METHODS: This review was registered on Prospero (CRD42021242495). Systematic record searches were undertaken in databases of peer-reviewed literature (Medline, Embase, PsycINFO, and Cinahl) and grey literature sources (Google Scholar) for work published up to and including 14 February 2023. Reference lists of selected full-text papers were searched for additional records. Studies were eligible if they included people who use drugs with a focus on relationships between psychosocial factors and overdose subsequent to illicit drug use. Results were tabulated and narratively synthesised.
RESULTS: Twenty-six studies were included in the review, with 150,625 participants: of those 3,383-4072 (3%) experienced overdose. Twenty-one (81%) studies were conducted in North America and 23 (89%) reported polydrug use. Psychosocial factors associated with risk of overdose (n = 103) were identified and thematically organised into ten groups. These were: income; housing instability; incarceration; traumatic experiences; overdose risk perception and past experience; healthcare experiences; perception of own drug use and injecting skills; injecting setting; conditions with physical environment; and social network traits.
CONCLUSIONS: Global rates of overdose continue to increase, and many guidelines recommend psychosocial interventions for dependent drug use. The factors identified here provide useful targets for practitioners to focus on at the individual level, but many identified will require wider policy changes to affect positive change. Future research should seek to develop and trial interventions targeting factors identified, whilst advocacy for key policy reforms to reduce harm must continue.
方法:这篇综述在Prospero(CRD42021242495)上注册。在同行评审的文献数据库中进行了系统记录搜索(Medline,Embase,PsycINFO,和Cinahl)和灰色文献来源(GoogleScholar),用于直到2023年2月14日为止发表的作品。搜索了选定全文论文的参考列表,以获取其他记录。如果研究包括使用药物的人,并且关注社会心理因素与非法药物使用后的过量之间的关系,则这些研究符合资格。结果列表并叙述合成。
结果:本综述纳入了26项研究,150,625名参与者:其中3,383-4072(3%)经历了用药过量。在北美进行了21项(81%)研究,其中23项(89%)报告了多药物使用。确定了与用药过量风险相关的社会心理因素(n=103),并按主题分为十组。这些是:收入;住房不稳定;监禁;创伤经历;过量风险感知和过去的经验;医疗保健经验;对自己的药物使用和注射技能的感知;注射环境;物理环境条件;和社交网络特征。
结论:全球用药过量率继续上升,许多指南建议对依赖药物的使用进行心理社会干预。这里确定的因素为从业者提供了有用的目标,可以在个人层面关注,但是许多确定的将需要更广泛的政策变化来影响积极的变化。未来的研究应寻求开发和试验针对已确定的因素的干预措施,同时,必须继续倡导减少伤害的关键政策改革。