Socioeconomic Inequalities in Fatal Opiate and Cocaine Related Overdoses: Transgenerational Baggage Versus Individual Attainments

Abstract

Background. To determine socioeconomic inequalities in opiates and cocaine related Fatal OverDose (FOD) cases and their implications in terms of prevention. Methods. Cross-examination of healthcare and forensic data in a nested case-control study design. FOD cases (272) were individually matched with 4 controls (1,056) according to sex, year of birth, drug administration route, duration of drug use and compared through conditional logistic regression. Findings. Employment [OR=0.662(95% CI 0.446–0.985)], salary as main income [OR=0.417(95% CI 0.258–0.674)] and educational attainment higher than primary school [OR=0.501(95% CI 0.344-0.729)] revealed to be protective, whereas parental professional status was not associated to FOD. Discussion. Among peers, drug users with lower socioeconomic profiles show increased odds of FOD. However, self-referred socioeconomic characteristics impacting on daily life quality such as education, employment and revenue, were more predictive of FOD than transgenerational factors (e.g. parental social status). Thus, motivational interventions fostering socio-professional integration should be given due attention in dedicated harm prevention policies.