Potential risk for fatal drug overdose perceived by people using opioid drugs



Introduction and Aims

Combinations of drugs can increase the risk of overdose. Our aim was to examine perceptions of people dependent on opioid drugs on the potential risk of overdose from taking a prescribed dose of methadone in combination with various other recreational substances.

Design and Methods

A peer-interviewer survey was conducted in three New Zealand regions. Recruitment was via snowballing initiated at needle exchange and opioid substitution treatment (OST) services.


Participants were 56% male, with a mean age of 37.5 years, 75% were New Zealand European, 24% Māori and 51% were receiving OST. Methadone and alcohol or benzodiazepine combinations were perceived as being of higher potential risk than methadone and stimulant or cannabis combinations. However, methadone taken in combination with alcohol or benzodiazepines was perceived as low risk by over half (55%) the participants. Factors associated with higher risk potential were area of residence, use of methadone in the previous month and a non-opioid drug injecting preference.

Discussion and Conclusions

People who use opioid drugs continue to perceive taking opioids in combination with alcohol and benzodiazepines as low risk. Prevention efforts could be informed by greater exploration of barriers to understanding potential overdose risk and changing high-risk behaviours, and accessible and relevant opioid-related fatality data. OST must be able to attract and retain people who are dependent on opioid drugs.


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