Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis

Article

Baliunas, Dolly O., Taylor, Benjamin J., Irving, Hyacinth, Roerecke, Michael, Patra, Jayadeep, Mohapatra, Satya and Rehm, Jürgen. 2009. "Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis." Diabetes Care. 32 (11), pp. 2123-2132. https://doi.org/10.2337/dc09-0227
Article Title

Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis

ERA Journal ID16018
Article CategoryArticle
AuthorsBaliunas, Dolly O., Taylor, Benjamin J., Irving, Hyacinth, Roerecke, Michael, Patra, Jayadeep, Mohapatra, Satya and Rehm, Jürgen
Journal TitleDiabetes Care
Journal Citation32 (11), pp. 2123-2132
Number of Pages10
Year2009
PublisherAmerican Diabetes Association
ISSN0149-5992
1935-5548
Digital Object Identifier (DOI)https://doi.org/10.2337/dc09-0227
Web Address (URL)https://diabetesjournals.org/care/article/32/11/2123/25991/Alcohol-as-a-Risk-Factor-for-Type-2-DiabetesA
Abstract

OBJECTIVE
To clarify the dose-response relationship between alcohol consumption and type 2 diabetes.

RESEARCH DESIGN AND METHODS
A systematic computer-assisted and hand search was conducted to identify relevant articles with longitudinal design and quantitative measurement of alcohol consumption. Adjustment was made for the sick-quitter effect. We used fractional polynomials in a meta-regression to determine the dose-response relationships by sex and end point using lifetime abstainers as the reference group.

RESULTS
The search revealed 20 cohort studies that met our inclusion criteria. A U-shaped relationship was found for both sexes. Compared with lifetime abstainers, the relative risk (RR) for type 2 diabetes among men was most protective when consuming 22 g/day alcohol (RR 0.87 [95% CI 0.76–1.00]) and became deleterious at just over 60 g/day alcohol (1.01 [0.71–1.44]). Among women, consumption of 24 g/day alcohol was most protective (0.60 [0.52–0.69]) and became deleterious at about 50 g/day alcohol (1.02 [0.83–1.26]).

CONCLUSIONS
Our analysis confirms previous research findings that moderate alcohol consumption is protective for type 2 diabetes in men and women.

KeywordsAlcohol ; Diabetes
ANZSRC Field of Research 2020420299. Epidemiology not elsewhere classified
Byline AffiliationsCentre for Addiction and Mental Health, Canada
University of Toronto, Canada
Dresden University of Technology, Germany
Permalink -

https://research.usq.edu.au/item/z14y0/alcohol-as-a-risk-factor-for-type-2-diabetes-a-systematic-review-and-meta-analysis

Log in to edit

Download files

Published Version
zdc01109002123.pdf
License: CC BY-NC-ND 3.0
File access level: Anyone

  • 88
    total views
  • 52
    total downloads
  • 0
    views this month
  • 3
    downloads this month

Export as

Related outputs

Green space, blue space and psychological distress in regional Australia: Cross-sectional and longitudinal analyses
Roba, Hirbo Shore, Biddle, Stuart J.H., Baliunas, Dolly and Kolbe-Alexander, Tracy. 2026. "Green space, blue space and psychological distress in regional Australia: Cross-sectional and longitudinal analyses." Environmental Research. 290. https://doi.org/10.1016/j.envres.2025.123391
Associations between green space, and blue space and mental health outcomes in regional Australia: Cross-sectional and longitudinal analyses
Roba, Hirbo Shore, Kolbe-Alexander, Tracy, Baliunas, Dolly and Biddle, Stuart J.H.. 2025. "Associations between green space, and blue space and mental health outcomes in regional Australia: Cross-sectional and longitudinal analyses." Journal of Affective Disorders. 389. https://doi.org/10.1016/j.jad.2025.119685
Healthcare Interventions to Reduce Stigma for People Who Use Drugs: A systematic review
Siggs, Rhonda and Baliunas, Dolly. 2024. "Healthcare Interventions to Reduce Stigma for People Who Use Drugs: A systematic review." Australasian Professional Society on Alcohol and other Drugs (APSAD) 2024 . Canberra, Australia 30 Oct - 02 Nov 2024
Primary healthcare provider experience of knowledge brokering interventions for mood management
Minian, Nadia, Saiva, Anika, Ahad, Sheleza, Zawertailo, Laurie, Veldhuizen, Scott, Ravindran, Arun, de Oliveira, Claire, Mulder, Carol, Baliunas, Dolly and Selby, Peter. 2023. "Primary healthcare provider experience of knowledge brokering interventions for mood management ." Health Psychology and Behavioral Medicine. 11 (1). https://doi.org/10.1080/21642850.2023.2265136
Publicly subsidised smoking cessation medicines in times of COVID-19 in Australia: An interrupted time series analysis
Baliunas, Dolly, Gartner, Coral, Hollingworth, Samantha A., Sullivan, Clair, Comans, Tracy and Pole, Jason D.. 2023. "Publicly subsidised smoking cessation medicines in times of COVID-19 in Australia: An interrupted time series analysis." Drug and Alcohol Review. 42 (1), pp. 225-232. https://doi.org/10.1111/dar.13557
Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data
Baliunas, Dolly, Selby, Peter, de Oliveira, Claire, Kurdyak, Paul, Rosella, Laura, Zawertailo, Laurie, Fu, Longdi and Sutradhar, Rinku. 2023. "Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data." Tobacco Control. 32 (1), pp. 72-79. https://doi.org/10.1136/tobaccocontrol-2021-056522
Association Between Smoking Cessation Treatment and Healthcare Costs in a Single-Payer Public Healthcare System
Baliunas, Dolly, Voci, Sabrina, de Oliveira, Claire, Selby, Peter, Kurdyak, Paul, Rosella, Laura, Zawertailo, Laurie, Fu, Longdi and Sutradhar, Rinku. 2023. "Association Between Smoking Cessation Treatment and Healthcare Costs in a Single-Payer Public Healthcare System." Nicotine and Tobacco Research. 25 (1), pp. 86-93. https://doi.org/10.1093/ntr/ntac166
Incidence of chronic disease following smoking cessation treatment: A matched cohort study using linked administrative healthcare data in Ontario, Canada
Baliunas, Dolly, Voci, Sabrina, Selby, Peter, de Oliveira, Claire, Kurdyak, Paul, Rosella, Laura, Zawertailo, Laurie, Fu, Longdi and Sutradhar, Rinku. 2023. "Incidence of chronic disease following smoking cessation treatment: A matched cohort study using linked administrative healthcare data in Ontario, Canada." PLoS One. 18 (7). https://doi.org/10.1371/journal.pone.0288759
Immediate and Ongoing Impact of COVID-19 on Chlamydia Treatment in Australia
Engstrom, Teyl, Baliunas, Dolly, Smith, Angela, Dean, Judith A. and Pole, Jason D.. 2023. "Immediate and Ongoing Impact of COVID-19 on Chlamydia Treatment in Australia." Sexually Transmitted Diseases. 50 (6), pp. 363-369. https://doi.org/10.1097/OLQ.0000000000001785
Toilet Paper, Minced Meat and Diabetes Medicines: Australian Panic Buying Induced by COVID-19
Engstrom, Teyl, Baliunas, Dolly O., Sly, Benjamin P., Russell, Anthony W., Donovan, Peter J., Krausse, Heike K., Sullivan, Clair M. and Pole, Jason D. Pole. 2021. "Toilet Paper, Minced Meat and Diabetes Medicines: Australian Panic Buying Induced by COVID-19." International Journal of Environmental Research and Public Health. 18 (13). https://doi.org/10.3390/ijerph18136954
Performance Change in Treating Tobacco Addiction: An Online, Interprofessional, Facilitated Continuing Education Course (TEACH) Evaluation at Moore's Level 5
Ivanova, Anna, Baliunas, Dolly, Ahad, Sheleza, Tanzini, Elise, Dragonetti, Rosa, Fahim, Myra and Selby, Peter. 2021. "Performance Change in Treating Tobacco Addiction: An Online, Interprofessional, Facilitated Continuing Education Course (TEACH) Evaluation at Moore's Level 5." Journal of Continuing Education in the Health Professions. 41 (1), pp. 31-38. https://doi.org/10.1097/CEH.0000000000000328
The effectiveness of generic emails versus a remote knowledge broker to integrate mood management into a smoking cessation programme in team-based primary care: a cluster randomised trial
Minian, Nadia, Ahad, Sheleza, Ivanova, Anna, Veldhuizen, Scott, Zawertailo, Laurie, Ravindran, Arun, de Oliveira, Claire, Baliunas, Dolly, Mulder, Carol, Bolbocean, Corneliu and Selby, Peter. 2021. "The effectiveness of generic emails versus a remote knowledge broker to integrate mood management into a smoking cessation programme in team-based primary care: a cluster randomised trial." Implementation Science. 16 (1). https://doi.org/10.1186/s13012-021-01091-6
Integrating a brief alcohol intervention with tobacco addiction treatment in primary care: qualitative study of health care practitioner perceptions
Minian, Nadia, Noormohamed, Aliya, Lingam, Mathangee, Zawertailo, Laurie, Le Foll, Bernard, Rehm, Jürgen, Giesbrecht, Norman, Samokhvalov, Andriy V., Baliunas, Dolly and Selby, Peter. 2021. "Integrating a brief alcohol intervention with tobacco addiction treatment in primary care: qualitative study of health care practitioner perceptions." Addiction Science and Clinical Practice. 16 (1). https://doi.org/10.1186/s13722-021-00225-x
Impact of comprehensive smoking cessation training of practitioners on patients' 6-month quit outcome
Baliunas, Dolly, Ivanova, Anna, Tanzini, Elise, Dragonetti, Rosa and Selby, Peter. 2020. "Impact of comprehensive smoking cessation training of practitioners on patients' 6-month quit outcome." Canadian Journal of Public Health. 111 (5), pp. 766-774. https://doi.org/10.17269/s41997-020-00318-1
Variability in patient sociodemographics, clinical characteristics, and healthcare service utilization among 107,302 treatment seeking smokers in Ontario: A cross-sectional comparison
Baliunas, Dolly, Zawertailo, Laurie, Voci, Sabrina, Gatov, Evgenia, Bondy, Susan J., Fu, Longdi and Selby, Peter. 2020. "Variability in patient sociodemographics, clinical characteristics, and healthcare service utilization among 107,302 treatment seeking smokers in Ontario: A cross-sectional comparison." PLoS One. 15 (7). https://doi.org/10.1371/journal.pone.0235709
Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial
Minian, Nadia, Ivanova, Anna, Voci, Sabrina, Veldhuizen, Scott, Zawertailo, Laurie, Baliunas, Dolly, Noormohamed, Aliya, Giesbrecht, Norman and Selby, Peter. 2020. "Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial." International Journal of Environmental Research and Public Health. 17 (3). https://doi.org/10.3390/ijerph17031024
Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis
Shah, Amika, Chaiton, Michael, Baliunas, Dolly and Schwartz, Robert. 2020. "Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis." Journal of Medical Internet Research. 22 (10). https://doi.org/10.2196/16255
Is cannabis use associated with tobacco cessation outcome? An observational cohort study in primary care
Voci, Sabrina, Zawertailo, Laurie, Baliunas, Dolly, Masood, Zara and Selby, Peter. 2020. "Is cannabis use associated with tobacco cessation outcome? An observational cohort study in primary care." Drug and Alcohol Dependence. 206. https://doi.org/10.1016/j.drugalcdep.2019.107756
Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol
Espinet, S., Corrin, T., Baliunas, D., Quilty, L., Zawertailo, L., Rizvi, S. J., deRuiter, W., Bonato, S., De Luca, V., Kennedy, S. and Selby, P.. 2019. "Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol." Systematic Reviews. 8 (1). https://doi.org/10.1186/s13643-019-1028-2
The effect of a clinical decision support system on prompting an intervention for risky alcohol use in a primary care smoking cessation program: a cluster randomized trial
Minian, Nadia, Baliunas, Dolly, Noormohamed, Aliya, Zawertailo, Laurie, Giesbrecht, Norman, Hendershot, Christian S., Le Foll, Bernard, Rehm, Jürgen, Samokhvalov, Andriy V. and Selby, Peter. 2019. "The effect of a clinical decision support system on prompting an intervention for risky alcohol use in a primary care smoking cessation program: a cluster randomized trial." Implementation Science. 14 (1). https://doi.org/10.1186/s13012-019-0935-x
Tailored Versus Generic Knowledge Brokering to Integrate Mood Management Into Smoking Cessation Interventions in Primary Care Settings: Protocol for a Cluster Randomized Controlled Trial
Minian, Nadia, Noormohamed, Aliya, Baliunas, Dolly, Zawertailo, Laurie, Mulder, Carol, Ravindran, Arun, de Oliveira, Claire and Selby, Peter. 2018. "Tailored Versus Generic Knowledge Brokering to Integrate Mood Management Into Smoking Cessation Interventions in Primary Care Settings: Protocol for a Cluster Randomized Controlled Trial." JMIR Res Protoc. 7 (4), p. e111. https://doi.org/10.2196/resprot.9715
A method for co-creation of an evidence-based patient workbook to address alcohol use when quitting smoking in primary care: a case study
Minian, Nadia, Noormohamed, Aliya, Zawertailo, Laurie, Baliunas, Dolly, Giesbrecht, Norman, Le Foll, Bernard, Rehm, Jürgen, Samokhvalov, Andriy and Selby, Peter. 2018. "A method for co-creation of an evidence-based patient workbook to address alcohol use when quitting smoking in primary care: a case study." Research Involvement and Engagement. 4. https://doi.org/10.1186/s40900-018-0086-2
Public health impact of a novel smoking cessation outreach program in Ontario, Canada
Selby, Peter, Voci, Sabrina, Zawertailo, Laurie, Baliunas, Dolly, Dragonetti, Rosa and Hussain, S.. 2018. "Public health impact of a novel smoking cessation outreach program in Ontario, Canada." BMC Public Health. 18 (1). https://doi.org/10.1186/s12889-018-6012-6
Combining alcohol interventions with tobacco addictions treatment in primary care-the COMBAT study: a pragmatic cluster randomized trial
Minian, Nadia, Baliunas, Dolly, Zawertailo, Laurie, Noormohamed, Aliya, Giesbrecht, Norman, Hendershot, Christian S., Le Foll, Bernard, Rehm, Jürgen, Samokhvalov, Andriy and Selby, Peter L.. 2017. "Combining alcohol interventions with tobacco addictions treatment in primary care-the COMBAT study: a pragmatic cluster randomized trial." Implementation Science. 12 (1). https://doi.org/10.1186/s13012-017-0595-7
Concurrent E-Cigarette Use During Tobacco Dependence Treatment in Primary Care Settings: Association With Smoking Cessation at Three and Six Months
Zawertailo, Laurie Z, Pavlov, Dmytro, Ivanova, Anna, Ng, Ginnie, Baliunas, Dolly and Selby, Peter. 2017. "Concurrent E-Cigarette Use During Tobacco Dependence Treatment in Primary Care Settings: Association With Smoking Cessation at Three and Six Months." Nicotine and Tobacco Research. 19 (2), pp. 183-189. https://doi.org/10.1093/ntr/ntw218
Target quit date timing as a predictor of smoking cessation outcomes
Zawertailo, Laurie, Ragusila, Andra, Voci, Sabrina, Ivanova, Anna, Baliunas, Dolly and Selby, Peter. 2017. "Target quit date timing as a predictor of smoking cessation outcomes." Psychology of Addictive Behaviors. 31 (6), pp. 655-663. https://doi.org/10.1037/adb0000301
Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months
Zawertailo, Laurie A., Baliunas, Dolly, Ivanova, Anna and Selby, Peter L.. 2015. "Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months." Nicotine and Tobacco Research. 17 (8), pp. 937-45. https://doi.org/10.1093/ntr/ntv013
Epidemiological analysis of health situation development in Europe and its causes until 1990
Zatonski, Witold A., Manczuk, Marta, Sulkowska, Urszula, Didkowska, Joanna, Wojciechowska, Urszula, Tarkowski, Wojciech, Przewozniak, Krzysztof, Gumkowski, Jakub, Koncewicz, Kinga, Boffetta, Paolo, Campos, Hannia, LaVecchia, Carlo, Powles, John, Rehm, Jurgen, Willet, Walter, Negri, Eva, Aaro, Leif, Boyle, Peter, Gilmore, Anna, ..., Taylor, Beniamin. 2011. "Epidemiological analysis of health situation development in Europe and its causes until 1990." Annals of Agricultural and Environmental Medicine. 18 (2), pp. 194-202.
Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis
Baliunas, Dolly, Rehm, Jürgen, Irving, Hyacinth and Shuper, Paul. 2010. "Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis." International Journal of Public Health. 55 (3), pp. 159-166. https://doi.org/10.1007/s00038-009-0095-x
Alcohol consumption and the risk of morbidity and mortality for different stroke types--a systematic review and meta-analysis
Patra, Jayadeep, Taylor, Benjamin, Irving, Hyacinth, Roerecke, Michael, Baliunas, Dolly, Mohapatra, Satya and Rehm, Jürgen. 2010. "Alcohol consumption and the risk of morbidity and mortality for different stroke types--a systematic review and meta-analysis." BMC Public Health. 10. https://doi.org/10.1186/1471-2458-10-258
The relation between different dimensions of alcohol consumption and burden of disease: an overview
Rehm, Jürgen, Baliunas, Dolly, Borges, Guilherme L. G., Graham, Kathryn, Irving, Hyacinth, Kehoe, Tara, Parry, Charles D., Patra, Jayadeep, Popova, Svetlana, Poznyak, Vladimir, Roerecke, Michael, Room, Robin, Samokhvalov, Andriy V. and Taylor, Benjamin. 2010. "The relation between different dimensions of alcohol consumption and burden of disease: an overview." Addiction. 105 (5), pp. 817-43. https://doi.org/10.1111/j.1360-0443.2010.02899.x
Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis
Rehm, Jürgen, Taylor, Benjamin, Mohapatra, Satya, Irving, Hyacinth, Baliunas, Dolly, Patra, Jayadeep and Roerecke, Michael. 2010. "Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis." Drug and Alcohol Review. 29 (4), pp. 437-45. https://doi.org/10.1111/j.1465-3362.2009.00153.x
Causal considerations on alcohol and HIV/AIDS--a systematic review
Shuper, Paul A. S, Neuman, Manuela, Kanteres, Fotis, Baliunas, Dolly, Joharchi, Narges and Rehm, Jürgen. 2010. "Causal considerations on alcohol and HIV/AIDS--a systematic review." Alcohol and Alcoholism. 45 (2), pp. 159-166. https://doi.org/10.1093/alcalc/agp091
Undergraduate drinking and academic performance: a prospective investigation with objective measures
Thombs, Dennis L., Olds, R. Scott, Bondy, Susan J., Winchell, Janice, Baliunas, Dolly and Rehm, Jürgen. 2009. "Undergraduate drinking and academic performance: a prospective investigation with objective measures." Journal of Studies on Alcohol and Drugs. 70 (5), pp. 776-785. https://doi.org/10.15288/jsad.2009.70.776
Smoking-attributable mortality and expected years of life lost in Canada 2002: conclusions for prevention and policy
Baliunas, Dolly, Patra, Jayadeep, Rehm, Jürgen, Popova, Svetlana, Kaiserman, Murray and Taylor, Benjamin. 2007. "Smoking-attributable mortality and expected years of life lost in Canada 2002: conclusions for prevention and policy." Chronic Diseases in Canada. 27 (4), pp. 154-162.
Smoking-attributable morbidity: acute care hospital diagnoses and days of treatment in Canada, 2002
Baliunas, Dolly, Patra, Jayadeep, Rehm, Jürgen, Popova, Svetlana and Taylor, Benjamin. 2007. "Smoking-attributable morbidity: acute care hospital diagnoses and days of treatment in Canada, 2002." BMC Public Health. 7. https://doi.org/10.1186/1471-2458-7-247
Substance-attributable Morbidity and Mortality Changes to Canada’s Epidemiological Profile: Measurable Differences Over a Ten-year Period
Patra, Jayadeep, Taylor, Benjamin, Rehm, Jürgen T., Baliunas, Dolly and Popova, Svetlana. 2007. "Substance-attributable Morbidity and Mortality Changes to Canada’s Epidemiological Profile: Measurable Differences Over a Ten-year Period ." Canadian Journal of Public Health. 98 (3), pp. 228-34.
Illegal drug-attributable morbidity in Canada 2002
Popova, Svetlana, Rehm, Jürgen, Patra, Jayadeep, Baliunas, Dolly and Taylor, Benjamin. 2007. "Illegal drug-attributable morbidity in Canada 2002." Drug and Alcohol Review. 26 (3), pp. 251-63. https://doi.org/10.1080/09595230701247673
The costs of alcohol, illegal drugs, and tobacco in Canada, 2002
Rehm, Jürgen, Gnam, William, Popova, Svetlana, Baliunas, Dolly, Brochu, Serge, Fischer, Benedikt, Patra, Jayadeep, Sarnocinska-Hart, Anna and Taylor, Benjamin. 2007. "The costs of alcohol, illegal drugs, and tobacco in Canada, 2002." Journal of Studies on Alcohol and Drugs. 68 (6), pp. 886-895. https://doi.org/10.15288/jsad.2007.68.886
Alcohol-attributable morbidity and resulting health care costs in Canada in 2002: recommendations for policy and prevention
Taylor, Benjamin, Rehm, Jürgen, Patra, Jayadeep, Popova, Popova and Baliunas, Dolly. 2007. "Alcohol-attributable morbidity and resulting health care costs in Canada in 2002: recommendations for policy and prevention." Journal of Studies on Alcohol and Drugs. 68 (1), pp. 36-47. https://doi.org/10.15288/jsad.2007.68.36
Illicit opioid use in Canada: comparing social, health, and drug use characteristics of untreated users in five cities (OPICAN study)
Fischer, Benedikt, Rehm, Jürgen, Brissette, Suzanne, Brochu, Serge, Bruneau, Julie, el-Gueb, Nady, Noel, Lina, Tyndall, Mark, Wild, Cameron, Mun, Phil and Baliunas, Dolly. 2005. "Illicit opioid use in Canada: comparing social, health, and drug use characteristics of untreated users in five cities (OPICAN study)." Journal of Urban Health: Bulletin of the New York Academy of Medicine. 82 (2), pp. 250-66. https://doi.org/10.1093/jurban/jti049
Willing to undergo hepatitis C treatment in a sample of injection drug users in Toronto, Canada
Fischer, B., Vasdev, S., Haydon, E., Baliunas, D. and Rehm, J.. 2005. "Willing to undergo hepatitis C treatment in a sample of injection drug users in Toronto, Canada." La Presse Medicale. 34 (17), pp. 1209-1212. https://doi.org/10.1016/s0755-4982(05)84158-2
Determinants of overdose incidents among illicit opioid users in 5 Canadian cities
Fischer, Benedikt, Brissette, Suzanne, Brochu, Serge, Bruneau, Julie, el-Gueb, Nady, Noel, Lina, Rehm, Jürgen, Tyndall, Mark, Wild, Cameron, Mun, Phil, Haydon, Emma and Baliunas, Dolly. 2004. "Determinants of overdose incidents among illicit opioid users in 5 Canadian cities." CMAJ. 171 (3), pp. 235-239. https://doi.org/10.1503/cmaj.1031416