Factors related to witnessing opioid overdose among people who inject drugs (PWID): a cross-sectional study

Opioid overdose is a major cause of preventable deaths globally, with people who inject drugs (PWID) at heightened risk of witnessing and experiencing such events. The World Health Organization (WHO) advocates for targeted opioid-overdose prevention strategies among the PWID. This study explored the prevalence of “witnessing opioid overdose” among PWID and associated factors A cross-sectional study was conducted over 12 months (January–December 2023) involving Male PWID aged 18 or above, recruited from the HIV prevention services of the National AIDS Control Organization in Bhubaneswar, India. The associations and relationships between various socioeconomic and clinical variables with witnessing opioid overdose among PWID were analyzed using suitable statistical models. Among 207 PWID surveyed, over 80% had witnessed an overdose, and 50% had witnessed one in the past 3 months. Multivariate regression showed that heroin injections [exp(B): 0.220, 95% CI: 0.09, 0.52], mixing different drugs for injections [exp(B): 0.191, 95% CI: 0.06, 0.60], past abstinence [exp(B): 0.399, 95% CI: 0.18, 0.87], and prior overdose experiences [exp(B): 0.252, 95% CI: 0.11, 0.56] significantly predicted witnessing an overdose. The findings may help identify the high-risk PWID and their peers, informing targeted prevention strategies to mitigate opioid overdose-related mortality.