Characterizing and responding to stimulant overdoses: Findings from a mixed methods study of people who use cocaine and other stimulants in New England

To explore people who use stimulants’ (PWUS) stimulant overdose experiences and identify factors associated with calling 911 for personal and witnessed stimulant overdoses. From 2022–2023, 222 people in Massachusetts and Rhode Island with past-30-day illicit stimulant use were surveyed. Adjusted multivariable logistic regression models examined the association between sociodemographics, substance use, and stimulant overdose history and whether 911 was called for participants’ last personally experienced and witnessed stimulant overdoses. Overall, 42.2 % of PWUS witnessed- and 34.5 % personally overdosed on stimulants. Nearly half (48.7 %) of participants who overdosed used crack cocaine prior, 35.5 % reported extremely severe symptoms (e.g., heart attack, stroke, seizure, loss of consciousness), and 34.2 % said 911 was called at their last overdose. Among those who last witnessed a stimulant overdose, 41.5 % reported crack cocaine involvement, and 47.9 % said 911 was called (20.0 % personally called). Higher educational attainment and experiencing extremely severe symptoms were positively associated with 911 being called at participants’ last stimulant overdose, whereas the number of overdoses witnessed and crack cocaine use by the person overdosing were negatively associated with 911 being called at participants’ last witnessed stimulant overdose (all p-values