Exploring risk tolerance among individuals who use opioids

Area of Science:

• * Addiction research
• * Behavioral economics
• * Public health

Background:

• * Opioid and stimulant misuse are significant public health concerns.
• * Risk tolerance may influence engagement in behaviors that increase overdose risk.
• * Understanding factors influencing risk tolerance is crucial for targeted interventions.

Purpose of the Study:

• * To investigate overdose-related risk tolerance among individuals misusing opioids and/or stimulants.
• * To examine the association between opioid preference (street vs. prescription) and risk tolerance.
• * To assess the impact of stimulant use severity on overdose risk tolerance.

Main Methods:

• * A remote questionnaire was administered to 181 adults (18-75 years) with past-month opioid misuse.
• * Data collected included demographics, substance use patterns, preferred opioid, and an overdose probabilistic discounting task to measure risk tolerance.
• * Regression models were used to analyze the relationship between opioid preference, stimulant use, and risk tolerance.

Main Results:

• * Overdose risk tolerance was significantly higher in individuals preferring street opioids compared to prescription opioids (p < .001).
• * Fentanyl users exhibited higher risk tolerance than heroin, prescription opioid, or medication for opioid use disorder users (p < .05).
• * Street opioid preference (F = 35.09, p < .0001) and stimulant use severity (F = 4.51, p = .035) were significantly associated with increased risk tolerance.

Conclusions:

• * Individuals preferring fentanyl and those with high stimulant use severity demonstrate the highest overdose risk tolerance.
• * These findings highlight specific subgroups that should be prioritized for overdose risk reduction interventions.
• * Understanding risk tolerance is key to developing effective strategies for preventing opioid and stimulant-related overdoses.