Powered by OpenAIRE graph
Found an issue? Give us feedback
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Addictionarrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Addiction
Article . 2024 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
Addiction
Article . 2025
versions View all 2 versions
addClaim

Drug overdose deaths among homeless veterans in the United States Department of Veterans Affairs healthcare system

Authors: Jack Tsai; Dorota Szymkowiak; Hind A. Beydoun;

Drug overdose deaths among homeless veterans in the United States Department of Veterans Affairs healthcare system

Abstract

Abstract Background and Aims With an epidemic of drug overdoses, contemporary research is needed to examine drug overdose deaths among homeless populations. This study measured rates, types and correlates of drug overdose deaths occurring over a 5‐year study period among veterans experiencing homelessness (VEH) and non‐homeless veterans (NHV) in the US Department of Veterans Affairs (VA) healthcare system. Design Retrospective cohort study. Setting USA. Participants A total of 6 128 921 veterans. We followed 399 125 VEH and 5 729 796 NHV between 2017 and 2021 using linked administrative VA and National Death Index data. Measurements Multivariable Cox regression models were constructed to estimate hazard ratios (HRs) for homelessness as a predictor of time‐to‐occurrence of overdose deaths with 95% confidence interval (CIs), sequentially controlling for demographic, medical, substance use and mental health characteristics. Findings Among overdose deaths, 8653 [93.7%, 95% confidence interval (CI) = 93.2–94.2%] were unintentional and 5378 (57.8%, 95% CI = 56.8–58.8%) involved opioids. The overdose‐specific mortality rate (per 100 000 person‐years) was 227.3 among VEH and 23.2 among NHV (HR = 9.76, 95% CI = 9.36, 10.16), with rates 7–14 times higher among VEH than NHV, depending on the drug involved. In fully adjusted models, homelessness was associated with greater risk of drug overdose death (HR = 3.33, 95% CI = 3.18, 3.49), with the greatest risk involving psychostimulants (HR = 4.19), followed by antiepileptic/sedative/hypnotic drugs (HR = 3.69), synthetic opioids (HR = 3.50) and natural and semi‐synthetic opioids (HR = 2.79). Conclusions US veterans experiencing homelessness appear to have three times the risk for drug overdose deaths than non‐homeless veterans. There may be specific risks associated with psychostimulant, antiepileptic, sedative and hypnotic drugs in this population that deserve greater attention.

Keywords

Male, Adult, Middle Aged, United States, United States Department of Veterans Affairs, Young Adult, Ill-Housed Persons, Humans, Female, Drug Overdose, Veterans, Retrospective Studies, Proportional Hazards Models, Aged

  • BIP!
    Impact byBIP!
    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    2
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Upload OA version
Are you the author of this publication? Upload your Open Access version to Zenodo!
It’s fast and easy, just two clicks!