Characterizing patterns of opioid and stimulant use by route and associations with non-fatal overdose and xylazine use in people who have injected drugs from Baltimore, MD, 2023-2024.

ABSTRACT:

Background

The fourth wave of the overdose epidemic in the United States (US) is characterized by deaths involving fentanyl with stimulants. Understanding patterns of substance use as novel drugs continue to emerge is critical to inform overdose prevention. Among people with a history of injection drug use in Baltimore, MD, we examined opioid-stimulant use by route and the association of injection with non-fatal overdose and xylazine use.

Methods

We included 1132 participants in the AIDS Linked to the IntraVenous Experience cohort with a study visit in 2023-2024. We characterized participants by self-reported past-six-month use of any opioid and any stimulant by route using descriptive statistics. Adjusted associations were estimated using targeted minimum loss-based estimat

SUBMITTER: Rudolph JE 

PROVIDER: S-EPMC12757556 | biostudies-literature | 2026 Mar

REPOSITORIES: biostudies-literature