Lifetime severe physical violence was not significantly associated with the number of overdoses.

Implications: Sexual trauma may increase women's risks of repeated personal overdose. Overdose prevention training should be integrated into existing violence support services for women who use drugs.

Authors: Janna Ataiants, MPA, MA, DrPH(c) and Stephen E. Lankenau, PhD.