{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:33:26Z","timestamp":1777883606647,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"NIDA","award":["Grant 5R01DA045690"],"award-info":[{"award-number":["Grant 5R01DA045690"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Fatal opioid overdoses in the United States have rapidly increased since 1999. While several risk factors for overdose are known, the association of overdose risk perception with subsequent overdose is not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We used data from a randomized trial of a counseling intervention to reduce opioid overdose among overdose survivors who use nonprescribed opioids. Participants were followed up for 16\u2009months with visits every 4\u2009months. At study visits participants were asked how likely they were to overdose in the next 4\u2009months (risk perception) and whether they had overdosed since their last visit. Responses of \u201cextremely likely\u201d or \u201clikely\u201d were considered \u201chigher risk perception,\u201d and those of \u201cneutral,\u201d \u201cunlikely,\u201d and \u201cextremely unlikely\u201d were considered \u201clower risk perception.\u201d We conducted an adjusted generalized estimating equation among participants in the control group to examine the association of higher versus lower risk perception and subsequent overdose. We adjusted for visit, recent overdose, and sociodemographic characteristics that were selected\n                      <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                      due to known associations with risk perception or opioid overdose.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 135 control participants, median age was 42\u2009years (interquartile range: 34-49) and over half were male (59%). Higher risk perception was associated with 2.65 times the adjusted odds of having a subsequent overdose compared with lower risk perception (95% confidence interval: 1.35-5.23,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009&lt;.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Incorporating an assessment of risk perception into opioid overdose prevention efforts may help prioritize prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342251355116","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T08:54:08Z","timestamp":1753260848000},"page":"153-158","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association of Perceived Risk for Opioid Overdose and Subsequent Overdose Among a Cohort of Opioid Overdose Survivors Who Use Nonprescribed Opioids"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3163-0343","authenticated-orcid":false,"given":"Yi-Shin Grace","family":"Chang","sequence":"first","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa M.","family":"McMahan","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Matheson","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xochitl","family":"Luna Marti","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mackenzie","family":"Robinson","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Rolles","sequence":"additional","affiliation":[{"name":"Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Kosakowski","sequence":"additional","affiliation":[{"name":"Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn-Milo","family":"Santos","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Y.","family":"Walley","sequence":"additional","affiliation":[{"name":"Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip O.","family":"Coffin","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, Center on Substance Use and Health, San Francisco, CA, USA"},{"name":"University of California, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"U.S. Department of Health & Human Services. 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